Indicator 5.1 Hospitalisation for diabetes by type of diabetes

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5.1.1 Type 1 diabetes

5.1.2 Type 2 diabetes

5.1.3 Diabetes during pregnancy

Considerations

Symptoms of type 1 and type 2 diabetes are similar, particularly in young adults, and the diagnosed diabetes type, and subsequently coded diabetes type, are not always correct (Stone et al. 2010).

5.1.1 Type 1 diabetes

Overview

In 2017–18, there were around 3,000 hospitalisations with a principal and/or additional diagnosis of type 1 diabetes among Indigenous Australians—361 hospitalisations per 100,000 population.

Trends

Between 2015–16 and 2017–18, the age-standardised rate of hospitalisations for type 1 diabetes in this cohort increased from 362 to 446 hospitalisations per 100,000 population (Figure 5.1.1.1).

Age and sex

In 2017–18, the age-standardised hospitalisation rate was higher among Indigenous males than females (525 and 381 hospitalisations per 100,000 population, respectively). Age-specific hospitalisation rates peaked in those aged 55–64 (905 hospitalisations per 100,000 population) (Figure 5.1.1.1).

Population groups

Hospitalisation rates for type 1 diabetes as a principal and/or additional diagnosis among Indigenous Australians in 2017–18 were around 3 times as high among Indigenous Australians living in Major cities and Regional areas as those living in Remote and very remote areas (482, 528 and 175 hospitalisations per 100,000 population, respectively).

State and territory

Among the states and territories, rates were highest in Victoria (575 per 100,000 population) and lowest in the Northern Territory (147 per 100,000 population). Other states had rates ranging from 322 to 562 per 100,000 population (Figure 5.1.1.2).

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5.1.1 Hospitalisation for type 1 diabetes among Indigenous Australians, by diagnosis type, age and sex, 2015–16 to 2017–18 and by selected population groups, 2017–18

Trends figure 5.1.1.1 shows hospitalisation rates for type 1 diabetes as a principal and/or additional diagnosis among Indigenous Australians increased from 362 to 446 per 100,000 between 2015–16 and 2017–18. Rates increased with age for both males and females being 3 times higher among those aged 55–64 compared to those aged 15–24 (905 and 302 per 100,000, respectively). Rates were higher among females in the younger age groups and higher among males from age 55 and over. As a principal diagnosis, type 1 diabetes hospitalisation rates increased from 109 to 126 per 100,000 between 2015–16 and 2017–18 with similar trends among males and females overall. Hospitalisation rates for type 1 diabetes as a principal diagnosis were 3.5 times as high among those aged 15–24 as those aged 65+ (186 and 53 per 100,000, respectively). Whilst rates among females were higher in the younger age groups, rates for males were higher from age 45 and over. 

Population group figure 5.1.1.2 shows the variation in hospitalisation rates for type 1 diabetes among Indigenous Australians by selected population group in 2017–18. As a principal and/or additional diagnosis, rates increased with age and peaked among males aged 55–64. Rates were higher in Major cities and Regional areas (482 and 528 per 100,000, respectively) than Remote and very remote areas (175 per 100,000 population). Rates varied among the states and territories from 147 per 100,000 in the Northern Territory to 575 per 100,000 in Victoria.

Hospitalisation rates for type 1 diabetes as a principal diagnosis were higher among younger age groups, peaking among females aged 35–44. Rates were higher in Major cities and Regional areas (129 and 142 per 100,000, respectively) than Remote and very remote areas (72 per 100,000 population). Rates varied among the states and territories from 51 per 100,000 in Western Australia to 355 per 100,000 in the Australian Capital Territory.

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Indicator 5.1.1 data specifications

 

Definition

Data source

Numerator

Number of hospital separations (principal, additional and principal and/or additional diagnosis) for type 1 diabetes (ICD-10-AM: E10) among Indigenous Australians.

AIHW National Hospital Morbidity Database (NHMD)

Denominator

Estimated Indigenous Australian resident population

AIHW Population Database (sourced from ABS Estimates and Projections, Aboriginal and Torres Strait Islander Australians)

5.1.2 Type 2 diabetes

Overview

In 2017–18, there were around 69,200 hospitalisations with a principal and/or additional diagnosis of type 2 diabetes among Indigenous Australians—8,400 hospitalisations per 100,000 population.

Trends

Between 2015–16 and 2017–18, the age-standardised rate of hospitalisations increased from 12,100 to 14,300 hospitalisations per 100,000 population.

Age and sex

In 2017–18, after adjusting for age, the hospitalisation rate was higher among Indigenous females compared to Indigenous males (15,500 and 13,100 per 100,000 population, respectively) (Figure 5.1.2.1). Type 2 diabetes hospitalisation rates increased with age, peaking in those aged 65 and over (45,800 hospitalisations per 100,000 population) Figure 3.8.1.1).

Population groups

Hospitalisations for type 2 diabetes in 2017–18 were 3.3 times as high among Indigenous Australians living in Remote and Very remote areas as those living in Major cities (30,800 compared with 9,200 per 100,000 population).

State and territory

In 2017–18, rates were highest in Western Australia (35,000 per 100,000 population) and lowest in Tasmania (4,100 per 100,000 population). Other states had rates ranging from 6,200 to 21,800 per 100,000 population (Figure 5.1.2.2).

