Goal 3: Reduce the occurrence of diabetes-related complications & improve quality of life

Goal 3 of the Strategy focusses on reducing the occurrence of complications and improving the quality of life of those living with diabetes.

Eighteen indicators were identified to measure progress against Goal 3:

Indicator 3.1 People with diabetes who achieve the target level for blood pressure

In 2011–12, an estimated 39% of Australian adults aged 18 and over with known diabetes achieved the target level for blood pressure (<130/80 mmHg). A person was considered to have known diabetes if they had ever been told by a doctor or nurse that they have diabetes and either they were taking diabetes medication or their blood test result for HbA1c was greater than or equal to the cut off point for diabetes (that is, greater than or equal to 6.5%). Of note, HbA1c levels generally reflect the average blood glucose over the past three months and provide an indication of effective diabetes management.

The proportion who met the blood pressure target decreased with age, from 55% in those aged 18 to 44 to 32% in those aged 75 and over (Figure 3.1.1).

In 2012–13, more than one third of Indigenous adults with known diabetes met the blood pressure target (Data tables).

Figure 3.1.1 People with diabetes who achieve the target level for blood pressure, by age group and sex, 2011–12

The vertical bar chart displays the proportion of adults with diabetes who achieved the target level for blood pressure, by age group and sex. Among males, the proportion who met the target was highest among those aged 18–44 years (54%25) and lowest among men aged 45–54 years where only 27%25 achieved the blood pressure target. Among females, the proportion who met the target decreased with age, from 55%25 among those aged 18–44 years to 31%25 among those aged 65–74 years.

Source: AIHW analysis of ABS 2014b. See data table ‘Indicator 3.1’ for data notes.

Indicator 3.2: People with diabetes who achieve target levels for cholesterol

In 2011–12, an estimated 38% of adults with known diabetes met the target level for total cholesterol (<4.0mmol/L). The age-standardised proportion of women who met the total cholesterol target was significantly higher than the proportion of men (60% and 25%, respectively) (Data tables). There was no evidence that the proportion who achieved the target level for total cholesterol varied by remoteness area or socioeconomic group. It should be noted that, when examining outcomes for subgroups of the population, the estimates obtained from the National Health Surveys are based on relatively small numbers. The lack of statistical significance does not necessarily mean that there is no difference between the estimates being compared.  It is possible that there is a difference but that the combination of the sample size achieved and the estimation method employed lacks the power to detect it.

In 2012–13, more than than one third of Indigenous adults met the target level for total cholesterol (37%) (Data tables). There was little difference between the age-standardised proportion of Indigenous men and women who met the target level (26% and 29%, respectively).

Figure 3.2.1 People with diabetes who achieve the target levels for cholesterol, by age group and sex, 2011–12

The vertical bar chart displays the proportion of adults with diabetes who achieved the target level for cholesterol, by age group and sex. The proportion was highest among females aged 18–44 years (85%25) and lowest among males aged 18–44 years (17%25).

Source: AIHW analysis of ABS 2014a. See data table ‘Indicator 3.2’ for data notes.

Indicator 3.3 People with diabetes who achieve the target level for HbA1c / Effective management of diabetes

In 2011–12, an estimated 55% of adults with known diabetes achieved the target level for HbA1c (≤7.0%). HbA1c levels reflect the average blood glucose over three months and provide an indicator of effective diabetes management. While the age-standardised proportion of men (49%) who met the HbA1c target was higher than that for women (40%), the difference was not statistically significant (Data tables).

The proportion who effectively managed their diabetes increased with age for both men and women (Figure 3.3.1). Overall, 40% of adults aged 18–54 effectively managed their diabetes and this proportion rose to 71% among those aged 75 and over. The proportion of people who effectively managed their diabetes did not vary significantly by remoteness area or socioeconomic group.

In 2012–13, 38% of Indigenous adults met the target level for HbA1c (Data tables).

Figure 3.3.1 People with diabetes who achieve the target level for HbA1c, by age group and sex, 2011–12

The vertical bar chart displays the proportion of adults with diabetes who achieved the target level for HbA1c by age group and sex. The proportion who achieved the target HbA1c level increased with increasing age. The proportion was lowest among females aged 18–54 years (31%25) and highest among females aged 75 years and older (81%25).

Source: AIHW analysis of ABS 2014a. See data table ‘Indicator 3.3’ for data notes.

Indicator 3.4 People with diabetes who had an HbA1c test in the last 12 months

In 2011–12, an estimated 78% of Australian adults with known diabetes reported that they had an HbA1c test within the previous 12 months. There were no significant differences between age groups, or by sex (Figure 3.4.1). There was little variation by socioeconomic group and remoteness area (Figure 3.4.2).

