Diabetes

As of 2022, around 1.3 million Australians—or 5.3% of the population—are living with some form of diabetes (ABS, 2022). The majority (85–90%) have type 2 diabetes, which is largely preventable (AIHW, 2023).  

In Queensland, the prevalence has surged from 3.2% in 2001 to 5.1% in 2022, reflecting national trends. Men are particularly at risk, with 6.4% affected compared to 4.1% of women (ABS, 2022). This steady rise signals a growing public health challenge. 

Diabetes isn’t just a clinical issue; it’s an economic one. In 2020–21, Australia spent $3.4 billion on diabetes care, accounting for 2.3% of all disease-related health expenditure (AIHW, 2022). Beyond direct healthcare costs, missed check-ups, delayed interventions, and preventable complications related to type 2 diabetes are estimated to cost an additional $2.3 billion annually (Diabetes Australia, 2022).  

The human toll is even more profound. Further complications from diabetes include heart disease, kidney failure, blindness, and amputations are common, significantly reducing quality of life. 

An incentivised approach

Practices that complete at least 2 CQI activities and submit the paperwork to Brisbane North PHN will be provided free access to the CDM Plus portal from 1 June 2025 – 30 June 2026. 

The CDM Plus portal also allows practices to access 25% discount on selected training services and products such as workshops, training sessions, and health promotion products as well as access to a range of online resources including templates, Webinars and information Sessions.   

CDM Plus resources are continually updated to reflect MBS, MyMedicare and Clinical Software changes and cover a range of topics including: 

• Asthma 
• CVD 
• Diabetes
• Kidney Disease
• Cervical cancer 
• COPD 
• Health Assessments
• Mental Health 
• Osteoporosis 
• Skin Cancer 
• COVID/ Immunization 

Practices can submit an EOI to participate in incentivised diabetes CQI activities until the 30th May 2025.

Step 1: Choose an activity

Given the rising prevalence of diabetes, its significant health and economic impacts, and the proven benefits of early intervention, our project has three focus areas:  

• Improve Identification and Prevention of Diabetes  
  By proactively identifying at-risk individuals and implementing early interventions, we can reduce the impact of diabetes and its complications. 
• Enhance Data Quality  
  Accurate, comprehensive data is the foundation of effective diabetes management. High-quality data helps us monitor trends, identify gaps, and tailor care to improve patient outcomes. 
• Improve Diabetes Care and Health Outcomes  
  Optimising clinical management, including regular HbA1c monitoring, complication screening, and coordinated care, will improve health outcomes and reduce preventable hospitalisations.  

Practices can choose between two and four Continuous Quality Improvement (CQI) activities from the practice payment guide. You can also develop practice-specific activities you think will improve the Diabetes Prevention and Care for your patient cohort. The Practice Development Matrix can help you to develop these activities. 

Step 2: Submit an expression of interest before the 30th of May

To participate, complete Part 1 of the Diabetes Continuous Quality Improvement Plan and submit it to practicesupport@brisbanenorthphn.org.au by 30 May 2025.  This document will outline the:  

• Diabetes care goals you want to achieve
• Activities you will implement to achieve these goals
• Timelines you are working to
• How you are going to measure your progress

Step 3. Written agreement between Brisbane North PHN and the practice

Brisbane North PHN will get back to let you know if you have been approved to participate in this CQI Activity. 

Step 4. Complete the agreed activities

Work on your proposed activities with the support of your QI&D Engagement Officer between April and August 2025. When you have completed your activities, complete Part 2 of the Diabetes Continuous Quality Improvement Plan and submit it to practicesupport@brisbanenorthphn.org.au by 30 August 2025.

Upon completion of the activities, we will send you your login details for the CDM Plus portal. 

Get Support

For support and guidance on implementing health assessments in your practice, contact our quality improvement and development engagement officers via the Practice Support email and phone line.