Roadmap to tackle diabetes in Aotearoa

The diabetes network, working closely with community and healthcare partners, including the Eye Health National Clinical Network, has identified a range of priority initiatives to strengthen how care is delivered, including improving access to foot and retinal screening.

The roadmap proposes evaluating the role of AI in supporting retinal photoscreening and signalled that diabetes retinal screening in primary and community care settings will be supported by an expansion of the kaiāwhina (non-registered community support) workforce, a model of care successfully piloted prior to the roadmap release.

A ministerial oversight group, chaired by endocrinologist Sir Jim Mann, will be established to champion the roadmap and drive its implementation, Associate Professor Ryan Paul, co-lead of the Diabetes National Clinical Network, told NZ Optics. Members of the eye-health community will be meeting with the group and eye health will be a key priority, he stressed. “It is critical we prevent diabetes-related eye disease, given the substantial impact, inequities and costs it currently creates and that is largely avoidable. This requires a shift to integrated, whole-person diabetes care, rather than the often fragmented and siloed care at present.”

Dr Oliver Comyn, New Zealand Save Sight Society chair, agrees that a coordinated approach is a step forward. “Across the country, eye clinics are struggling to keep up with the demand and retinal specialists are unfortunately all too familiar with the late presentations of proliferative retinopathy that go on to require difficult and lengthy surgery, with uncertain outcomes for vision. We know that major risk factors for retinopathy include poor diabetic control, together with uncontrolled systemic conditions like blood pressure, high cholesterol and renal failure. So a coordinated approach that improves care for patients with diabetes will ultimately be beneficial for their eye conditions, too.”

Another key intervention is the update of the diagnostic threshold for type 2 diabetes, allowing more people to be identified earlier. By July, around 34,500 New Zealanders previously classified as having prediabetes will meet the criteria for diabetes, aligning Aotearoa with international standards and supporting earlier intervention to reduce complications and improve long‑term outcomes, Minister Brown said. “This is about system-level change. Diabetes cannot be managed by individual effort alone – it requires coordinated action across the health system and our communities.”

Next steps highlighted in the roadmap include the establishment of the oversight group and developing a Diabetes Roadmap Implementation Plan with priorities, actions and costings.