Diabetes: Australian facts

The AIHW Disease Expenditure Database provides a broad picture of the use of health system resources classified by disease groups and conditions.

It contains estimates of expenditure by the Australian Burden of Disease Study diseases and injuries, age group, and sex for admitted patient, emergency department and outpatient hospital services, out-of-hospital medical services, and prescription pharmaceuticals.

It does not allocate all expenditure on health goods and services by disease – for example, neither administration expenditure nor capital expenditure can be meaningfully attributed to any particular condition due to their nature.

For more information see Health system spending on disease and injury in Australia 2020–21.

The Australian Burden of Disease Study undertaken by the AIHW provides information on the burden of disease for the Australian population. Burden of disease analysis measures the impact of fatal (years of life lost, YLL) and non-fatal burden (years lived with disability, YLD), with the sum of non-fatal and fatal burden equating to the total burden (disability-adjusted life year, DALY).

The Australian Burden of Disease Study 2023 includes national estimates for 220 diseases and injuries including estimates of burden for COVID‑19 in 2023 based on projections using historical trends in data. The ABDS 2023 is different to the 2003, 2011, 2015 and 2018 studies in that estimates have been produced for the current year (2023). It builds on work from the ABDS 2022, which was the first study where burden was estimated for the year of release (2022). This Study provides burden of disease estimates best matched to the public health context for the Australian population for 2023. 

General methods for estimation of burden of disease can be found in Australian Burden of Disease Study: methods and supplementary material 2018 (AIHW 2021a). This includes descriptions for years of life lost (YLL), years lived with disability (YLD), disability-adjusted life years (DALY) and health-adjusted life expectancy (HALE).

For further information see Burden of disease.

The Australian National Diabetes Audit - Australian Quality Clinical Audit (ANDA–AQCA) is an annual diabetes audit open to all services providing diabetes services across Australia, from primary to tertiary care centres.

ANDA–AQCA provides an overview of the clinical status of people with diabetes attending services for diabetes care.

The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered by Diabetes Australia. People with a diagnosis of diabetes by a health professional can register with the scheme. Once registered, they can access diabetes self-management information, services, and subsidised products – such as pens and needles to administer insulin, blood glucose test strips, insulin pump consumables, and continuous glucose monitoring products.

The Australasian Paediatric Endocrine Group (APEG) is a professional body that represents health professionals involved in managing and researching disorders of the endocrine system, including diabetes in children and adolescents. The APEG maintains clinic-based state and territory diabetes registers of children.

The AIHW holds information derived through the linkage of the NDSS and APEG datasets on the broader population of people living with type 1 diabetes, type 2 diabetes, gestational diabetes and other less common forms of diabetes. Unlike the NDR, this broader dataset contains information about all people with diabetes and not just those taking insulin for their diabetes. The data contained in this linked dataset includes people registered with the NDSS from 1987 onwards and people registered with APEG from 1999 onwards. These data were used to report on incidence and prevalence for people living with diabetes, including type 1, type 2 and other diabetes.

The NDSS registration forms and database have changed over time. Between 2 December 2002 and 28 February 2003, the clinical terminology used to describe diabetes types was updated from juvenile-onset diabetes, Insulin Dependent Diabetes Mellitus (IDDM) and Non-Insulin Dependent Diabetes Mellitus (NIDDM), to type 1 and type 2 diabetes. Prior to this, people registering with the NDSS with insulin-treated type 2 diabetes may have been incorrectly recorded as type 1 so that their insulin using needs could be met. This occurred because the NDSS registration form did not have an option for insulin-treated type 2 diabetes, reflecting diabetes classification at that time. All registrants that were classified as IDDM were reclassified as type 1 diabetes as there was no effective way to differentiate between diabetes types, resulting in misclassification for some people with insulin-treated type 2 diabetes. Some records can be checked against APEG registrations, as is done with the NDR, but older records may be prone to misclassification. Due to this issue, an algorithm has been applied to check diabetes status based on insulin use, age at diagnosis and the lag time between insulin diagnosis and initiating insulin therapy. The following criteria was applied:

• Type 1 diabetes status was assigned to registrants recorded as type 1 who were diagnosed at age <45 and taking insulin.
• Registrants with type 2 diabetes who were diagnosed before age 30 and were taking insulin within 1 year of the diagnosis date were reclassified as having type 1 diabetes.

The registration date was used as a proxy for the diagnosis date due to a high level of missing diagnosis date information for older registrants.

Statistics in this release were extracted by the AIHW from the Medicare Benefits Schedule (MBS) claim records data in the Australian Government Department of Health Enterprise Data Warehouse.

