Australia is in the grip of a silent epidemic— one that is affecting millions, but flying under the radar for far too many. Diabetes, particularly type 2, has become one of the nation’s fastest-growing chronic conditions.

Despite growing awareness and medical advances, the numbers continue to rise while the consequences of late diagnoses can be life threatening.

“In addition to the 1.5 million people already diagnosed with diabetes, there are approximately 500,000 (maybe more) who are living with the disease without knowing it – mostly type 2 diabetes,” Associate Professor Sof Andrikopoulos, a leading Australian diabetes researcher and clinician, currently serving as Chief Executive Officer of the Australian Diabetes Society, told Neos Kosmos.

These undetected cases are more than just a gap in the data — they are a ticking time bomb for both individual health and the healthcare system. When left untreated, type 2 diabetes can silently progress, leading to devastating and often irreversible complications such as heart attacks, strokes, kidney failure, and limb amputations.

“Type 2 diabetes is also prevalent in our Greek community,” Dr Andrikopoulos continues.

“As our parents get older the prevalence of type 2 diabetes is increasing. Furthermore, the incidence of type 2 diabetes in the younger Greek generation is also at an increase, linked to overweight/obesity and lack of physical activity. We are an obesogenic community. We love our food! And the consequence is an increased risk of type 2 diabetes.”

Early intervention is critical

Type 2 diabetes is a leading contributor to mortality in Australia, not just directly but through its many complications.

So why do so many Australians remain undiagnosed?

Dr Andrikopoulos points to the simple fact that “people ignore the symptoms -tiredness, loss of weight, going to the toilet more often than usual, feeling thirsty constantly. They don’t go to the doctor to get checked. In many people the symptoms are mild and hence they can be put down to a stressful and busy life. One solution to this, is a national screening program for people at high risk of developing diabetes.”

When detected early, the risks of serious complications can be significantly reduced—and in some cases, even prevented altogether.

“We are in such a fortunate and exciting time in the management of type 2 diabetes with so many effective therapies being available. We have SGLT2 inhibitors which have strong evidence for protection against kidney and heart failure and we have the GLP-1 receptor agonists which lead to weight loss and have been shown to reduce your risk of cardiovascular death, protect against kidney failure and improve liver function.”

The Associate Professor who also heads the Islet Biology and Metabolism Research Group at the University of Melbourne says that “there is no doubt that the GLP-1 receptor agonist-based therapies are a game-changer and are having a huge impact, in type 2 diabetes. I think this is the biggest recent advance in our field. An early diagnosis means that people can receive these therapies much earlier and change the course of the disease so that diabetes-related complications are delayed or even prevented.”

Recognising the early warning signs

Symptoms of type 2 diabetes can be subtle and easy to dismiss. They include tiredness, excessive thirst, frequent urination, blurred vision, and sometimes numbness.

Because these signs are often confused with the effects of stress, overwork, or ageing, many people do not seek medical advice. That’s why annual check-ups and routine blood tests are essential.

An early diagnosis can even put diabetes into remission. “This can be done by significant weight loss (at least 10-15 per cent) using a dietary intervention, particularly if this intervention is started early in the disease process. The issue with this approach is that it is not easy to sustain – usually people will put on weight over time and this results in diabetes coming back.

“The exciting part about the current state of type 2 diabetes management is that remission can now be achieved with pharmacotherapy,” says Dr Andrikopoulos. “The new GLP-1 receptor agonist drugs can lead to 20 per cent or more weight loss, and many people with diabetes are now seeing their blood glucose levels drop below the diagnostic threshold. That’s why I’m so optimistic about where we’re at.

“We don’t yet know the long-term effectiveness of these drugs, but we do see weight returning if treatment is stopped—unless someone is extremely disciplined with their diet. But the GLP-1 receptor agonists are incredibly effective in driving weight loss and managing type 2 diabetes. I would go as far as to call them disease-modifying.”

Prevention is possible

Key to prevention is healthy living—balanced eating, regular physical activity, and maintaining a healthy weight.

The Mediterranean diet, often referenced for its health benefits, offers protection against metabolic conditions, including type 2 diabetes. But as Dr Andrikopoulos points out, many Greek Australians have strayed from its original principles.

“We need to remember that the Mediterranean diet is predominantly plant-based. Boiled wild greens (horta), lentils, okra, green beans, dairy, cheese and eggs, sourdough bread, and excellent quality olive oil which has significant benefits, particularly when used in its raw, uncooked form.

“In Australia we have modified the Mediterranean diet and have loaded it with animal meats, simple carbohydrates and sweets as a regular occurrence, rather than occasional foods, which together with a sedentary lifestyle increase the propensity of weight gain and hence the risk of type 2 diabetes.”

On the subject of diet, he always tells people that the best diet is the one that they can stick to.

“The one that suits your situation—your finances, family situations, customs and religious beliefs. General principles would be to limit simple carbohydrates, sugars, sweets. And always remember to eat in moderation. Παν μέτρον άριστον.”

A national health priority

Over the past two decades, Australia has seen a dramatic and sustained surge in diabetes diagnoses. Since 2000, the total number of people living with all types of diabetes has increased by approximately 220 per cent. If this trend continue, projections estimate that this number could soar to 3.6 million by 2050. Particularly alarming is the sharp rise among younger adults, with a 44 per cent increase in diagnoses for those aged 21–39 in just the past ten years.

This growing epidemic places immense pressure on individuals, families, and the healthcare system. National Diabetes Week (13–19 July 2025) will focus on the urgent need for early detection, preventative strategies, and fair and equitable access to the latest therapies and technologies, “for a future where diabetes can do no harm”.

As CEO of the Australian Diabetes Society, Dr Sof Andrikopoulos is at the forefront of these efforts, working to improve diabetes care and shape national health policy.

“We are in constant discussions with the Federal Department of Health to make diabetes management therapies equitable and affordable for all people with diabetes. Specifically with type 2 diabetes we are advocating for reimbursement of more GLP-1 receptor agonist drugs (at the moment we only have Ozempic reimbursed) and authority to use combinations of different classes of drugs.

“With Continuous Glucose Monitors for people with type 2 diabetes, the clinical evidence is showing very strong benefit — particularly if the patient is taking insulin to manage their type 2 diabetes. We are continuing to lobby the government and it is good that we have a returning health minister who understands the importance of continuous glucose monitors so that we can continue our advocacy.”