Burden of disease
In 2015, type 2 diabetes contributed to 2.2% of the total disease burden (fatal and non-fatal) in Australia. Type 2 diabetes was the 12th leading contributor to total burden. Overall, the burden from type 2 diabetes increased slightly from 1.8% in 2003 to 2.2% in 2015. Type 1 diabetes contributed to 0.3% of Australia’s disease burden in 2015—unchanged from both 2003 and 2011 (AIHW 2019a).
In 2015, 4.7% of the total burden of disease could have been prevented by reducing exposure to the modifiable risk factor ‘high blood plasma glucose levels’ (including diabetes) (AIHW 2019a).
See Burden of disease.
Expenditure
In 2015–16, an estimated 2.3% ($2.7 billion) of total disease expenditure in the Australian health system was attributed to diabetes (AIHW 2019c).
See Health expenditure.
Adverse effects in pregnancy
Based on data from the National Perinatal Data Collection for 2014–2015, mothers with pre-existing diabetes (type 1 and type 2 diabetes) and gestational diabetes had higher rates of caesarean section, induced labour, pre-existing and gestational hypertension, and pre-eclampsia compared with mothers with no diabetes in pregnancy (AIHW 2019b).
Compared with babies of mothers with gestational diabetes or no diabetes, babies of mothers with pre-existing diabetes had higher rates of pre-term birth, stillbirth, low and high birthweight, low Apgar score, resuscitation, and special care nursery/neonatal intensive care unit admission, and stayed longer in hospital (AIHW 2019b).
See Health of mothers and babies.
Deaths
According to the AIHW National Mortality Database, diabetes was the underlying cause of around 4,700 deaths in 2018. However, it contributed to around 16,700 deaths (10.5% of all deaths) (AIHW 2019e).
See Causes of death.
Glycaemic control
Glycosylated haemoglobin (HbA1c) can be used to assess the average blood glucose over the preceding 6–8 weeks and is considered the gold standard for assessing glycaemic control. Targets for HbA1c in people with diabetes should be individualised, but a general target of less than or equal to 7.0% is recommended for people with type 2 diabetes (Phillips 2012).
In 2011–12, an estimated 55% of adults with known diabetes achieved the target level for HbA1c based on measured data from the 2011–12 Australian Health Survey. The proportion who effectively managed their diabetes increased with age for both men and women. Overall, 40% of adults aged 18–54 effectively managed their diabetes and this proportion rose to 71% among those aged 75 and over (AIHW 2018).
In 2018, the mean HbA1c of individuals attending services for diabetes care at 50 diabetes centres across Australia was 8.2%, according to the Australian National Diabetes Audit–Australian Quality Self-Management Audit (ANDA-AQSMA) (National Association of Diabetes Centres 2018). The average HbA1c has remained relatively stable since 2010.
See Biomedical risk factors.
Medicines
In 2018–19, over 14 million Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) prescriptions for medicines used to treat diabetes were dispensed to the Australian community (Department of Health 2019). Metformin was the eighth most dispensed medicine in 2018–19.
According to the NDR, 31,300 people began using insulin to treat their diabetes in 2018. Of the people with diabetes who began using insulin, 54% had type 2 diabetes, 34% were females who had gestational diabetes, 9.0% were people who were newly diagnosed with type 1 diabetes and 2.0% were people who had other forms of diabetes (AIHW 2020).
See Medicines in the health system.
Hospitalisations
Around 1.2 million hospitalisations were associated with diabetes in 2017–18, with 4.5% recorded as the principal and 95.5% recorded as the additional diagnosis, according to the AIHW National Hospital Morbidity Database. This represents 11% of all hospitalisations in Australia (AIHW 2019d).
See Hospital care.
The impact of diabetes was higher among Aboriginal and Torres Strait Islander people, those living in lower socioeconomic areas and in remote areas. The diabetes prevalence rate was 2.9 times as high among Aboriginal and Torres Strait Islander people as among non-Indigenous Australians based on age-standardised self-reported data from the 2018–19 National Aboriginal and Torres Strait Islander Health Survey (ABS 2019b). Generally, the impact of diabetes increases with increasing remoteness and socioeconomic disadvantage. Deaths related to diabetes were 2.1 times as high in Remote and very remote areas compared with Major cities, and 2.3 times as high in the lowest compared with the highest socioeconomic areas (Figure 3).