Wenbo Peng

Rural and remote health systems continue to face persistent workforce challenges that affect the delivery of chronic disease care, including diabetes management. Mentorship is widely recognised as a valuable strategy for supporting health professionals, with demonstrated benefits for practice development and workforce sustainability. However, many mentorship approaches are developed in well-resourced settings and assume stable infrastructure, protected time, and workforce capacity. These assumptions may not align with the realities of rural and remote practice, where service pressures and resource constraints shape everyday care. This commentary examines how mentorship can be designed for constrained health systems. It proposes a systems-oriented perspective that positions mentorship as part of routine practice rather than as a separate professional development activity. Emphasis is placed on flexibility, co-design, and cultural safety, with attention to how mentorship can be integrated within workforce development pathways. This reframing has implications for strengthening rural health services by supporting continuous, context-responsive learning within routine practice. More broadly, this approach offers a scalable pathway to workforce strengthening in geographically dispersed and resource-variable health systems.

Background: Diabetes has a greater impact on people living in rural and remote Australia because of limited access to specialist diabetes services and ongoing workforce shortages. Primary healthcare professionals in these regions play a central role in diabetes care, but they often lack targeted training and professional support. Innovation: This project introduced a co-designed, face-to-face workshop model to build clinical skills, strengthen confidence in culturally responsive communication and foster professional networks among rural healthcare workers. Developed through an academic–clinical partnership with health organisations for Aboriginal and Torres Strait Islander peoples, the workshops used evidence-based teaching methods to improve professional development tailored to the realities of rural primary healthcare needs. Methods: Two full-day workshops took place in Queensland and New South Wales in 2024. A pretest–posttest survey design was used to evaluate the workshops, assessing changes in clinical confidence and professional engagement. Of 120 participants, 73 completed post-workshop surveys, and 48 provided matched pre- and post-workshop data. Impact: Participants reported substantial increases in clinical confidence, particularly in using diabetes technologies (+72.4%) and understanding recent advances (+66.5%). Notably, 96.3% reported enhanced professional connections, with 87.0% intending to maintain them post-workshop. High levels of participants’ satisfaction and partner support highlight the model’s potential for broader implementation. Conclusion: This innovative workshop model addresses critical gaps in diabetes care training for rural health professionals by integrating clinical education, culturally responsive communication skills and opportunities for peer support. It offers a sustainable approach to rural health workforce development that aligns with national rural health priorities, and supports quality improvement in primary health care.

Background/Objectives: Achieving a balanced wholefood diet while stabilising glycaemic management is challenging for many people with type 2 diabetes (T2D) due to barriers such as food preparation skills, time, and medication effects. Diabetes-specific nutritional formulas (DSNFs) are nutritionally complete products designed to support glycaemic management and overall nutritional adequacy and may complement wholefood dietary approaches when these are not feasible or are insufficient. Despite growing clinical evidence of efficacy, practical guidance for routine use is limited. Methods: A multidisciplinary expert working group developed a Clinical Practice Guide (CPG) for integrating DSNFs into diabetes care. Development was informed by a literature review and iterative consensus among experts, including representatives of the Australian Diabetes Society, Australian Diabetes Educators Association, and the Royal Australian College of General Practitioners. Results: The CPG outlines a three-step pathway: (1) assess suitability (clinical indications, contraindications, preferences, cultural context); (2) tailor the approach (individual goals, dose/timing relative to weight and body composition goals and observed glycaemic patterns, integration with lifestyle care); and (3) monitor progress (baseline, 2–4 weeks to assess initial response, then 3, 6, and 12 months for glycaemic indices, weight/body composition where available, and medication review). Conclusions: This CPG provides practical, multidisciplinary guidance for the person-centred use of DSNFs as an adjunct to standard care, supporting translation of current evidence into clinical practice and promoting consistent, multidisciplinary implementation.

Background/Objectives: Achieving a balanced wholefood diet while stabilising glycae-mic management is challenging for many people with type 2 diabetes (T2D) due to barri-ers such as food preparation skills, time, and medication effects. Diabetes-specific nutri-tional formulas (DSNF) are nutritionally complete products designed to support glycae-mic management and overall nutritional adequacy and may complement wholefood die-tary approaches when these are not feasible or are insufficient. Despite growing clinical evidence of efficacy, practical guidance for routine use is limited. Methods: A multidisci-plinary expert working group developed a Clinical Practice Guide (CPG) for integrating DSNF into diabetes care. Development was informed by a literature review and iterative consensus among experts, including representatives of the Australian Diabetes Society, Australian Diabetes Educators Association, and the Royal Australian College of General Practitioners. Results: The CPG outlines a three-step pathway: (1) Assess suitability (clinical indications, contraindications, preferences, cultural context); (2) Tailor the approach (indi-vidual goals, dose/timing relative to weight and body composition goals and observed glycaemic patterns, integration with lifestyle care); and (3) Monitor progress (baseline, 2–4 weeks to assess initial response, then 3, 6, and 12 months for glycaemic indices, weight/body composition where available, and medication review). Conclusions: This CPG provides practical, multidisciplinary guidance for the person-centred use of DSNF as an adjunct to standard care, supporting translation of current evidence into clinical prac-tice and promoting consistent, multidisciplinary implementation.