The MBS provides a subsidy for services listed in the MBS, for all Australian residents and certain categories of visitors to Australia. The major elements of Medicare are contained in the Health Insurance Act 1973. See details of the services covered by the MBS. The statistics in this release are reported using date of processing up to 23 November 2021 and date of service up to 31 August 2021. 

Items 66554, 66545 and 66548 are pregnancy related. The data contains some males and also persons in the 0–5 or 10–15 age groups. This can be attributed to a number of reasons, such as the medical services being attributed to the wrong member of the family, the sex or age information in the Medicare enrolment file being wrong or persons reporting their gender at the time of claiming the Medicare service, as male. These data were excluded from the analysis.

MBS items for pathology tests are subject to episode coning. Episode coning is an MBS funding arrangement that applies to general practitioners ordering more than three items in an episode for a non-hospitalised patient on the same day. Under the coning rule, Medicare benefits are only payable for the three most expensive items. The remaining items are coned out. As a result of the application of this rule, MBS data for some items will not reflect the number of tests performed for non-hospitalised patients.

Pathology services requested for hospitalised patients, or ordered by specialists, are not subject to these coning arrangements. Episode coning was introduced to prevent over servicing by doctors.

The National (insulin-treated) Diabetes Register (NDR) holds information about people who use insulin as part of their treatment for diabetes. The NDR was established in 1999 and includes most people diagnosed with type 1 diabetes since this time, as well as those who use insulin to manage type 2 diabetes, gestational diabetes and other, less common forms of diabetes. Almost all people with type 1 diabetes who were diagnosed from 1999 onwards are captured on the NDR. This is because all people with type 1 diabetes require insulin to treat their condition and this need for insulin acts as a driver to register with the National Diabetes Services Scheme (NDSS) where the products for administering insulin (pens/needles, or insulin pump consumables) can be obtained at subsidised prices. Additionally, the coverage rate of the NDR is high for those diagnosed under 15 years as data are also obtained from the Australasian Paediatric Endocrine Group (APEG) state-based registers.

Due to the scope of data collected on the NDR, prevalence estimates can only be reported for people aged up to 21 as of the NDR 2021.

For more information see the NDR 2021 data quality statement.

The National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) is conducted by the ABS to obtain national information on the health of Indigenous Australians, their use of health services and health-related aspects of their lifestyle. The most recent NATSIHS was conducted in 2018–19.

The NATSIHS collects information from Aboriginal and Torres Strait Islander people of all ages in non-remote and remote areas of Australia, including discrete Indigenous communities.

Further information can be found in ABS National Aboriginal and Torres Strait Islander Health Survey, 2018–19.

The National Health Survey (NHS) is conducted by the Australian Bureau of Statistics (ABS) to obtain national information on the health status of Australians, their use of health services and facilities, and health-related aspects of their lifestyle. The most recent NHS was conducted in 2020–21. It is important to note that the 2020–21 NHS data should be considered a break in time series from previous NHS collections and used for point-in-time national analysis only. The survey was collected during the COVID-19 pandemic, via an online, self-complete form, which significantly changed the data collection and survey estimates. For this report, the 2017–18 NHS was used as the latest available data for time series.

The NHS collects self-reported data on whether a respondent had one or more long-term health conditions; that is, conditions that lasted, or were expected to last, 6 months or more.

When interpreting data from the 2017–18 NHS, some limitations need to be considered:

• Data that are self-reported rely on respondents knowing and providing accurate information.
• The survey does not include information from people living in nursing homes or otherwise institutionalised.
• Residents of Very remote areas and discrete Aboriginal and Torres Strait Islander communities were excluded from the survey. This is unlikely to affect national estimates, but will impact prevalence estimates by remoteness.

Further information can be found in National Health Survey: First results, 2017–18.

The National Hospital Morbidity Database (NHMD) is a compilation of episode-level records from admitted patient morbidity data collection systems in Australian hospitals.

Reporting to the NHMD occurs at the end of a person’s admitted episode of care (separation or hospitalisation) and is based on the clinical documentation for that hospitalisation.

The NHMD is based on the Admitted Patient Care National Minimum Data Set (APC NMDS). It records information on admitted patient care (hospitalisations) in essentially all hospitals in Australia, and includes demographic, administrative and length-of-stay data, as well as data on the diagnoses of the patients, the procedures they underwent in hospital and external causes of injury and poisoning.

The hospital separations data do not include episodes of non-admitted patient care given in outpatient clinics or emergency departments. Patients in these settings may be admitted subsequently, with the care provided to them as admitted patients being included in the NHMD.

The following care types were excluded when undertaking the analysis: 7.3 (newborn – unqualified days only), 9 (organ procurement – posthumous) and 10 (hospital boarder).