In 2012–13, 80% of Indigenous Australians with known diabetes had an HbA1c test in the past year (Data tables).

Figure 3.4.1 People with diabetes who had an HbA1c test in the last 12 months, by age group and sex, 2011–12

The vertical bar chart displays the proportion of adults with diabetes who had an HbA1c test in the past year by age group and sex. The proportion of adults who had an HbA1c test was 70%25 or higher among all age groups. The proportion peaked in males aged 65–74 years (87%25) and females aged 75 years and older (77%25).

Source: AIHW analysis of ABS 2014a. See data table ‘Indicator 3.4’ for data notes.

Indicator 3.5 Prevalence of treated end-stage kidney disease among people with diabetes

Among Australians aged 18 and over with self-reported diabetes, an estimated 8,900 people had treated end-stage kidney disease in 2015 (Data tables). Men had a higher prevalence rate than women (739 and 596 per 100,000 population, respectively) and, by age, the rate was highest among those aged 45–54 (909 per 100,000 population) (Figure 3.5.1).

After adjusting for age, the prevalence rate of treated end-stage kidney disease among Indigenous Australians was 3 times as high as that in all Australians (2,113 and 667 per 100,000 population, respectively) (Figure 3.5.2).

By remoteness area, the prevalence was lowest in Major cities and Inner regional areas (621 and 480 per 100,000 population, respectively) and highest in Outer regional/Remote areas (960 per 100,000 population) (Figure 3.5.2).

Caution:  this is a proxy measure based on the prevalence of self-reported diabetes from ABS 2014–15 National Health Survey and the prevalence of treated end-stage kidney disease from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA). This method is likely to underestimate the total population of people with diabetes as some people are unaware they have the condition. In 2012–13, the ABS identified that, for every four adult Australians with diabetes, there was one who was undiagnosed. Therefore, based on these estimates, one in five people with diabetes would not be identified in self-report data (ABS, 2013). This is likely to result in an overestimation of the prevalence of treated end-stage kidney disease among those with diabetes.   

Figure 3.5.1 Prevalence of treated end-stage kidney disease among people with diabetes, by age group and sex, 2015

The vertical bar chart shows the prevalence of treated end–stage kidney disease among adults with self–reported diabetes, as a number per 100,000 population, by age group and sex.  The prevalence was higher among men than women across all age groups. The prevalence peaked among males aged 45–54 years (1,065 per 100,000 population) and lowest among women aged 75 years and older (475 per 100,000 population)

Source: AIHW analysis of data from ANZDATA and ABS 2016a. See data table ‘Indicator 3.5’ for data notes.

Figure 3.5.2 Prevalence of treated end-stage kidney disease among people with diabetes, by population characteristics, 2015

The horizontal bar chart displays the age-standardised prevalence of treated end–stage kidney disease among adults with self–reported diabetes, as a number per 100,000 population, by remoteness area and Indigenous status.  The rate was substantially higher among Indigenous Australians (2,113 per 100,000 population) when compared with all Australians (667 per 100,000 population) and higher among those living in Outer regional and Remote areas compared to those in less remote areas.

Note:

  1. Age-standardised to the 2001 Australian population.

Source: AIHW analysis of data from ANZDATA, ABS 2016a & ABS 2015b. See data table ‘Indicator 3.5’ for data notes.

Indicator 3.6 Prevalence of vision loss caused by diabetes

In 2014–15, it was estimated that over 99,000 adults with self-reported diabetes reported that they had vision loss due to their diabetes, representing 10% of adults with self-reported diabetes. The prevalence of vision loss caused by diabetes was not significantly different among men and women after adjusting for age (Data tables). Among men, vision loss due to diabetes was highest in those aged 75 and over (15%), while in women it was highest in those aged 18–54 (15%) (Figure 3.6.1). There were no significant differences evident in the prevalence of vision loss due to diabetes by remoteness area or socioeconomic group (Figure 3.6.2). However, it is important to note that these estimates are based on relatively small numbers and are associated with large sampling error.

In 2012–13, almost one third of Indigenous Australian with known diabetes reported they had vision loss as a result of the disease. After adjusting for age, there was little difference in the prevalence between Indigenous men and women (31% and 33% respectively) (Data tables).

Figure 3.6.1 Prevalence of vision loss caused by diabetes, by age group and sex, 2014-15

The vertical bar chart shows the prevalence of vision loss caused by diabetes, by age group and sex. The proportion of females with diabetes related vision loss was greatest among those aged 18–54 years (15%25). Among men, it was highest among those aged 75 years and older (15%25).