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5.1.2 Hospitalisation for type 2 diabetes among Indigenous Australians, by diagnosis type, age and sex, 2015–16 to 2017–18 and by selected population groups, 2017–18

Trends figure 5.1.2.1 shows hospitalisation rates for type 2 diabetes as a principal and/or additional diagnosis among Indigenous Australians increased from around 12,100 to 14,300 per 100,000 between 2015–16 and 2017–18. Rates increased with age for both males and females, and were almost 300 times higher among those aged 65 and over compared to those aged 0–24 (around 45,800 and 155 per 100,000, respectively). As a principal diagnosis, type 2 diabetes hospitalisation rates remained steady between 2015–16 and 2017–18 (from 487 to 510 per 100,000 population, respectively). Rates were higher among females in the younger age groups and higher among males from 35 years and over.

Population group figure 5.1.2.2 shows hospitalisation rates for type 2 diabetes as a principal and/or additional diagnosis increased with age and peaked among females aged 65+. Rates were more than 3 times higher in Remote and very remote areas as Major cities (30,800 and 9,200 per 100,000, respectively). Rates varied among the states and territories from 4,100 per 100,000 in Tasmania to 35,000 in Western Australia.

Hospitalisation rates for type 2 diabetes as a principal diagnosis were higher among older age groups, peaking among males aged 65+. Rates were 2.3 times higher in Remote and very remote areas as Major cities (836 and 360 per 100,000). Rates varied among the states and territories from 353 per 100,000 in Tasmania to 748 per 100,000 in Western Australia.

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Indicator 5.1.2 data specifications

 

Definition

Data source

Numerator

Number of hospital separations (principal, additional and principal and/or additional diagnosis) for type 2 diabetes (ICD-10-AM: E11) among Indigenous Australians.

AIHW NHMD

Denominator

Estimated Australian Indigenous resident population

AIHW Population Database (sourced from ABS Estimates and Projections, Aboriginal and Torres Strait Islander Australians)

5.1.3 Diabetes during pregnancy

Overview

In 2017–18, there were almost 3,800 hospitalisations with a principal and/or additional diagnosis of diabetes during pregnancy (pre-existing and gestational diabetes), equating to a rate of 24,800 per 100,000 Indigenous females aged 10–44.

Trends

Between 2015–16 and 2016–17, the age-standardised rate of hospitalisations increased slightly from 26,600 to 28,700 hospitalisations per 100,000 females, before decreasing to 26,900 per 100,000 females (Figure 5.1.3.1). 

Age

The hospitalisation rates for diabetes during pregnancy as a principal and/or additional diagnosis were highest among Indigenous women aged 35–39 (50,100 per 100,000 females) (Figure 5.1.3.1).

Population groups

Hospitalisation rates increased substantially along with the level of remoteness. The rate was over 2 times as high among those living in Remote and very remote areas (44,100 per 100,000 females) as those living in Major cities (20,600 per 100,000 females).

State and territory

Rates were highest in the Northern Territory (42,300 per 100,000 population) and lowest in Tasmania (15,500 per 100,000 population). Other states had rates ranging from 16,100 to 31,300 per 100,000 population (Figure 5.1.3.2).

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5.1.3 Hospitalisation for diabetes during pregnancy among Indigenous females, by diagnosis type and age, 2015–16 to 2017–18 and by selected population groups, 2017–18

Trends figure 5.1.3.1 shows the steady trend in hospitalisations for diabetes during pregnancy as a principal and/or additional diagnosis among Indigenous mothers mothers aged 10–44 years between 2015–16 and 2017–18 (from around 26,600 to 26,900 per 100,000 population, respectively). Rates were higher among older age groups with varying trends during the three year period.

Hospitalisation rates for diabetes during pregnancy as a principal diagnosis increased slightly from 4,200 to 4,400 per 100,000 population between 2015–16 and 2017–18. Rates were higher in the older age groups with notable increases during this period in the 20–24 and 35–39 age groups.

Population group figure 5.1.3.2 shows the hospitalisation rates for diabetes during pregnancy as a principal and/or additional diagnosis among Indigenous mothers increased with age, peaking in the 35–39 age group with around 50,100 per 100,000 population. Rates were twice as high among those living in Remote and very remote areas as Major cities (44,100 and 20,600 per 100,000, respectively). Rates per 100,000 varied among the states and territories from 15,500 in Tasmania to 42,300 in the Northern Territory. Hospitalisation rates for diabetes during pregnancy as a principal diagnosis followed a similar pattern for age and remoteness as the rates for principal and/or additional diagnosis. Rates per 100,000 population varied among the states and territories from around 1,700 in New South Wales to 12,600 in the Northern Territory. Rates for Victoria, Tasmania and the Australian Capital Territory were not included due to small numbers.

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Indicator 5.1.3 data specifications

 

Definition

Data source

Numerator

Number of hospital separations (principal, additional and principal and/or additional diagnosis) for diabetes during pregnancy (ICD-10-AM: O24) among Indigenous Australians.

AIHW NHMD

Denominator

Number of hospitalisations for pregnancy outcomes (ICD-10 AM: Z37, O03 O04, O05, O06, O80, O81, O82, O83, O84, P95 and P964) for Indigenous Australians.

AIHW NHMD

Reference

Stone MA, Camosso‐Stefinovic J, Wilkinson J, Lusignan SD, Hattersley AT & Khunti K 2010. Incorrect and incomplete coding and classification of diabetes: a systematic review. Diabetic Medicine 27:491–7.