Most diabetes management takes place in primary care settings, such as GP clinics. This can be more of a challenge in rural areas, but a new service is helping connect GPs and their patients with specialist care, writes ZOE DELEUIL
GPs and nurse practitioners working in rural and remote areas often deal with complex medical cases and have called for streamlined support to enable them to treat locally where possible and refer on when necessary.
As the sole GP practice in the Wheatbelt town of Quairading, GP Sing Jack Yap and nurse practitioner Dr Min Ding are vital to the town and its residents. Quairading has a significant older population with many people living with diabetes and heart disease, so there is an ongoing demand for high-quality care.
Diabetes Connect, a new Diabetes WA service that allows rural GPs and nurse practitioners to book a call or virtual case conference with an endocrinologist, gives Dr Ding and Dr Yap the opportunity to access specialist input without their patients needing to travel to Perth. This service operates in addition to Diabetes WA Telehealth, which is the first line of support for rural and remote people.
“As a nurse practitioner it’s helpful that I can also access the service, for example in a recent multi-disciplinary case conference (MDCC) with endo Dr Gan and diabetes educator Nyaree Lawler.”
“We may need advice on patients with type 2 diabetes, who sometimes have other issues including hypertension or kidney deterioration,” Dr Ding says.
“If they have been stable for a while the hospital may have stopped following up, but then their HbA1c rise higher than target range and sometimes transport is an issue, particularly if they live alone.” (HbA1c is a measurement that shows overall blood glucose levels over the last three months).
Diabetes Connect gives her and Dr Yap the opportunity to access specialist input about medication and dosage while also considering other challenges and barriers a patient may be facing.
Nyaree, who lives in the Wheatbelt and has a long connection to the region, says that in these small towns Diabetes Connect can make a real difference.
The Wheatbelt is huge and doesn’t have big centres like you see in Perth or even in the Southwest and the Pilbara and Kimberley,” she says.
“It’s made up of lots of very small towns, often with many elderly people. Logistically, this makes it harder to give people the health care they need.”
She adds that a local GP practice is not just essential for patients but provides a boost for the town’s economy, too.
“If you have a GP practice within a town, that means that when people head to the doctor for an appointment, they are also likely to visit the shops, the pharmacist, get a coffee. Losing a GP practice means all that economic activity is lost, so it’s really important that these smaller towns hold onto their own GP practice, and it’s great that Diabetes Connect is there to support them.”
Dr Ding learned of Diabetes Connect when Nyaree visited the practice soon after the launch of the service in late 2024.
“Nyaree had a chat with us and distributed some handouts. With an older population and many patients with diabetes and heart disease, we knew it would help us to have access to high-quality specialised care. We like that we can also phone the diabetes educators, and some of our patients regularly use the Diabetes WA Telehealth service, which we encourage,” says Dr Ding.
Another area where Diabetes Connect can assist is with ongoing professional development, with one rural GP calling it a ‘masterclass on the phone.’
“Local medics have less flexibility to travel because they are often the only GP in town,” says Nyaree. “But by having a discussion with an endo about one patient, they gain the skills and confidence to apply similar care to other people living with diabetes.”
The service can also reduce the amount of traveling patients need to do, because GPs and nurse practitioners can prepare ahead for their patients’ hospital appointments.
“If a GP or nurse practitioner has already spoken to Diabetes Connect, they can get the relevant tests done and information gathered ahead of a patient travelling to an endocrinologist appointment. This makes for a more efficient consultation and ideally reduces the need for the patient to travel again,” says Nyaree.
Dr Ding says that the service allows for a more consistent approach to patient management, rather than relying on occasional visits from metro-based specialists.
“We did have a dietitian and diabetes educator visiting the town but that’s not really enough for us, and they haven’t been for around a year, so the launch of Diabetes Connect has been great timing. I only wish it was available for all specialities.”
Diabetes Connect for Country WA
Supporting GPs and nurse practitioners in regional WA with diabetes management.
GPs and nurse practitioners: visit our professional hub to book a call, multi-disciplinary case conference or education event targeted to your needs with one of our endocrinologists.
Telehealth for country WA
Diabetes WA Telehealth for country WA service is a free education and clinical support service, available to people living with diabetes in rural and remote areas of Western Australia. Virtual appointments are provided by credentialled diabetes educators who can assist you to self-manage your diabetes.
