First Nations people

Page highlights

  • An estimated 92,000 First Nations adults (16%) were living with diabetes in 2022–24 based on data from the National Aboriginal and Torres Strait Islander Health Measures Survey.
  • Around 2,400 First Nations women (16%) were diagnosed with gestational diabetes in 2023–24.
  • In 2023–24, around 87,500 hospitalisations were associated with diabetes among First Nations people – a rate of 8,500 per 100,000 population.
  • In 2024, diabetes contributed to around 1,100 deaths in First Nations people, a rate of 102 per 100,000 population.
  • Type 2 diabetes accounted for 3.2% of total disease burden among First Nations people in 2022 (10,200 DALY).

Overview

Diabetes is a significant health issue facing Aboriginal and Torres Strait Islander (First Nations) communities (AIHW and NIAA 2023). This chapter presents key statistics on the prevalence and incidence of all diabetes, type 1, type 2, and gestational diabetes, as well as associated hospitalisations, emergency department presentations, burden of disease, and mortality. This chapter also presents key comparisons with non-Indigenous Australians.

All diabetes

Prevalence and incidence

Based on measured HbA1c test results and self-reported data from the National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS), in 2022–24 (ABS 2025a):

  • around 16% of First Nations people (92,000) aged 18 and over were living with diabetes, comprising 13% with known and 2.8% with newly diagnosed diabetes (ABS 2025b)
  • the crude prevalence of diabetes was similar for First Nations men (17%) and women (15%).

According to self-reported data from the National Aboriginal and Torres Strait Islander Health Surveys (NATSIHS), after adjusting for changes in the age structure of the population over time, the self-reported prevalence of diabetes in First Nations people declined by 23% between 2012–13 and 2022–23, from around 14% to 11%, respectively (Figure 1) (ABS 2014 and ABS 2025c). 

Of note, due to the large increase of 25% in the First Nations population between 2016 and 2021, care should be taken when comparing estimates from the 2022–23 NATSIHS with previous surveys (ABS 2025d).

Figure 1: Prevalence of self-reported diabetes from the National Aboriginal and Torres Strait Islander Health Surveys, by sex, 2012–13, 2018–19 and 2022–23

The chart shows prevalence of diabetes has declined between 2012-13 and 2022-23 for both First Nations men and women.

Notes

  1. Age-standardised to the 2001 Australian Standard Population.
  2. Based on self-reported data.
  3. Due to the large increase of 25% in the First Nations population between 2016 and 2021, care should be taken when comparing estimates from the 2022–23 NATSIHS with previous surveys.

Source: AIHW analysis of detailed Microdata, ABS 2014; ABS 2020; ABS 2025c.

In 2021, according to linked data from the National Diabetes Services Scheme (NDSS) and Australasian Paediatric Endocrine Group (APEG):

  • there were around 2,200 new cases of diabetes among First Nations people – a rate of 256 per 100,000 population
  • incidence rates increased with increasing age and peaked among those aged 65–69 (788 per 100,000 population)
  • incidence rates were highest in the 65–69 age group in First Nations males and in the 60–64 age group among First Nations females (925 and 712 per 100,000 population, respectively) (Figure 2)
  • crude incidence was slightly higher among First Nations males than First Nations females (263 and 248 per 100,000 population, respectively).

Figure 2: Incidence of diabetes for First Nations people, by age and sex, 2021

The chart shows that among people aged 0–39, incidence was similar for both males and females at 115 per 100,000 population.

The chart shows that among people aged 0–39, incidence was similar for both males and females at 115 per 100,000 population.

For further information, see Limitations of estimating diabetes prevalence.

Comorbidity

Based on data from the NATSIHMS, in 2022–24, an estimated 162,000 First Nations people aged 18 and over (30%) were living with diabetes, CKD and/or HSVD. Of the First Nations adults who participated in the NATSIHMS (ABS 2025a):

  • 34,800 (6.4%) had diabetes only
  • 39,300 (7.2%) had diabetes and CKD
  • 4,900 (0.9%) had diabetes and HSVD
  • 7,600 (1.4%) had diabetes, CKD and HSVD (Figure 3).