Source: AIHW analysis of ABS 2016a. See data table ‘Indicator 3.6’ for data notes.

Figure 3.6.2 Prevalence of vision loss caused by diabetes, by population characteristics, 2014–15(1)

The horizontal bar chart displays the age-standardised percentage of adults with vision loss caused by diabetes, by Indigenous status, remoteness area and socioeconomic group. The proportion was more than twice as high among Indigenous Australians compared with All Australians (32%25 and 14%25 respectively). The proportion did not vary substantially by remoteness area of socioeconomic group.

Note:

  1. Indigenous results were estimated using data from the ABS Australian Aboriginal and Torres Strait Islander Health Survey, 2012–13
  2. Age-standardised to the 2001 Australian population.

Sources: AIHW analysis of ABS 2016a and ABS 2014c. See data table ‘Indicator 3.6’ for data notes.

Indicator 3.7 Prevalence of cardiovascular disease among people with diabetes

In 2014–15, an estimated 735,000 Australian adults with self-reported diabetes had cardiovascular disease (CVD), corresponding to 63% of adults with self-reported diabetes. Among those aged 18–74, the prevalence increased with age, peaking in those aged 65–74 (76%) (Figure 3.7.1). There was no significant differences by remoteness area or by socioeconomic status (Figure 3.7.2).

In 2012–13, 42% of Indigenous Australians with known diabetes reported that they had CVD. There was no significant difference in the age-standardised prevalence of CVD among Indigenous men and women with self-reported diabetes (Data tables).

Figure 3.7.1 Prevalence of cardiovascular disease among people with diabetes, by age group and sex, 2014–15

The vertical bar chart shows the prevalence of cardiovascular disease among adults with diabetes, by age group and sex. The proportion increased with age, peaking in females aged 65–74 years (73%25) and males aged 65 years and older (78%25).

Source: AIHW analysis of ABS 2016a. See data table ‘Indicator 3.7’ for data notes.

Figure 3.7.2 Prevalence of cardiovascular disease among people with diabetes, by population characteristics, 2014–15(2)

The horizontal bar chart displays the age-standardised prevalence of cardiovascular disease among adults with diabetes, by Indigenous status, remoteness area and socioeconomic group. The proportion was slightly higher among all Australians (47%25) when compared with Indigenous Australians (40%25) and lower among those living in Outer regional and remote areas when compared with those in less remote areas.

Notes:

  1. Age-standardised to the 2001 Australian population.
  2. Indigenous results were estimated using data from the ABS Australian Aboriginal and Torres Strait Islander Health Survey, 2012–13

Sources: AIHW analysis of ABS 2016a and ABS 2015a. See data table ‘Indicator 3.7’ for data notes.

Indicator 3.8 Diabetes hospitalisations by type of diabetes

Type 1 diabetes

In 2015–16, there were around 14,600 hospitalisations with a principal diagnosis of type 1 diabetes (Data tables). The age-standardised hospitalisation rates were similar between males and females (62 and 63 hospitalisations per 100,000 population, respectively), and age-specific rates peaked in those aged 15–24 (108 hospitalisations per 100,000 population, Figure 3.8.1).

The type 1 diabetes hospitalisation rate was almost twice as high among Aboriginal and Torres Strait Islander people compared with other Australians (Figure 3.8.2), and twice as high among those living in the most disadvantaged areas compared to those living in the least disadvantaged areas (82 and 40 hospitalisations per 100,000 population, respectively). There was some variation between states and territories with the highest hospitalisation rate in Tasmania (91 per 100,000 population, Figure 3.8.3).

Figure 3.8.1 Type 1 diabetes hospitalisations (principal diagnosis), by age group and sex, 2015–16

The vertical bar chart shows the rate of hospitalisations for type 1 diabetes as a principal diagnosis, by age group and sex. The rate of hospitalisations peaked among those aged 15–24 years in both males (96 per 100,000 population) and females (120 per 100,000 population).

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.8’ for data notes.

Figure 3.8.2 Hospitalisations for type 1 diabetes (principal diagnosis), by population characteristics, 2015–16

The horizontal bar chart displays the age-standardised rate of hospitalisations for type 1 diabetes, as a principal diagnosis, by Indigenous status, remoteness area and socioeconomic status. The rate was almost twice as high among Indigenous Australians (116 per 100,000 population) when compared with non-Indigenous Australians (60 per 100,000 population), and decreased with decreasing levels of disadvantage.  The hospitalisation rate was lower among those living in Major cities when compared with those living in other areas.

Note:

  1. Age-standardised to the 2001 Australian Population.

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.8’ for data notes.

