Western Health's diabetes education services manager, Cheryl Steele, says many people are still being diagnosed late or aren't taking diabetes seriously enough.

"On average, people have diabetes seven years before diagnosis. You can imagine walking around for seven years with higher-than-average blood-sugars and what that does to your liver and eyesight. It's very easy to mistake the symptoms with getting older."

Every Wednesday, 50 patients attend a diabetes clinic at Western Hospital. However, the clinic, staffed with nurses and endocrinologists, has a four-week waiting list.

Every Monday, another 7-14 pregnant women who have been diagnosed with diabetes go to a gestational diabetes clinic at Sunshine Hospital.

Western Health has also started a specialist type1 diabetes clinic for young people. Last year 64 youths were admitted to hospitals in the west with serious diabetes complications.

Ms Steele said it was an uphill battle to teach people. "It's not so much ignorance of diabetes as an ignorance of how serious it is, because you can't see it and it's not until they have to have a leg amputated that some people realise the complications. It's sad that sometimes the first presentation [at hospital] is when they turn up to our emergency department with a black toe, when had they presented 10 years ago they could have avoided all of that."

Other people are afraid of insulin and think it's harmful because in the countries where they were born it was administered to diabetes patients as a last resort, and often too late.

Increasingly, diabetes nurses and endocrinologists are seeking out patients.

But outreach patients have many extra complications. Nurse Rachel Gleeson said these included mobility, housing problems, isolation, literacy, cultural barriers and mental illness. "I've been seeing one lady who refused to have laser [surgery on her eyes] because she was scared that if she did she would go blind. Now, the damage to her eyesight from diabetes has got to a point she can't have laser, and she is going blind." As nurse Thu Thai put it: "We don't look at diabetes only. Sometimes we have to look at other issues first and come back to the diabetes."

If there was just one message diabetes nurses could get across it would be: Get checked by your GP and, if diagnosed, do something about it immediately.

Details: Western Health on 83456666, WRHC on 83984100, or ISIS on 92961200.