Type 2 diabetes mellitus (T2DM) is one of the most common long term conditions affecting NZ adults. The prevalence of both T2DM and prediabetes is rapidly increasing in NZ. Māori, Pacific and Indian people have particularly high rates of T2DM with rates up to three times higher than European New Zealanders. Diabetes is associated with multiple long-term complications, higher mortality and substantial healthcare costs.
We have completed multiple projects in the context of improving diabetes outcomes. We have used New Zealand’s Virtual Diabetes Register linked to other national health datasets to identify risk factors for poor outcomes among people with diabetes, including lower limb complications and amputation. We have evaluated interventions to reduce the burden of diabetes in our community, including a trial investigating the usefulness of a self-management intervention, which shifts the focus from clinical management in the surgery or clinic, to prevention and management in the hands of the people living with these conditions.
Key publications
McLeod M, Stanley J, Signal V, Stairmand J, Thompson D, Henderson K, et al. (2020). Impact of a comprehensive digital health programme on HbA1c and weight after 12 months for people with diabetes and prediabetes: a randomised controlled trial. Diabetologia; 63(12):2559-70.
Signal V, McLeod M, Stanley J, Stairmand J, Sukumaran N, Thompson DM, et al. (2020). A mobile- And web-based health intervention program for diabetes and prediabetes self-management (BetaMe/Melon): Process evaluation following a randomized controlled trial. Journal of Medical Internet Research; 22(12).
Gurney JK, Stanley J, York S, Sarfati D. (2019). Regional variation in the risk of lower-limb amputation among patients with diabetes in New Zealand. ANZ Journal of Surgery; 89(7-8):868-73.
Gurney, J., Stanley, J., York, S., Sarfati, D. (2018). Lower-limb amputation in New Zealand: temporal changes and the role of diabetes mellitus. New Zealand Medical Journal, 131 (1484).
Sarfati D, McLeod M, Stanley J, Signal V, Stairmand J, Krebs J, Dowell A, Leung W, Davies C, Grainger R. (2018). BetaMe: Impact of a comprehensive digital health programme on HbA1c and weight at 12 months for people with diabetes and pre-diabetes: study protocol for a randomised controlled trial. Trials, 19(1), p161.
Gurney J, Stanley J, Rumball-Smith J, York S, Sarfati D. Post-operative death following lower limb amputation in a national prevalent cohort of patients with diabetes. Diabetes Care 2018; 41:1204–1211| https://doi.org/10.2337/dc17-2557
Sarfati D, McLeod M, Stanley J, Signal V, Stairmand J, Krebs J, Dowell A, Leung W, Davies C, Grainger R. BetaMe: Impact of a comprehensive digital health programme on HbA1c and weight at 12 months for people with diabetes and pre-diabetes: study protocol for a randomised controlled trial. Trials 2018; 19: 161 https://doi.org/10.1186/s13063-018-2528-4
Gurney J, Stanley J, York S, Rosenbaum D, Sarfati D. Risk of lower limb amputation in a national prevalent cohort of patients with diabetes. Diabetologia 2017; https://doi.org/10.1007/s00125-017-4488-8
Gurney, JK, Kersting U, Rosenbuam D, Dissanayake A, York S, Grech R, Ng A, Milne B, Stanley J, Sarfati D. Pedobarography as a clinical tool in the management of diabetic feet in New Zealand: a feasibility study. Journal of Foot and Ankle Research 2017; 10(11):24.
Gurney, J.K., Marshall, P.W.M., Rosenbaum, D., Kersting, U.G. (2013). Test-retest reliability of dynamic plantar loading and foot geometry measures in diabetics with peripheral neuropathy. Gait and Posture, 37 (1), p135-137.
Gurney, J.K., Kuch, C., Rosenbaum, D., Kersting, U.G. (2012). The Māori foot exhibits differences in plantar loading and midfoot morphology to the Caucasian foot. Gait and Posture, 36, p157-159.