Figure 3: Prevalence of diabetes, CKD and HSVD, and their comorbidity, among First Nations people aged 18 and over, 2022–24

The Venn diagram shows that of the adults in the NATSIHMS, about 6.4% had diabetes only and 1.4% were living with all 3 conditions, that is diabetes, CKD or HSVD.

The Venn diagram shows that of the adults in the NATSIHMS, about 6.4% had diabetes only and 1.4% were living with all 3 conditions, that is diabetes, CKD or HSVD.

Note: Diabetes prevalence is based on HbA1c and self-reported data, CKD prevalence is based on eGFR and ACR test results and HSVD prevalence is based on self-reported data of people who participated in the measured component of the 2022–24 National Health Measures Survey. 

Source: AIHW analysis of detailed Microdata, ABS 2025a.

Hospitalisations

In 2023–24, according to data from the National Hospital Morbidity Database (NHMD): 

  • there were around 87,500 hospitalisations associated with diabetes (as the principal and/or additional diagnosis) among First Nations people – a rate of 8,500 per 100,000 population
  • hospitalisation rates (as the principal and/or additional diagnosis) generally increased with increasing age, peaking among First Nations males aged 80–84 and females aged 75–79 (Figure 4)
  • the crude rate for diabetes hospitalisations (as the principal and/or additional diagnosis) was 1.5 times as high among First Nations females as First Nations males.

Figure 4: Diabetes hospitalisation rates for First Nations people, principal and/or additional diagnosis, by age and sex, 2023–24

The chart shows hospitalisations rates were highest for First Nations males aged 80–84 and females aged 75–79 (52,500 and 47,200 per 100,000 population, respectively).

The chart shows hospitalisations rates were highest for First Nations males aged 80–84 and females aged 75–79 (52,500 and 47,200 per 100,000 population, respectively).

Emergency department presentations

Based on data from the National Non-Admitted Patient Emergency Department Care (NNAPEDC) Database, in 2024–25 there were around 3,000 emergency department presentations with a principal diagnosis of diabetes among First Nations people, a rate of 298 per 100,000 population. First Nations males presented at the emergency department with diabetes at the same rate as First Nations females (298 per 100,000 population, each).

Deaths

In 2024, according to data from the National Mortality Database (NMD): 

  • there were around 1,100 deaths from diabetes (as the underlying and/or associated cause) among First Nations people, a rate of 102 per 100,000 population
  • more than 2 in 5 First Nations people (45%) who died from diabetes were aged under 65
  • First Nations males and females aged 85 and over had the highest diabetes mortality rate across all age groups (2,700 and 3,500 deaths per 100,000 population, respectively) (Figure 5).

Figure 5: Diabetes death rates for First Nations people, underlying and/or associated cause of death, by age group and sex, 2024

The chart shows that diabetes deaths rates increased with age for both sexes and were highest in those aged 85 and over.

Notes

  1. Rates are expressed as deaths per 100,000 population, for New South Wales, Victoria, Queensland, Western Australia, South Australia and the Northern Territory combined. 
  2. Includes persons with missing or unassigned information on age and/or sex.
  3. Deaths registered in 2024 are based on preliminary data and are subject to further revision by the Australian Bureau of Statistics.

Source: AIHW National Mortality Database. | Data source overview

Of note, data for diabetes deaths among First Nations people are reported for 6 jurisdictions, including New South Wales, Victoria, Northern Territory, Queensland, South Australia and Western Australia. Data quality issues and the small number of deaths for First Nations people makes the data less reliable in the other jurisdictions.

Type 1 diabetes

Prevalence and incidence

Based on data from National (insulin-treated) Diabetes Register (NDR), in 2021: 

  • 587 First Nations children and young adults aged 0–19 were living with type 1 diabetes (158 per 100,000 population) 
  • there were 151 new diagnoses of type 1 diabetes among First Nations people (17 per 100,000)
  • the crude incidence of type 1 diabetes was 1.3 times as high among First Nations males as First Nations females. 

