Australians are risking amputations, kidney failure and blindness by not taking type 2 diabetes seriously, says a leading specialist on the disease.
Diabetes is one of the greatest health epidemics in modern times, says Associate Professor Neale Cohen, General Manager of Diabetes Services at the Baker IDI Heart and Diabetes Institute.
"People need to take a lot more responsibility for their health.
"It's a worldwide problem largely driven by sedentary lifestyle and unhealthy eating, said Prof Cohen, who is making several presentations at a world diabetes congress in Melbourne from Tuesday.
Australia has parallel epidemics. For most, type 2 diabetes is caused by too much food and too little exercise, with an added genetic risk for some.
Indigenous people, however, are at serious risk regardless of their lifestyle.
"It's a national tragedy," said Prof Cohen.
"Really these communities do not eat a lot worse than other Australians.
"But they get an extremely aggressive form of type 2 diabetes that can occur at a young age.
"The kidney failure rate is so extreme that Alice Springs has one of the largest kidney dialysis units in the southern hemisphere."
Prof Cohen said people liked to blame carbohydrates for diabetes, but the real danger food was fat.
"People are generally surprised that olive oil or avocados are not particularly good for diabetes or weight."
It would be a great start if high-risk and diabetic people reduced the fat in their diet and limited the number of times they ate out, he said.
"Most takeaway foods are high in fat. Most restaurant food is much higher in fat than we should be eating."
A big problem is that many people do not know their diabetes status and those who do often do not take it seriously.
"You can't see it or feel it. But it is a serious condition.
"If people are told they have cancer they get really upset and worried.
"Often when people are told they have diabetes they are fairly relaxed. They don't realise how serious it is."
High-risk people should have a fasting glucose test every year, he said.
"People may have had it for five or 10 years before they get tested. They could have kidney damage or bleeding at the back of the eyes.
"They could have had a heart attack."