Objectives: Diabetes is highly prevalent in older women worldwide. This study explores the associations of psychosocial factors with both health service utilisation and self-management in older women aged 68 to 73 years with type 2 diabetes (T2D) or pre-diabetes. Design and setting: This cross-sectional study used data from the Australian Longitudinal Study on Women’s Health (ALSWH), which is a national population-based cohort study that has collected information on factors related to women’s health and well-being over 20 years. Participants: Women aged 68–73, born between 1946 and 1951, participated in ALSWH and self-reported their diagnosis of T2D or pre-diabetes. Outcome measures: Resilience, dispositional optimism and perceived control were the measures of psychosocial factors. The associations between these factors and diabetes self-management behaviours, healthcare visits and preventive service use were examined by numerous regression models. Results: There were 939 women aged 68–73 years with T2D or pre-diabetes. Women with T2D who exhibited higher dispositional optimism had significantly higher odds of participating in moderate/vigorous physical activity (OR: 1.06), visiting a dentist (OR: 1.07) and a lower rate of general practitioner (GP) visits (rate ratio (RR): 0.99). Women with T2D with greater resilience were likely to have a lower rate of consulting with mental health professionals (RR: 0.63) and higher odds of blood sugar level checks (OR: 1.68). The rate of GP visits within a year decreased by 16% for women with pre-diabetes who had a higher resilience score (RR: 0.84), and women with pre-diabetes with greater resilience had a 13% lower rate of visits to a nurse (RR: 0.87). Conclusions: Psychosocial aspects of diabetes care may be important for supporting the physical and mental well-being of older women with T2D or pre-diabetes. Healthcare providers may consider whether integrating assessments of resilience and optimism into routine diabetes management might help identify older women who could benefit from targeted psychosocial support.

Sport-related injuries are common presentations to primary care and hospital settings. Australian osteopaths practice mainly in private clinical settings in which the frequency of sport-related injury presentations, and how these injuries are managed, is unknown. The objective of the study was to describe the demographic, practice, and clinical management characteristics of Australian osteopaths who report often treating sport-related injuries. The study is a secondary analysis of data derived from the Australian osteopathy practice-based research network. Respondents indicated the frequency treating sports-related injuries in addition to other demographic, practice, and patient management characteristics. Backward logistic regression identified significant characteristics associated with often treating sport injuries. Over half (51%) of a nationally representative sample of Australian osteopaths reported treating sport-related injuries often. Those osteopaths who treat sports injuries often were likely to be male (p < 0.01) and utilise exercise prescription (OR2.34) and sports taping (OR5.99). Australian osteopaths who often treat sports-related injuries provide advice to patients and use exercise prescription more frequently than osteopaths who do not treat these injuries often. The data in the current work begin to explore how osteopaths manage sports-related injuries and highlights how they may be able to provide sports injury care for both recreational and elite sport populations.

This review is to systematically explore the relationship between muscle dysfunction and diabetes in adults, and to examine the impact of glycemic variability on muscle health and the development of diabetes-related complications. The review was conducted using three databases: MEDLINE, Scopus, and EMBASE, targeting peer-reviewed journal articles written in English and published from January 2014 to September 2024. The methodological quality assessment of the eligible studies was conducted using Joanna Briggs Institute Critical Appraisal Checklists. A total of 17 studies were included. Most studies were undertaken in Asian countries (n = 11) and focused on adults with type 2 diabetes (n = 12). There were 8,392 adults with diabetes, and their mean age ranged from 52 to 75 years old. The measurements for muscle function and glycemic variability varied across studies. The research findings regarding the relationship between muscle dysfunction and glycemic variability metrics among adults with diabetes, both with and without complications were inconsistent. For adults with diabetes and sarcopenic obesity, poor glycemic control was identified as an independent risk factor for sarcopenic obesity. Additionally, all included studies were rated as moderate or high quality in relation to their methodology. In conclusion, this review underscores the complex and inconsistent relationship between glycemic variability and muscle dysfunction in older adults with diabetes. Poor glycemic management is a significant risk factor for sarcopenic obesity, highlighting the need for tailored interventions to improve glycemic control and muscle health in this population.

