Hospital care for diabetes

All diabetes hospitalisations

There were over 1 million hospitalisations where diabetes was recorded as the principal and/or additional diagnosis in 2015–16, according to the AIHW National Hospital Morbidity Database. This represents 10% of all hospitalisations in Australia. Note that hospitalisation data presented here are based on admitted patient episodes of care, including multiple events experienced by the same individual.

In 2015–16 there were around:

  • 50,000 hospitalisations with diabetes as the principal diagnosis (the diagnosis largely responsible for hospitalisation). Of these hospitalisations, 29% were due to type 1 diabetes and 63% were due to type 2 diabetes (Figure 1).
  • 1,053,700 hospitalisations with diabetes as an additional diagnosis (a coexisting condition with the principal diagnosis or a condition arising during hospitalisation that affects patient management). Of these hospitalisations, 4% were due to type 1 diabetes and 90% were due to type 2 diabetes (Figure 1).

Figure 1: Hospitalisations by diabetes type, 2015–16

The horizontal bar chart shows that type 1 diabetes as a principal diagnosis accounted for 29%25 of all diabetes hospitalisations as a principal diagnosis in 2015–16, compared to only 4%25 of all diabetes as an additional diagnosis. For type 2 diabetes, 90%25 of diabetes hospitalisations were recorded as an additional diagnosis and 63%25 as a principal diagnosis.

Source: AIHW National Hospital Morbidity Database (Data tables).

Type 1 diabetes

There were around 59,900 hospitalisations where type 1 diabetes was recorded as the principal and/or additional diagnosis in 2015–16—14,600 (24% of type 1 diabetes hospitalisations) as the principal diagnosis and 45,300 as an additional diagnosis.

Age and sex

In 2015–16, type 1 diabetes hospitalisation rates (as the principal diagnosis) were:

  • Overall similar among males and females (62 and 63 per 100,000 population).
  • Highest among young people aged 10–19 (101 and 127 per 100,000 for males and females, respectively)  (Figure 2).

Hospitalisation rates for type 1 diabetes showed a different age pattern when recorded as an additional diagnosis rather than a principal diagnosis—rates increased steadily up to age group 70–79 and then declined (see data).

Figure 2: Type 1 diabetes hospitalisations (principal diagnosis), by age and sex, 2015–16

The vertical bar chart shows that rates of type 1 diabetes hospitalisations in 2014–15 (as a principal diagnosis) peaked at age 10–19 for both females and males. Hospitalisation rates for type 1 diabetes were higher for females in younger age groups (those less than 30 years), while males were more likely to be hospitalised for type 1 diabetes in the older age groups (from age 50 onwards).

Source: AIHW National Hospital Morbidity Database (Data tables).

Variations by population groups

In 2015–16, type 1 diabetes hospitalisation rates (as the principal and/or additional diagnosis) varied by remoteness and increased with socioeconomic disadvantage. Rates were:

  • Higher in Inner regional and Outer regional areas (318 and 268 per 100,000 population) compared with Major cities and Remote and very remote areas (225 and 197 per 100,000 population) (Figure 3).
  • 1.5 times as high in the lowest socioeconomic group compared with the highest socioeconomic group (based on area of usual residence)—289 compared with 190 per 100,000. This gap was similar for males and females (Figure 3).

Figure 3: Type 1 diabetes hospitalisations, (principal and/or additional diagnosis), by remoteness and socioeconomic group, 2015–16

The horizontal bar chart shows that in 2015–16 type 1 diabetes hospitalisation rates (as a principal and/or additional diagnosis) were highest in inner and outer regional areas compared with other areas for both males and females. Type 1 diabetes hospitalisation rates were overall 1.7 times as high in the lowest socioeconomic group compared with the highest.

Note: Age-standardised to the 2001 Australian Standard Population.

Source: AIHW National Hospital Morbidity Database (Data tables).

Aboriginal and Torres Strait Islander people

In 2015–16, there were around 2,400 hospitalisations for type 1 diabetes (as the principal and/or additional diagnosis) among Aboriginal and Torres Strait Islander people, a rate of 393 per 100,000 population.

  • The rate among Indigenous Australians was 1.7 times as high as for non-Indigenous Australians (393 compared with 234 per 100,000).
  • The disparity between Indigenous Australians and non-Indigenous Australians was greater for females than males—1.6 times as high for females (381 compared with 233 per 100,000) and 1.7 times as high for males (407 compared with 237 per 100,000).

Type 2 diabetes

There were around 980,000 hospitalisations with type 2 diabetes recorded as the principal and/or additional diagnosis in 2015–16―31,700 (3% of type 2 diabetes hospitalisations) as the principal diagnosis and 948,000 as an additional diagnosis. 

