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Between 1997 and 2010, the diabetes-related death rate among all Australians declined by 20%.

Indigenous Australians, people born overseas and people living outside major cities of Australia had higher rates of diabetes-related deaths than the general population.

Why is this an important indicator for diabetes?

Diabetes and conditions related to diabetes are among the leading causes of death, illness and disability in Australia (AIHW 2012a; AIHW 2012b). Diabetes has been one of the top 10 causes of death in Australia for some years. Common complications of diabetes, such as heart disease, stroke and kidney disease, are also leading causes of death and are included with diabetes in the indicator diabetes-related deaths.

Diabetes-related death rates differ among different population groups. Data are presented on:

  • the general population
  • Australian-born and overseas-born people
  • Aboriginal and Torres Strait Islander peoples
  • people living in different geographic areas

What are the results?

General population

  • In 2010, nearly 7,750 Australians died from diabetes and causes related to diabetes. This is 5.4% of all deaths in that year.
  • Between 1997 and 2010, deaths from diabetes-related causes fell by 20%, from 39 to 31 deaths per 100,000 population (Figure 1).
  • In 2010, the diabetes-related death rate was 55% higher among males than females (the rate for males was 39 per 100,000 males and for females, 25 deaths per 100,000 females).

Figure 1: Diabetes-related deaths, 1997–2010

Stacked line chart showing for males, females and persons; deaths per 100,000 on the y axis and years 1997 to 2010 on the x axis.

Notes

  1. Directly age-standardised to the 2001 Australian population.
  2. Diabetes-related deaths are defined in Table 1.
  3. Death data for 2009 and 2010 are based on revised and preliminary data respectively, and are subject to further revision.
  4. These data have not been adjusted for the additional deaths arising from the delayed registration of Queensland deaths for 2010. For more detail please refer to Technical note 3 in Causes of death, Australia, 2010 (ABS Cat. No. 3303.0).

Source:AIHW National Mortality Database (NMD). Data are available in Table 2.

Other population groups

Country of birth

  • In 2010 almost 2,790 diabetes-related deaths occurred among people born overseas.
  • Between 1997 and 2010, deaths from diabetes-related causes among overseas born people:

    • increased in absolute numbers by 2.4% annually
    • but the death rates decreased by 1.1% each year.

Indigenous status

  • In 2010, there were almost 300 diabetes-related deaths among Aboriginal and/or Torres Strait Islander people in NSW, Qld, WA, SA and the NT. This corresponds to an age-standardised rate of 161 deaths per 100,000 population.
  • Between 2001 and 2010 the age-standardised death rate from diabetes-related causes among Indigenous Australians decreased each year by 1.0%.
  • Between 2001 and 2010, the overall death rate from diabetes-related causes was 5.4 times as high in Aboriginal and Torres Strait Islander people as in non-Indigenous people.

Geographic location

  • In 2010, there were over 1,150 diabetes-related deaths among people living in outer regional, remote and very remote Australia.
  • Between 2001 and 2010, the death rate from diabetes-related causes fell from:
    • 33 to 28 deaths per 100,000 population among people living in major cities.
    • 36 to 32 deaths per 100,000 population among people living in inner regional areas.
    • 45 to 43 deaths per 100,000 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 mortality data were provided by the Registries of Births, Deaths and Marriages, the Australian Bureau of Statistics and the National Coroners Information System. These data are held by the AIHW in the National Mortality Database (NMD).
  • the Australian Bureau of Statistics (ABS) Estimated Resident Population (ERP).

For more information on quality of mortality data, please see the 3303.0 - Causes of Death, Australia, 2011 quality declaration. The year of registration of death has been used instead of year of death.

How is this indicator calculated?

These rates are given as the number of deaths per 100,000 population. They are directly age-standardised using the 2001 Australian population.

In each of these population groups:

  • the general population
  • Australian-born and overseas-born people
  • Aboriginal and Torres Strait Islander people
  • people living in major cities of Australia, inner regional Australia, and outer regional, remote and very remote Australia

the rates compare:

  • numerator: the number of people who died from diabetes and diabetes-related causes (from the NMD), to
  • denominator: the total number of people in that population group (from the ABS ERP).

Data limitations

  • Where diabetes is identified as a contributing cause of death, it is selected more often as an associated cause rather than the underlying cause. Hence analyses of causes of death using the underlying cause only, tend to underestimate deaths where diabetes contributed to the death (AIHW 2012b).
  • 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.
  • Indigenous mortality estimates rely on accurate identification of Aboriginal and Torres Strait Islander peoples on death registration records. Currently only 5 jurisdictions have been assessed to have adequate identification (NSW, Qld, WA, SA and NT). Indigenous deaths are only captured when the death is registered in one of these five jurisdictions and when the state of usual residence is also one of these five jurisdictions. The incompleteness of Indigenous identification means the number of deaths recorded as Indigenous underestimates the true levels of mortality.
  • Remoteness classification of geographic locations can change over time. Deaths are classified based on the geographical location of usual residence of the person.

Definitions

Country of birth has been defined based on the Standard Australian Classification of Countries (SACC), 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 using the Remoteness Structure in the ASGC which is based on the ARIA. Three categories are used in this indicator: 'Major cities of Australia', 'Inner regional Australia' and 'Outer regional, remote or very remote Australia'.

Diabetes-related deaths
Table 1 below shows which conditions are considered as diabetes-related deaths in this publication and their International Classification of Diseases (ICD–10) code.

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: Dixon T & Webbie K 2006. The National System for Monitoring Diabetes in Australia. Cat. no. CVD 32. Canberra: AIHW.

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 2012a: Australia’s health 2012. Australia’s health series no. 13. Cat. no. AUS 156. Canberra: AIHW.

AIHW 2012b: Multiple causes of death. Bulletin no. 105. Cat. no. AUS 159. Canberra: AIHW.

Abbreviations

ABS
Australian Bureau of Statistics
AIHW
Australian Institute of Health and Welfare
ARIA
Accessibility/Remoteness Index of Australia
ASGC
Australian Standard Geographic Classification
ERP
Estimated Resident Population
ICD-10
International Classification of Disease Tenth Revision
NDDWG
National Diabetes Data Working Group
NMD
National Mortality Database
SACC
Standard Australian Classification of Countries
UKPDS
United Kingdom Prospective Diabetes Study

Source data

Table 2: Diabetes-related deaths per 100,000 population, 1997–2010
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Males 48.0 45.3 45.1 44.2 44.6 46.3 44.1 43.0 40.0 41.1 40.8 43.4 41.2 38.5
Females 31.9 30.0 28.9 28.3 27.3 28.0 26.8 27.1 26.1 26.6 26.1 27.4 26.9 24.9
Persons 38.8 36.6 35.9 35.2 34.8 35.9 34.3 34.0 32.3 33.0 32.6 34.6 33.3 30.9

Notes  

  1. Directly age-standardised to the 2001 Australian population.
  2. Refer to Table 1 for the conditions and ICD-10 codes that describe diabetes-related deaths.
  3. Deaths for 2009 and 2010 are based on revised and preliminary data, respectively, and are subject to further revision.
  4. These data have not been adjusted for the additional deaths arising from outstanding registrations of deaths in Queensland in 2010. For more detail please refer to Technical note 3 in Causes of death, Australia, 2010 (ABS Cat. no. 3303.0).

Source: AIHW analysis of National Mortality Database (NMD).