Diabetes can’t have anything on its own it seems. It is often included under broad umbrellas such as non-communicable diseases (NCDs) or, (horribly), lifestyle diseases. Diabetes and obesity are linked as though the second is an inevitable consequence of the first. And, of course, within the overarching category of diabetes, there are many sub-types, each deserving of its own attention.

Often, discussions framed writhing diabetes contexts actually pivot away from diabetes, instead focusing on creating healthier environments – something for which we should all strive. But that isn’t just a diabetes issue. It’s an everyone issue.

And so, discussions about people living with diabetes right now, are watered down and lost in general population health conversations. Efforts to improve our diabetes-related outcomes, or make our lives with diabetes get swallowed by ‘big picture’ thinking that isn’t necessarily be all that relevant to diabetes specifically. Or, it is relevant to people with diabetes, but also to everyone else. Either way, diabetes gets lost.

Regardless of diabetes status, healthier environments are good for everyone. So why do these topics become the focus of so many sessions at a diabetes conference?

At last month’s IDF WPR Congress I attended a panel discussion organised by the Parliamentarians for Diabetes Global Network (PDGN). On stage were HCPs, parliamentarians and health professionals.

The first item on the agenda was sugar taxes. Do we need them? Super important topic to debate. Relevant exclusively to diabetes? Absolutely not.

From there, we detoured to urban planning with a comment about how houses on new estates are being built with barely any space to plant trees between boundaries. Sure, trees are critical for reducing urban air temperatures and improving air quality. Specifically, a diabetes-related topic? Nope.

I don’t disagree with any of these points. I definitely think we need more trees, and I think that urban planning and creating green spaces need better consideration. I’m also 100% pro-sugar tax, provided that it comes with policy that bans ‘junk food’ advertising, funds education programs and offers subsidies for healthier foods. I absolutely believe that we should do all we can to make healthier options easier.

But none of this relates exclusively to diabetes. These are public health and community issues.

And it’s not just conferences. We see this same conflation of diabetes with broader public health and wellbeing agendas in government policy too.

Australia missed an opportunity with the National Diabetes Inquiry a few years ago. The fact that it combined diabetes and obesity was the first miss. Two issues requiring attention and distinct strategies, and instead, they were folded into the same inquiry.

There were twenty-three recommendations in the inquiry report, and a number of those recommendations had little to do with diabetes at all, or were not specifically relevant to people with diabetes. What we miss when we conflate health and wellbeing initiatives with diabetes programs and policies is that we lose the ‘diabetesness’ in the discussion.

For example, recommendation 5 was about regulating the marketing of unhealthy food to children. Go ahead! Do it! Kids should not be bombarded with a barrage of advertising from unhealthy food companies every time they look at a screen. Their weekend sports shouldn’t be sponsored by burger companies, and those burger purchases should not come with a free toy. But tell me how that is a diabetes specific recommendation?

To be clear, I would like to see all 23 recommendations implemented. But because they’re so varied, any real focus on the diabetes-specific ones has been lost. To date none of the recommendations have been adopted, which is understandable when we consider the scale and cost recommendations spanning such huge, disparate populations. I can’t help but think that had the inquiry focused on diabetes alone (or even been broken down to specific types of diabetes), the recommendations would have been more manageable and easier to implement. For example, recommendation 16 (Explore expanded subsidised access to insulin pumps for all Australians with T1D) already had broad community-wide consensus. That’s the kind of focused, deliverable recommendation we lose when diabetes is diluted across a sprawling, catch-all inquiry.

A diabetes conference or inquiry should centre diabetes. Not anything on the periphery that may may only tangentially relate to it.

Can you imagine a policy forum about breast cancer being hijacked by discussions of planting more trees? Or a sugar tax?

Living with diabetes is a hard gig. The people doing that work every day deserve conversations, policies and conferences that are actually about us. Not a line item in a broader public health agenda. There’s nothing wrong with planting a tree. Just don’t plant it and think it’s addressing diabetes.

Planted last year, this blood plum tree in our garden is looking very springlike!