Figure 3.8.3 Hospitalisations for type 1 diabetes (principal diagnosis), by state and territory, 2015–16

The vertical bar chart shows the age-standardised rate of hospitalisations for type 1 diabetes as a principal diagnosis, by state and territory. The rate was highest among those living in Tasmania (91 per 100,000 population) and lowest in the Australian Capital Territory (49 per 100,000 population).

Note:

  1. Age-standardised to the 2001 Australian Population.

Source: AIHW National Hospital Morbidity Database.

Type 2 diabetes

In 2015–16, there were around 31,700 hospitalisations with a principal diagnosis of type 2 diabetes (Data tables). The age-standardised hospitalisation rate was more than twice as high among males as females (159 and 78 hospitalisations per 100,000 population, respectively). The rate increased with age, reaching a peak in those aged 85 and over (703 per 100,000 population, Figure 3.8.4).

The hospitalisation rate was 5 times as high among Indigenous Australians as non-Indigenous Australians. The disparity was greater for females than males, with Indigenous females 7 times as likely to be hospitalised with a principal diagnosis of type 2 diabetes than non-Indigenous females. Indigenous males were 4 times as likely to be hospitalised as non-Indigenous males (514 compared with 70 per 100,000 population for females, respectively, and 576 compared with 146 per 100,000 for males, respectively).

The type 2 diabetes hospitalisation rate was twice as high among those living in the most disadvantaged areas compared to those living in the least advantaged areas (Figure 3.8.5), and 2.5 times as high among those living in Remote and Very remote areas compared to those living in Major cities. Rates varied by state and territory, with the Australian Capital Territory having the lowest rate (80 per 100,000 population) and the Northern Territory having the highest (254 per 100,000 population, Figure 3.8.6).

Figure 3.8.4 Hospitalisations for type 2 diabetes (principal diagnosis), by age group and sex, 2015–16

The vertical bar chart shows the rate of hospitalisations for type 2 diabetes as a principal diagnosis, by age group and sex. The rate of hospitalisations was higher among males than females and increased with increasing age. Among those aged 85 years and older, the rate of hospitalisations was 1,081 per 100,000 population among males and 483 per 100,000 population in females.

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.8’ for data notes.

Figure 3.8.5 Hospitalisations for type 2 diabetes (principal diagnosis), by population characteristics, 2015–16

The horizontal bar chart displays the age-standardised rate of hospitalisations for type 2 diabetes, as a principal diagnosis, by Indigenous status, remoteness area and socioeconomic group. The rate was over 5 times as high among Indigenous Australians (543 per 100,000 population) when compared with non-Indigenous Australians (106 per 100,000 population). The rate was substantially higher among those living in Remote and Very Remote areas when compared to those living in other areas.

Note:

  1. Age-standardised to the 2001 Australian Population.

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.8’ for data notes.

Figure 3.8.6 Hospitalisations for type 2 diabetes (principal diagnosis), by state and territory, 2015–16

The vertical bar chart shows the age standardised rate of hospitalisations for type 2 diabetes as a principal diagnosis, by state and territory. The rate was highest among those living in the Northern Territory (254 per 100,000 population) and lowest in the Australian Capital Territory (80 per 100,000 population).

Note:

  1. Age-standardised to the 2001 Australian Population. See data table ‘Indicator 3.8’ for data notes.

Source: AIHW National Hospital Morbidity Database.

Diabetes during pregnancy

In 2015–16, there were around 2,900 hospitalisations with a principal diagnosis of diabetes during pregnancy (Data tables). The hospitalisation rate reached a peak in those aged 30–34 (107 per 100,000 women) and then fell in older age groups (Figure 3.8.7).

The hospitalisation rate was over 6 times as high among Indigenous women as non-Indigenous women (207 and 32 per 100,000 women respectively). Hospitalisation rates for diabetes during pregnancy increased with increasing socioeconomic disadvantage and remoteness (Figure 3.8.8).

Figure 3.8.7 Hospitalisations for diabetes during pregnancy (principal diagnosis), by age group, 2015–16

The vertical bar chart shows the rate of hospitalisations for diabetes during pregnancy, as a principal diagnosis, among women aged 10–54 years, by age group. The rate of hospitalisations was peaked among women aged 30–34 years (107 per 100,000 population).

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.8’ for data notes.

Figure 3.8.8 Hospitalisations for diabetes during pregnancy (principal diagnosis), by population characteristics, 2015–16

The horizontal bar chart displays the age-standardised rate of hospitalisations for diabetes during pregnancy, as a principal diagnosis, by Indigenous status, remoteness area and socioeconomic group. The rate was over 6 times as high among Indigenous women (207 per 100,000 women) when compared with non-Indigenous women (32 per 100,000 women). The rate was substantially higher among those living in Remote and Very Remote areas when compared to those living in less remote areas, and those living in the most disadvantaged areas when compared with those in less disadvantaged areas.