The National Hospital Morbidity Database include information on people’s area of usual residence at the time of hospitalisation. 

For 2021–22, this was their SA2 based on the 2016 ASGS. In this report, 2016 SA2 values have been concorded to SA2 values based on the 2021 census prior to calculating rates

Further information about the NHMD can be found in Admitted patient care NMDS 2021–22.

The National Mortality Database (NMD) comprises information about causes of death and other characteristics of the person, such as sex, age at death, area of usual residence and Indigenous status. The cause of death data are provided to the AIHW by the Registries of Births, Deaths and Marriages and the National Coronial Information System (managed by the Victorian Department of Justice) and include cause of death coded by the ABS. The data are maintained by the AIHW in the NMD.

In this report, deaths registered in 2019 and earlier are based on the final version of cause of death data; deaths registered in 2020 are based on the revised version; and deaths registered in 2021 and 2022 are based on the preliminary version. Revised and preliminary versions are subject to further revision by the ABS.

For data by Indigenous status, counts of death are reported for 8 jurisdictions combined – New South Wales, Australian Capital Territory, Victoria, Queensland, Western Australia, South Australia, Tasmania and the Northern Territory. Death rates are reported for 5 jurisdictions combined – New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. These jurisdictions are considered to have adequate levels of First Nations identification in mortality data.

This report adjusts for Victorian additional death registrations of deaths that were registered in Victoria in 2017 and 2018 but were not provided to the ABS for compilation until 2019. As a result, the number of diabetes deaths reported for 2017 to 2019 may differ from previously reported numbers. For more detail, see the Technical note: Victorian additional registrations and time series adjustments in Causes of death, Australian methodology.

The NMD includes information on people’s area of usual residence prior to death. For 2022, this was their SA2 based on the 2021 ASGS. This location information from the National Mortality Database, along with IRSD values based on the ABS 2021 Census of Population and Housing, and estimated resident populations for 2022, have been used to approximate statistics for 2022 ASGS Remoteness Areas and 2022 IRSD SEIFA quintiles.

The data quality statements underpinning the AIHW NMD can be found in the following ABS publications:

• ABS quality declaration summary for Deaths, Australia.
• ABS quality declaration summary for Causes of death, Australia.

For more information see National Mortality Database (NMD).

The AIHW National Non-admitted Patient Emergency Department Care Database (NNAPEDCD) is a compilation of episode-level records (including waiting times for care) for non-admitted patients registered for care in emergency departments in selected public hospitals. The database only captures information for physical presentations to emergency departments and does not include advice provided via telehealth or videoconferencing.

Patients being treated in emergency departments may be subsequently admitted, including admission in the emergency department, another hospital ward or to hospital-in-the-home. For this reason, there is an overlap in the scope of the NNAPEDCD NMDS and the APC NMDS.

The National Non-Admitted Patient Emergency Department Care Database include information on people’s area of usual residence at the time of ED admission. 

For 2022–23, this was their SA2 based on the 2016 ASGS. In this report, 2016 SA2 values have been concorded to SA2 values based on the 2021 census prior to calculating rates.

Principal diagnoses for episodes of care in the NNAPEDCD 2022–23 are coded according to the Emergency Department ICD-10-AM Principal Diagnosis Shortlist. 

Further information about the NNAPEDCD can be found in Non-admitted patient emergency department care NMDS 2022–23.

MedicineInsight is a database managed by NPS MedicineWise containing de-identified electronic health records (EHRs) from over 700 Australian general practices.

MedicineInsight data include information on people living with diabetes and their interaction with the primary health care system through general practice.

Patient population percentages have been weighted to adjust for an over-representation of registered GP sites in Tasmania.

The Australian Government subsidises the cost of a wide range of medicines through the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS). Claims for reimbursement for the supply of PBS- or RPBS-subsidised medicines are submitted by pharmacies through Services Australia for processing and are provided to the Australian Government Department of Health. Subsidies for prescription medicines are available to all Australian residents who hold a current Medicare card, and overseas visitors from countries with which Australia has a Reciprocal Health Care Agreement. In general, patients pay a contribution to the cost of the medicine (co-payment), and the Australian Government covers the remaining cost. This remaining cost is referred to as the benefit paid.

PBS data in this report are from records of prescriptions dispensed under the PBS and RPBS, where either:

• the Australian Government paid a subsidy
• The prescription was dispensed at a price less than the relevant patient co-payment (under co-payment prescriptions) and did not attract a subsidy.

PBS data cover all PBS prescriptions dispensed by approved suppliers, including community pharmacies, public and private hospital pharmacies and dispensing doctors.