Age and sex

In 2015­–16, type 2 hospitalisation rates (as the principal and/or additional diagnosis):

  • Were overall 1.4 times as high for males as females (4,217 and 2,991 per 100,000 per population). Age-specific rates were higher among males than females from 45 years onwards (Figure 4).  
  • Increased with age, with the majority (87%) of type 2 diabetes hospitalisations occurring in those 55 years and over. Type 2 diabetes hospitalisation rates were highest among males aged 85 and over (30,055 per 100,000) and females aged 75–84 (19,261 per 100,000) (Figure 4).

Figure 4: Type 2 diabetes hospitalisations (principal and/or additional diagnosis), by age and sex, 2015–16

The vertical bar chart shows that rates of type 2 diabetes hospitalisations (as a principal and/or additional diagnosis) increased steadily with age in 2015–16. The peak age group for males was at age 85 and over  and for females at age  75–84. Males had higher rates than females from age 45 upwards.

Source: AIHW National Hospital Morbidity Database (Data tables).

Variations by population groups

In 2015–16, type 2 diabetes hospitalisation rates (as the principal and/or additional diagnosis) increased with remoteness and socioeconomic disadvantage:

  • Nearly twice as high in Remote and very remote areas compared with Major cities. This gap was much larger for females than males―2.7 times as high for females (7,854 compared with 2,870 per 100,000 population) and 1.3 times as high for males (5,582 compared with 4,167 per 100,000) (Figure 5).
  • Almost twice as high in the lowest socioeconomic group compared with the highest socioeconomic group (based on area of usual residence). This gap was higher for females than males—2.1 times as high for females (4,062 compared with 1,975 per 100,000) and 1.6 times as high for males (5,221 compared with 3,172 per 100,000) (Figure 5). 

Figure 5: Type 2 hospitalisation rates (principal and/or additional diagnosis), by remoteness and socioeconomic group, 2015–16

The horizontal bar chart shows that in 2015–16, type 2 diabetes hospitalisation rates (as a principal and/or additional diagnosis) were highest in Remote/Very remote areas for both males and females. Rates for type 2 diabetes hospitalisations in the lowest socioeconomic group (group 1) were considerably higher than in the highest socioeconomic group (group 5).

Note: Age-standardised to the 2001 Australian Standard Population.

Source: AIHW National Hospital Morbidity Database (Data tables).

Aboriginal and Torres Strait Islander people

In 2015–16, there were around 54,000 hospitalisations for type 2 diabetes (as the principal and/or additional diagnosis) among Aboriginal and Torres Strait Islander people, a rate of 13,350 per 100,000 population.

  • The rate among Indigenous Australians was overall 4 times as high as for non-Indigenous Australians (13,350 compared with 3,266 per 100,000).
  • The disparity in type 2 diabetes hospitalisation rates between Indigenous Australians and non-Indigenous Australians was greater for females than males―5 times as high for females (14,727 compared with 2,716 per 100,000 population, respectively) and 3 times as high for males (11,843 compared with 3,883 per 100,000 population, respectively).

Gestational diabetes

There were around 48,300 hospitalisations with gestational diabetes recorded as the principal and/or additional diagnosis in 2015–16―the vast majority of these recorded as an additional diagnosis (46,000 or 95% of gestational diabetes hospitalisations).

The majority (83%) of hospitalisations for gestational diabetes occur between the ages 25 and 39, with the highest hospitalisation rate occurring for those aged 30–34 years (1,935 per 100,000 population) (Figure 6).

Figure 6: Gestational diabetes hospitalisations (principal and/or additional diagnosis), by age, 2015–16

The vertical bar chart shows that in 2015–16, gestational diabetes hospitalisations peaked at age 30–34 years and then declined with age.

Source: AIHW National Hospital Morbidity Database (Data tables).

Hospital procedures for diabetes complications

There are no diabetes specific hospital procedures. Lower-limb amputation is one of the procedures often associated with diabetes.

Lower-limb amputation

For people with diabetes, high blood sugar levels can damage the nerves (peripheral neuropathy) and result in poor circulation (peripheral vascular disease) in the lower limbs, potentially causing ischemia, gangrene and impaired wound healing. These complications may lead to foot ulcers and infections, and in the most severe cases, amputations of the affected toes, foot and lower leg. Diabetes is the leading cause of non-traumatic lower-limb amputation.

In 2015–16, there were 5,000 lower-limb amputations provided in hospital to patients with a diagnosis of diabetes or peripheral vascular disease. Lower-limb amputations were more common in males (75%) and for those aged 65 and over (62%).

Note that hospitalisation data presented here provides counts on the total number of in-hospital episodes for amputations, but cannot calculate the number of individuals undergoing amputation, the number of repeat amputations, nor establish the link between the amputation and diabetes.