Background: Indigenous Australians are disproportionately affected by diabetes, with a diagnosis rate nearly four times higher than people from a non-Indigenous background. This health disparity highlights the urgent need for healthcare providers to develop cultural empathy - a critical competency for delivering culturally safe and person-centered care. Cultural empathy is essential for building trust and effective communication in diabetes education and management within Indigenous people. However, there is a significant gap in targeted interventions to enhance this skill among healthcare providers.Aims: The aim of this study was to evaluate the effectiveness of a digital storytelling intervention for enhancing cultural empathy levels of postgraduate diabetes education students.Design: This study has a pre-post survey design to measure changes in participants' cultural empathy levels after exposure to a digital story.Methods: Students enrolled in a postgraduate diabetes education course at an Australian university were eligible to participate. The intervention included a first-person digital story about an Indigenous man with type 2 diabetes, accompanied by group-based discussions and self-reflection. The Comprehensive State Empathy Scale was utilised to assess empathy levels.Results: A total of 98 students completed both pre- and post-intervention surveys. There was a statistically significant increase in mean Comprehensive State Empathy Scale scores post-intervention (p < 0.001), indicating higher empathy levels. Improvements were observed across all six Comprehensive State Empathy Scale subscales, suggesting a multidimensional impact of the intervention.Conclusions: The digital story intervention significantly enhanced the cultural empathy levels of postgraduate diabetes education students. This study contributes to the evidence base for narrative-based pedagogies in cultivating empathy among healthcare providers. The findings highlight the potential of digital storytelling as a tool for improving cultural competency in healthcare education and practice, ultimately contributing to more empathic care for Indigenous people with diabetes.

Background: Developmental challenges of adolescence, such as puberty and social pressures, exacerbate the complexity of managing type 1 diabetes (T1D) as they transition from pediatric to adult care. However, there is a paucity of codesigned, evidence‐based diabetes education and support programs and services to guide adolescents through this transition. Objective: This study aimed to explore the experiences, perspectives, facilitators, and barriers faced by adolescents with T1D in diabetes education and program services and to identify feasible approaches to support them as they transition from pediatric to adult care. Methods: Semistructured interviews were conducted with 13 adolescents aged 13–19 years with T1D. Thematic analysis was used to understand participants’ past experiences, facilitators, barriers, and preferences regarding diabetes education programs and services. Results: Participants highly valued the opportunity to meet with peers living with T1D and the emotional support from those interactions. Participants also highlighted the need for age‐appropriate content and interactive learning experiences. Suggested gamification features were well‐received, with participants emphasizing the importance of interactivity. While there was not a strong preference between virtual or in‐person game formats, it was suggested that online options offered flexibility and inclusiveness regardless of physical abilities. Participants were not as enthusiastic for a one‐on‐one live chat compared to an online community chat, again, for the opportunity for peer support. Conclusion: The study highlights the value that adolescents with T1D place on peer support that arises from opportunities to meet others through in‐person events. It was evident that codesigning diabetes education programs and services with adolescents with T1D is key to develop tailored offerings for this population.

Health equity is a fast emerging priority for most healthcare systems around the world. Factors impacting health equity include education level, geographical location, age, gender, employment status and income. However, research examining the effect of these demographic variables on health service utilisation among mid-aged and older post-stroke adults is limited. Data was obtained from a sub-study of the Sax Institute’s 45 and Up Study, which is conducted in Australia. The sub-study survey collected demographic, health service utilisation and health status information from 576 participants who had a previous stroke diagnosis. Poisson regression was used to examine the association between demographic characteristics and number of consultations with a doctor and/or an allied health practitioner over a 12 month period. All demographic measures were significantly associated with the number of consultations with doctors and/or allied health practitioners. The number of doctor consultations increased for those who struggled to live on their available income (IRR = 1.41), but decreased for females (IRR = 0.81), those who reside in an inner regional area (IRR = 0.83), those who were separated, divorced or widowed (IRR = 0.61), and for those who completed a trade, apprenticeship or diploma (IRR = 0.83). The number of allied health practitioner consultations increased for those who completed a trade, apprenticeship or diploma (IRR = 1.27), and for those who struggled to live on their available income (IRR = 1.38), but decreased for increasing age (IRR = 0.87), females (IRR = 0.78), and for those who reside in an outer regional or remote area (IRR = 0.49). We identified several demographic factors associated with a lower frequency and type of health care services used by post-stroke adults. These possible barriers need to be explored further, as reduced use of healthcare services may lead to poorer stroke outcomes in these demographics. Specifically, researching strategies to best support individuals facing these additional challenges is necessary to ensure equitable healthcare for all Australians.