Type 2 diabetes and cardiovascular disease prevention

Preventing chronic disease, including type 2 diabetes and cardiovascular disease, is a complex challenge that requires a comprehensive package of interventions and a sustained effort over the longer term.

A complex whole-of-systems approach is required for the effective prevention of lifestyle-related chronic disease.

As part of the range of initiatives offered across the state to strengthen Victoria’s prevention system, the Life! program is specifically aimed at Victorians at moderate to high risk of type 2 diabetes and cardiovascular disease.

Life! program

The Victorian Government established Life! Taking action on diabetes in 2007, a program that targeted people aged 50 years and above who were at high risk of developing type 2 diabetes. Its authors used the principles from three studies, including a randomised control trial. Large-scale clinical trials to date have demonstrated that lifestyle interventions focused on weight loss, physical activity and nutrition can prevent or delay the onset of diabetes.

In 2012 the program was expanded to include a focus on cardiovascular disease risk factors in addition to type 2 diabetes. The program was retitled Life! Helping you prevent diabetes, heart disease and stroke. It is funded by the Department of Health & Human Services and is delivered by Diabetes Victoria.

Life! is a lifestyle modification program designed to help people at moderate to high risk reduce their risk of type 2 diabetes and cardiovascular disease by providing them with support to adopt healthy behaviours and a more active lifestyle.

The program is run by health professionals and is delivered as a group course or a telephone health coaching service.

Participants receive information about:

• risk factors for type 2 diabetes, heart disease and stroke and their link to lifestyle behaviours
• the importance of healthy eating and regular physical activity
• goal setting and managing lapses
• stress management and improving sleep patterns.

Aboriginal communities

Life! includes a type 2 diabetes prevention program for Aboriginal people and their families. The program is called Road to Good Health and is facilitated by Aboriginal health workers.

Culturally and linguistically diverse communities

The Life! program is available to culturally and linguistically diverse (CALD) communities. Translators and bilingual facilitators deliver culturally relevant sessions to CALD communities on how to prevent type 2 diabetes and cardiovascular disease and improve health and wellbeing.

Who is eligible?

Type 2 diabetes

People aged 18 years and have scored 12 or higher on the Australian Diabetes Risk Assessment (AUSDRISK) tool and have a body mass index of > 25. AUSDRISK is a self-assessment tool available on the Life! website.

Cardiovascular disease

People aged 45 years or more, or 18 years or more and of Aboriginal and/or Torres Strait Islander descent, and have an Absolute Risk score of 10 per cent or more when referred by a GP clinic. A self-assessment check is also available on the website of the National Vascular Disease Prevention Alliance.

Other eligibility

A person is also eligible if they have a pre-existing condition known to place them at increased risk of cardiovascular disease or type 2 diabetes.

A person must be aged 18 years or more and have previously been diagnosed with one or more of the following:

• pre-existing cardiovascular disease
• gestational diabetes
• moderate or severe chronic kidney disease (CKD)
• familial hypercholesterolemia
• serum total cholesterol more than 7.5 mmol per litre
• systolic blood pressure of 180 mmHg or more, or diastolic blood pressure of 110 mmHg or more
• impaired glucose tolerance (by FPG, OGTT or HbA1c)
• polycystic ovary syndrome.

Individuals can be referred by their doctor or can sign up to the program by enquiring through the Life! website or calling the Life! infoline on 13 RISK (13 7475).

Facilitators and providers

Facilitators

Life! facilitators come from a variety of allied health backgrounds.

They need to demonstrate that they have the required:

• health professional qualifications and skills
• experience in facilitating groups.

There are two ways to become a facilitator:

• applying as an individual
• the health organisation you work for applies to become a Life! provider and then enrols you into facilitator training.

Training to become a Life! program facilitator includes both online modules and a one-day training session.

Providers

Health organisations across Victoria can apply to become Life! providers. They are to commit staff and resources to raising community awareness as well as delivering the Life! courses.

To be eligible to become a Life! provider, an organisation must:

• have public liability and indemnity insurance
• meet the required program standards.