Diabetes

Diabetes is a chronic condition marked by high levels of glucose in the blood. It is caused by the inability of the body to produce or effectively use insulin, a hormone made by the pancreas to control blood glucose levels. Type 2 diabetes is the most common form. It involves a genetic component but is largely preventable and can be managed with changes to diet and physical activity, and with medications (Diabetes Australia 2022).

Diabetes is one of the main causes of chronic kidney disease (CKD) (AIHW 2021, ANZDATA 2021). High blood glucose levels can damage the kidney’s filters (nephrons), affecting the ability to remove waste and fluid from the body. Diabetic kidney disease is also called ‘diabetic nephropathy’.

Diabetes and CKD share risk factors. Many people with diabetes develop high blood pressure, which can also damage the kidneys. People with both CKD and diabetes are more likely to develop other complications of diabetes such as nerve damage and eye damage.

Diabetes is the most common reason that people with CKD need to have dialysis or a kidney transplant. The mortality risk for people with kidney failure and diabetes is greater than the risk for people with kidney failure alone (Lim et al. 2018).

In 2020, based on linked data from the National Diabetes Services Scheme (NDSS) and Australasian Paediatric Endocrine Group (APEG) state-based registers:

  • 1 in 20 (almost 1.3 million) Australians were living with diabetes. This includes people with type 1 diabetes, type 2 diabetes and other diabetes, but excludes gestational diabetes (AIHW 2022)
  • diabetes was more common in males (4.8%) than females (3.8%) after controlling for age
  • almost 1 in 5 (19%) Australians aged 80–84 were living with diabetes, which was almost 30 times as high as those aged under 40 (0.7%)
  • age-standardised prevalence rose from 2.4% in 2000 to 4.3% in 2020 (Figure 1). The diabetes rate remained stable between 2016 and 2020.

Information based on linked NDSS and APEG data underestimates prevalence as it does not include people with undiagnosed diabetes. The ABS 2011–12 Australian Health Survey, which included both measured and self-reported data, showed that for every 4 adults with diagnosed diabetes, there was 1 who was undiagnosed (ABS 2013).

Figure 1: Prevalence of diabetes from linked NDSS and APEG data, by sex, 2000 to 2020

This chart shows the estimated age–standardised proportion of people with diabetes based on data from the linked National Diabetes Services Scheme and Australasian Paediatric Endocrine Group between 2000 and 2020. The proportion increased from 2.4% in 2000 to 4.3% in 2020 but remained relatively stable between 2015 and 2020.

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Variation between population groups

  • Around 7.9% of Indigenous Australians (64,100 people) were living with diabetes according to self-reported data from the ABS 2018–19 National Aboriginal and Torres Strait Islander Health Survey (ABS 2019). After controlling for differences in the age structures of the populations, Indigenous Australians were almost 3 times as likely to have diabetes as non-Indigenous Australians (13% compared with 4.3%) (AIHW 2022).
  • The age-standardised prevalence rate of diabetes in 2020 was around 1.8 times as high among those living in the lowest socioeconomic areas (6.0% and 5.1% for males and females, respectively) as among those living in the highest socioeconomic areas (3.5% and 2.5% for males and females, respectively).
  • The age-standardised prevalence rate of diabetes in 2020 was highest in Outer regional (4.6%) and Remote and very remote areas (5.5%); it was 4.2% in both Major cities and Inner regional areas.