Notes:

  1. Age-standardised to the 2001 Australian Female Population (10–54 years).

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.8’ for data notes.

Indicator 3.9 Hospitalisation for end-stage renal disease as the principal diagnosis with diabetes as an additional diagnosis

In 2015–16, there were approximately 2,700 hospitalisations with a principal diagnosis of end-stage renal disease and an additional diagnosis of diabetes (Data tables). The hospitalisation rate was higher in males than females (13 and 8 hospitalisations per 100,000 population, respectively).

The hospitalisation rate was over 15 times as high among Aboriginal and Torres Strait Islander people as non-Indigenous Australians. The disparity between the Indigenous and non-Indigenous rates was greater among females (23 times as high) than males (11 times as high).

The hospitalisation rates were substantially higher among those living in Remote and Very remote areas, and in the most disadvantaged areas of Australia, when compared to those living in other areas (Figure 3.9.2). This, in part, reflects the higher proportion of Indigenous Australians living in Remote and Very remote and disadvantaged areas of Australia.

Figure 3.9.1 Hospitalisations for end-stage renal disease (principal diagnosis) with diabetes as an additional diagnosis, by age group and sex, 2015–16

The vertical bar chart shows the rate of hospitalisations for end–stage renal disease as a principal diagnosis, with diabetes as an additional diagnosis, by age group and sex. The rate of hospitalisations was higher among males than females in all age groups, and peaked among males (69 per 100,000 population) and females (37 per 100,000 population) aged 75–84 years.

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.9’ for data notes.

Figure 3.9.2 Hospitalisations for end-stage renal disease (principal diagnosis) with diabetes as an additional diagnosis, by population characteristics, 2015–16

The horizontal bar chart displays the age-standardised rate of hospitalisations for end-stage renal disease as a principal diagnosis, with diabetes as an additional diagnosis, by Indigenous status, remoteness area and socioeconomic group. The rate was over 15 times as high among Indigenous Australians (122 per 100,000 population) when compared with non-Indigenous Australians (8 per 100,000 population). The rate was substantially higher among those living in Remote and Very Remote areas when compared to those living in less remote areas, and those living in the most disadvantaged areas when compared with those in less disadvantaged areas.

Notes:

  1. Age-standardised to the 2001 Australian Population.

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.9’ for data notes.

Indicator 3.10 Hospitalisation for coronary heart disease or stroke as the principal diagnosis with diabetes as an additional diagnosis

In 2015–16, there were almost 60,000 hospitalisations with a principal diagnosis of coronary heart disease (CHD) or stroke and an additional diagnosis of diabetes (Data tables). The rate was over twice as high among males as females (301 and 130 hospitalisations per 100,000 population, respectively). This finding was consistent across all age groups (Figure 3.10.1).

The hospitalisation rate for a principal diagnosis of CHD or stroke with an additional diagnosis of diabetes was substantially higher in Aboriginal and Torres Strait Islander people when compared to non-Indigenous Australians (Figure 3.10.2). The rate was almost 7 times as high in Indigenous females compared with non-Indigenous females, and 3 times as high in Indigenous males compared to non-Indigenous males.

Rates were higher among those living in Remote and Very remote areas than those living in other remoteness areas, and increased with increasing socioeconomic disadvantage (Figure 3.10.2).

Figure 3.10.1. Hospitalisations for coronary heart disease or stroke (principal diagnosis) with diabetes as an additional diagnosis, by age group and sex, 2015–16

The vertical bar chart displays the rate of hospitalisations for coronary heart disease or stroke as a principal diagnosis, with diabetes as an additional diagnosis, by age group and sex. The rate increased with increasing age, and was consistently higher among males than females. The rate peaked among males aged 75–84 years (2,020 per 100,000 population). Among females, it was highest among those aged 85 years and older (972 per 100,000 population).

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.10’ for data notes.

Figure 3.10.2. Hospitalisations for coronary heart disease or stroke (principal diagnosis) with diabetes as an additional diagnosis, by population characteristics, 2015–16

The horizontal bar chart displays the age-standardised rate of hospitalisations for coronary heart disease or stroke as a principal diagnosis, with diabetes as an additional diagnosis, by Indigenous status, remoteness area and socioeconomic status. The rate was substantially higher among Indigenous Australians (820 per 100,000 population) compared with non-Indigenous Australians (194 per 100,000 population). The hospitalisation rate increased with increasing remoteness and levels of socioeconomic disadvantage.

