Between 1997 and 2007, the diabetes-related death rate among all Australians fell by 18%.
Indigenous Australians, people born overseas and people living in non-urban areas of Australia had higher rates of diabetes-related death than the general population.
Why is this an important indicator for diabetes?
Diabetes and illnesses related to diabetes are among the leading causes of death, illness and disability in Australia (AIHW: Dixon & Webbie 2006). Diabetes has been one of the top ten causes of death in Australia for a number of years. Common complications of diabetes, such as heart disease, stroke and kidney disease, are also leading causes of death, and are included in the indicator deaths from diabetes and diabetes-related causes.
The diabetes-related death rate among different population groups compares trends in deaths related to diabetes among:
- the general population
- people of culturally and linguistically diverse backgrounds, and
- people living in different geographic areas.
What are the results?
General population
- In 2007, nearly 7,500 Australians died from diabetes and causes related to diabetes. This is 5.4% of all deaths in that year.
- Between 1997 and 2007, deaths from diabetes-related causes fell by 18%, from 39 to 32 deaths per 100,000 population (Figure 1).
- In 2007, the rate for diabetes-related death for males was 36% higher than for females.
Other population groups
Country of birth
Indigenous status
- In 2006, there were over 250 diabetes-related deaths among Aboriginal and/or Torres Strait Islander people in NSW, Qld, WA, SA and the NT.
- From 2001 to 2006, the death rate from diabetes-related causes among Aboriginal and/or Torres Strait Islander people fell from 52 deaths per 100,000 population to 46 deaths per 100,000 population.
Geographic location
- In 2006, there were almost 1,100 diabetes-related deaths among people living in outer regional, remote and very remote Australia.
- Between 1997 and 2006, the death rate from diabetes-related causes:
- fell from 38 deaths per 100,000 population to 30 deaths per 100,000 population among people living in major cities.
- fell from 38 deaths per 100,000 population to 34 deaths per 100,000 population among people living in inner regional areas.
- remained stable at around 45 deaths per 100,000 per population among people living in outer regional, remote and very remote areas.
What are the data sources?
There are two main data sources for this indicator:
- the National Morbidity Database (NMD), and
- the Australian Bureau of Statistics (ABS) Estimated Resident Population (ERP).
Death data varies in quality across states and territories. The year of registration has been used instead of year of death where the actual year of death is unknown.
Death certificates under-report diabetes by listing it as an associated cause of death rather than an underlying cause of death (AIHW 2007). However, since 1997, death certificates have recorded multiple causes of deaths, improving the reporting of diabetes related deaths.
How is this indicator calculated?
These rates are given as the number of deaths per 100,000 population. They are age-standardised using the 2001 Australian adult population.
In each of these population groups:
- the general population
- people from a culturally and linguistically diverse background
- people living in major cities, regional and remote Australia
the rates compare
- numerator: the number of people who died from diabetes and diabetes-related causes (from the NMD), to
- denominator: to the total number of people (from the ABS ERP).
Are there any data limitations?
- Country of birth has been used as a proxy for cultural and linguistic diversity. This measure does not fully represent the complexity of cultural diversity in Australia.
Definitions
Country of birth has been defined based on the Australian Standard Geographical Classification (ASGC), as either Australian-born or overseas-born. Australian-born includes the areas Australia, Norfolk Island and Australian External Territories. Overseas-born includes all other areas and those that were not stated or inadequately described.
Geographic areas have been defined based on Accessibility/Remoteness Index of Australia (ARIA). Three categories are used in this indicator: 'Major cities of Australia', 'Inner regional Australia' and 'Outer regional or Remote Australia' (which is a combination of Outer regional and Remote Australia).
Indigenous status is self-reported.
Diabetes-related deaths
Table 1 below shows how diabetes-related deaths have been coded using the International Classification of Diseases (ICD–10).
Table 1: Diabetes-related death
| Diabetes related deaths |
ICD–10 codes |
| Diabetes is listed as the underlying cause of death |
E10, E11, E13, E14, O24 |
| Diabetes is listed as an associated cause of death, where the underlying cause of death was one of: |
|
| Myocardial infarction (heart attack) |
I21–I22 |
| Ischaemic heart disease |
I20,I24,I25 |
| Stroke or sequelae of stroke |
I60–I64, I69.0–I69.4 |
| Heart failure |
I50 |
| Sudden death (cardiac arrest) |
I46 |
| Peripheral vascular disease |
I70–I74 |
| Kidney disease |
N00–N28 |
| Hyperglycaemia |
R73 |
| Hypoglycaemia |
E16.1–E16.2 |
Note: ‘Diabetes-related deaths’ is based on the definition of ‘deaths related to diabetes’ used in the United Kingdom Prospective Diabetes Study (UKPDS 1998). The UKPDS definition has been modified by diabetes specialists on the National Diabetes Data Working Group (NDDWG) to include ischaemic heart disease, sequelae of stroke and heart failure, and other commonly recognised complications of diabetes.
Source: AIHW 2007.
Where can I find more information?
AIHW 2007. National indicators for monitoring diabetes: report of the Diabetes Indicators Review Subcommittee of the National Diabetes Data Working Group. Diabetes series no. 6. Cat. no. CVD 38. Canberra: AIHW.
AIHW: Dixon T & Webbie K 2006. The National System for Monitoring Diabetes in Australia. Cat. no. CVD 32. Canberra: AIHW.
Abbreviations
- ABS
- Australian Bureau of Statistics
- AIHW
- Australian Institute of Health and Welfare
- ERP
- Estimated Resident Population
- ICD-10
- International Classification of Disease Tenth Revision
- NDDWG
- National Diabetes Data Working Group
- NMD
- National Mortality Database
- UKPDS
- United Kingdom Prospective Diabetes Study
Source data
Table 2: Diabetes-related deaths per 100,000 people, 1997–2007
|
1997 |
1998 |
1999 |
2000 |
2001 |
2002 |
2003 |
2004 |
2005 |
2006 |
2007 |
| Males |
48.0 |
45.3 |
45.1 |
44.2 |
44.6 |
46.3 |
44.1 |
43.0 |
40.0 |
40.9 |
40.5 |
| Females |
31.9 |
30.0 |
28.9 |
28.3 |
27.3 |
28.0 |
26.8 |
27.1 |
26.1 |
26.6 |
26.0 |
| Persons |
38.8 |
36.6 |
35.9 |
35.2 |
34.8 |
35.9 |
34.3 |
34.0 |
32.3 |
32.9 |
32.4 |
Notes
1. Directly age-standardised to the 2001 Australian population.
2. Refer to Table 1 for coding details for diabetes deaths and diabetes-related deaths.
3. 2007 Cause of Death data are not complete.
Source: AIHW National Mortality Database (NMD).