Notes:

  1. Age-standardised to the 2001 Australian Population.

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.10’ for data notes.

Indicator 3.11 Hospitalisation for ophthalmic conditions with type 2 diabetes as a principal diagnosis

In 2015–16, there were around 2,550 hospitalisations for ophthalmic conditions (e.g. diabetic retinopathy) with type 2 diabetes as a principal diagnosis (Data tables). The hospitalisation rate increased to age 75–84 and was consistently higher in males than females (Figure 3.11.1).

The rate of hospitalisations for type 2 diabetes related ophthalmic conditions was twice as high among Indigenous Australians compared with non-Indigenous Australians. There was no consistent difference by remoteness area or level of socioeconomic disadvantage (Figure 3.11.2).

Figure 3.11.1: Hospitalisations for ophthalmic conditions with type 2 diabetes as a principal diagnosis, by age group and sex, 2015–16

The vertical bar chart displays the rate of hospitalisations for ophthalmic conditions with type 2 diabetes as a principal diagnosis, by age group and sex. The rate increased with increasing age, and was consistently higher among males than females. The rate peaked in the 75–84 year age group for both males (56 per 100,000 population) and females (45 per 100,000 population).

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.11’ for data notes.

Figure 3.11.2: Hospitalisations for ophthalmic conditions with type 2 diabetes as a principal diagnosis, by population characteristics, 2015–16

The horizontal bar chart displays the age-standardised rate of hospitalisations for ophthalmic conditions with type 2 diabetes as a principal diagnosis, by Indigenous status, remoteness area and socioeconomic status. The rate was almost 2 times as high among Indigenous Australians (17 per 100,000 population) when compared with non-Indigenous Australians (9 per 100,000 population). There was no consistent difference in the rate of hospitalisations between remoteness areas or by socioeconomic status.

Notes:

  1. Age-standardised to the 2001 Australian Population.

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.11’ for data notes.

Indicator 3.12 Hospitalisation for lower limb amputation with type 2 diabetes as a principal or additional diagnosis

In 2015–16, there were almost 4,800 hospitalisations where a lower limb amputation was performed with type 2 diabetes as a principal or additional diagnosis (Data tables). The rate was almost 4 times as high in males as females (28 and 8 hospitalisations per 100,000 population, respectively). This was consistent across age groups (Figure 3.12.1)

Indigenous Australians had a higher rate of hospitalisations for lower limb amputation with type 2 diabetes as a principal or additional diagnosis compared with non-Indigenous Australians (Figure 3.12.2). The rate was 11 times as high in Indigenous females and 5 times as high among Indigenous males when compared to their non-Indigenous counterparts.

The rate increased with increasing remoteness, and was 3 times as high among those living in Remote and Very remote areas compared to those living in Major cities. Hospitalisation rates also increased with increasing level of socioeconomic disadvantage. The rate was 2.6 times as high among those living in the most disadvantaged areas compared with those living in the most advantaged areas (Figure 3.12.2)

Figure 3.12.1: Hospitalisations for lower limb amputation with type 2 diabetes as a principal or additional diagnosis, by age group and sex, 2015–16

The vertical bar chart displays the rate of hospitalisations for lower limb amputation with type 2 diabetes as a principal or additional diagnosis, by age group and sex. The rate increased with age, and was substantially higher among males than females. The rate peaked in the 75–84 year age group among males (169 per 100,000 population) and among females aged 85 years and above (47 per 100,000 population).

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.12’ for data notes.

Figure 3.12.2: Hospitalisations for lower limb amputation with type 2 diabetes as a principal or additional diagnosis, by population characteristics, 2015–16

The horizontal bar chart displays the age-standardised rate of hospitalisations for lower limb amputation with type 2 diabetes as a principal or additional diagnosis, by Indigenous status, remoteness area and socioeconomic status. The rate was substantially higher among Indigenous Australians (99 per 100,000 population) when compared with non-Indigenous Australians (16 per 100,000 population). The hospitalisation rate increased with increasing levels of remoteness and socioeconomic disadvantage.

Notes:

  1. Age-standardised to the 2001 Australian Population.

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.12’ for data notes.

Indicator 3.13 Hospitalisation for other complications with type 2 diabetes as a principal diagnosis

In 2015–16, there were around 27,900 hospitalisations for other complications (e.g. kidney or circulatory complications) with type 2 diabetes as a principal diagnosis (Data tables). The hospitalisation rate was twice as high in males as females (142 and 67 per 100,000 population, respectively).

The rate among Indigenous Australians was over 5 times as high as that of non-Indigenous Australians. The disparity in rates between the Indigenous and non-Indigenous populations was greater in females than males (8 and 4 times as high compared to their non-Indigenous counterparts, respectively).

Rates increased with increasing remoteness and socioeconomic disadvantage (Figure 3.13.2). The rate was highest in  the Northern Territory (246 per 100,000 population) and lowest in the Australian Capital Territory (68 per 100,000 population, Figure 3.13.3).

Figure 3.13.1: Hospitalisation for complications with type 2 diabetes as a principal diagnosis, age group and sex, 2015–16

The vertical bar chart displays the rate of ‘other’ hospitalisations with type 2 diabetes as a principal diagnosis, by age group and sex. The rate increased with age, and was substantially higher among males than females. The rate peaked in those aged 85 years and above for both males (1,019 per 100,000 population) females (434 per 100,000 population).

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.13’ for data notes.

Figure 3.13.2: Hospitalisation for complications with type 2 diabetes as a principal diagnosis, by population characteristics, 2015–16

The horizontal bar chart displays the age-standardised rate of ‘other’ hospitalisations with type 2 diabetes as a principal diagnosis, by Indigenous status, remoteness area and socioeconomic status. The rate increased with age, and was substantially higher among males than females. The rate was more than 5 times as high among Indigenous Australians (510 per 100,000 population) when compared with non-Indigenous Australians (93 per 100,000 population). The rate of hospitalisations increased with increasing levels of remoteness and socioeconomic disadvantage.

Note:

  1. Age-standardised to the 2001 Australian Population.

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 3.13’ for data notes.

Figure 3.13.3: Hospitalisation for complications with type 2 diabetes as a principal diagnosis, by state and territory, 2015–16

The vertical bar chart displays the age-standardised rate of ‘other’ hospitalisations with type 2 diabetes as a principal diagnosis, by state and territory. The rate was substantially higher among those in living in the Northern Territory (246 per 100,000 population) and lowest among those living in the Australian Capital Territory (68 per 100,000 population).

Notes:

  1. Age-standardised to the 2001 Australian Population. See data table ‘Indicator 3.13’ for data notes.

Source: AIHW National Hospital Morbidity Database

Indicator 3.14 Deaths from diabetes

Between 2014 and 2016, there were around 48,600 deaths due to diabetes (underlying and/or associated cause) (Data tables). The diabetes-related death rate increased with age for both males and females (Figure 3.14.1). Overall, the rate was 1.6 times as high in males as females (71 and 44 deaths per 100,000 population, respectively). The diabetes-related death rate among Indigenous Australians was 4 times as high as that for non-Indigenous Australians (225 and 54 deaths per 100,000 population respectively) (Figure 3.14.2).

The death rate due to diabetes increased with increasing levels of remoteness and socioeconomic disadvantage. The rate was 1.8 times as high among those living in Remote and Very remote areas as those living in Major cities and 2.1 times as high among those living in the most disadvantaged areas than those living in the least disadvantaged areas of Australia (Figure 3.14.2).

Figure 3.14.1 Deaths from diabetes, by age group and sex, 2014–2016

The vertical bar chart displays the death rate from diabetes by age group and sex. The rate increased across age groups and was consistently higher among males than females within each age group. The rate was highest among those in those aged 85 years and older for both males (1,513 per 100,000 population) and females (1,153 per 100,000 population).

Source: AIHW analysis of National Mortality Database. See data table ‘Indicator 3.14’ for data notes.

Figure 3.14.2 Deaths from diabetes, by population characteristics, 2014–2016

The horizontal bar chart displays the age-standardised death rate from diabetes by Indigenous status, remoteness area and socioeconomic status. The rate increased with increasing remoteness and level of socioeconomic disadvantage. The number of deaths per 100,000 people were substantially higher among Indigenous Australians (225 per 100,000 population) compared with non-Indigenous Australians (54 per 100,000 population).

Notes:

  1. Indigenous comparison includes data for 5 jurisdictions—New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. Other jurisdictions have a small number of Indigenous deaths, and identification of Indigenous deaths in their death registration systems is relatively poor, making the data less reliable.
  2. Age-standardised to the 2001 Australian Population.

Source: AIHW analysis of National Mortality Database. See data table ‘Indicator 3.14’ for data notes.

Figure 3.14.3 Deaths from diabetes, by state and territory, 2014–2016

The vertical bar chart displays the age-standardised death rate from diabetes by state and territory. The rate was highest among those living in the Northern Territory (126 per 100,000 population) and lowest in Western Australia (37 per 100,000 population).

Notes:

  1. Age-standardised to the 2001 Australian Population.

Source: AIHW analysis of National Mortality Database. See data table ‘Indicator 1.2’ for data notes.

Indicator 3.15 Death rates for coronary heart disease and stroke among people with diabetes

In 2014, the death rate for coronary heart disease (CHD) and stroke among males with type 1 or type 2 diabetes was 1.5 times as high as the rate among their female counterparts (394 and 260 deaths per 100,000 population, respectively) (Data tables). The death rate increased with age and was consistently higher in males than females in each age group (Figure 3.15.1).

The rate increased with increasing remoteness and socioeconomic disadvantage. The death rate was 1.7 times as high among those living in Remote and Very remote areas as those living in Major cities, and 1.4 times as high among those living in the most disadvantaged areas as those in the least disadvantaged areas of Australia (Figure 3.15.2).

Figure 3.15.1 Death rates for CHD and stroke among people with type 1 or type 2 diabetes, by age group and sex, 2014

The vertical bar chart displays the death rate for coronary heart disease and stroke among people with type 1 or type 2 diabetes, by age group and sex.  The death rate increased with increasing age and was consistently higher among males than females. The rate peaked in those aged 85 years and above for both males (6,430 per 100,000 population) and females (5,675 per 100,000 population).

Source: AIHW analysis of the NDSS-NDI linked data and the AIHW National Mortality Database. See data table ‘Indicator 3.15’ for data notes.

Figure 3.15.2 Death rates for CHD and stroke among people with type 1 or type 2 diabetes, by population characteristics, 2014

The horizontal bar chart displays the age-standardised death rate for coronary heart disease and stroke among people with type 1 or type 2 diabetes, by remoteness area and socioeconomic status.  The death rate increased with remoteness and levels of socioeconomic disadvantage.

Notes:

  1. Age-standardised to the 2001 Australian Population.

Source: AIHW analysis of the NDSS-NDI linked data and the AIHW National Mortality Database. See data table ‘Indicator 3.15’ for data notes.

Indicator 3.16 People with diabetes who achieve the target level for weight / Body Mass Index (BMI)

In 2014–15, 13% of adults with self-reported diabetes met the target level for weight (BMI≤25). The proportion of adults with diabetes who met the target for weight was lowest among those aged 45–54 (8%) and highest among those aged 75 and over (21%) (Figure 3.16.1). There were no significant differences by socioeconomic group or by remoteness area (Data tables).

In 2012–13, 11% of Indigenous adults with known diabetes met the target for body weight. There was no significant difference in the proportion meeting the target for weight between Indigenous men and women (Data tables).

Figure 3.16.1 People with diabetes who achieve the target level for weight, by age group and sex, 2014–15

The vertical bar chart displays the percentage of people with diabetes who achieve the target level of weight, by age group and sex. The proportion was lowest among men aged 45-54 (3%25) and women aged 55-64 (8%25).

Source: AIHW analysis of ABS 2016a. See data table ‘Indicator 3.16’ for data notes.

Indicator 3.17 People with diabetes who have attended a diabetes educator

In 2014–15, 24% of adults with self-reported diabetes had attended a diabetes educator in the past 12 months. The proportion was highest among men aged 18–44 (33%) and women aged 45–54 (39%) (Figure 3.17.1).

The proportion of adults with self-reported diabetes who attended a diabetes educator was lower in Major cities (20%) and Inner regional areas (26%) than Outer regional/Remote areas (38%) but the difference was only significant between Major cities and Outer regional/Remote areas (Figure 3.17.2). There were no significant differences by socioeconomic group.

Figure 3.17.1 People with diabetes who attended a diabetes educator, by age group and sex, 2014–15

The vertical bar chart displays the percentage of people with diabetes who attended a diabetes educator, by age group and sex. The proportion was highest among males aged 18–44 years (33%25) and among females aged 45–54 years (39%25)

Source: AIHW analysis of ABS 2016a. See data table ‘Indicator 3.17’ for data notes.

Figure 3.17.2 People with diabetes who attended a diabetes educator, by population characteristics, 2014–15

The horizontal bar chart displays the percentage of people with diabetes who attended a diabetes educator, by remoteness area and socioeconomic status. The proportion was highest among those living in Outer Regional and Remote areas (38%25) and lowest among those in Major cities (20%25). The proportion who attended a diabetes educator declined with decreasing levels of socioeconomic disadvantage.

Source: AIHW analysis of ABS 2016a. See data table ‘Indicator 3.17’ for data notes.

Indicator 3.18 Quality of life of people with diabetes

We currently lack reliable national data relating to quality of life among people living with diabetes. While the Australian Diabetes, Obesity and Lifestyle Study collected information about quality of life, these data are now 18 years old. Further, recent National Survey data have not included specific quality of life questions, but rather broad general health questions. Additional data development is required to populate this indicator.