Hospitalisations

In 2023–24, according to data from the NHMD, among First Nations people: 

  • there were around 3,800 hospitalisations for type 1 diabetes (as the principal and/or additional diagnosis) (371 per 100,000 population)
  • more than half (58%) of the hospitalisations for type 1 diabetes were among First Nations females
  • type 1 diabetes hospitalisation rates (as the principal and/or additional diagnosis) were highest among males aged 60–64 and females aged 30–34 (625 and 962 per 100,000 population, respectively) (Figure 6)
  • First Nations females were 1.4 times as likely to be hospitalised with type 1 diabetes as their male counterparts.

Figure 6: Type 1 diabetes hospitalisation rates for First Nations people, principal and/or additional diagnosis, by age and sex, 2023–24

The chart shows rates were highest in those aged 60–64 for males and 30–34 for females (625 and 962 per 100,000 population, respectively).

The chart shows rates were highest in those aged 60–64 for males and 30–34 for females (625 and 962 per 100,000 population, respectively).

Burden of disease

In 2022, type 1 diabetes was responsible for 918 DALY among First Nations people – equating to 0.9 DALY per 1,000 population. The proportion attributed to fatal burden was higher (74%, or 681 YLL) than that attributed to non-fatal burden (26% or 237 YLD) (AIHW 2026). Between 2011 and 2022, there was a 40% decrease in the age-standardised DALY rates attributed to type 1 diabetes among First Nations people, from 2.0 to 1.2 DALY per 1,000 population.

Type 2 diabetes

Prevalence and incidence

In 2022–23, based on self-reported data from the ABS National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), among First Nations people aged 18 and over (ABS 2025c): 

  • an estimated 10.2% (61,400) First Nations adults were living with type 2 diabetes
  • prevalence of type 2 diabetes increased with age and was highest among people aged 65–74 at 28% 
  • the crude prevalence of type 2 diabetes was similar among First Nations men and First Nations women (10% and 11%, respectively). 

Based on linked NDSS and APEG data, in 2021: 

  • around 2,000 First Nations people were newly diagnosed with type 2 diabetes, equating to 225 per 100,000 population
  • incidence rates were highest among First Nations males aged 65–69 and First Nations females aged 60–64 (914 and 699 per 100,000, respectively) (Figure 7)
  • the crude incidence of type 2 diabetes for First Nations males was 230 per 100,000 population and that for First Nations females was 220 per 100,000 population.

Figure 7: Incidence of type 2 diabetes, First Nations people, by age and sex, 2021

The chart shows incidence of type 2 diabetes in First Nations people is higher among females than males in those aged 0–39 and 70–74.

The chart shows incidence of type 2 diabetes in First Nations people is higher among females than males in those aged 0–39 and 70–74.

For more information about issues with reporting First Nations type 2 diabetes prevalence data from the linked National Diabetes Services Scheme (NDSS) and Australasian Paediatric Endocrine Group (APEG) data refer to Using the NDSS for reporting on First Nations people.

Hospitalisations

In 2023–24, according to data from the NHMD:

  • there were around 78,400 hospitalisations for type 2 diabetes (as the principal and/or additional diagnosis) among First Nations people – a rate of 7,600 per 100,000 population 
  • type 2 diabetes hospitalisation rates peaked among First Nations females aged 75–79 and First Nations males aged 80–84 (46,800 and 52,300 per 100,000 population, respectively) (Figure 8) 
  • First Nations females were 1.4 times as likely to be hospitalised with type 2 diabetes when compared with First Nations males.

Figure 8: Type 2 diabetes hospitalisation rates for First Nations people, principal and/or additional diagnosis, by age and sex, 2023–24

The chart shows rates increased with age for both males and females and peaked in the 75–79 age group in females and 80–84 in males.

The chart shows rates increased with age for both males and females and peaked in the 75–79 age group in females and 80–84 in males.

Burden of disease

In 2022, type 2 diabetes was responsible for around 10,200 DALY among First Nations people – equating to 10 per 1,000 population. The proportion attributed to fatal burden (53% or 5,400 YLL) was slightly higher than that attributed to non-fatal burden (47% or 4,800 YLD) (AIHW 2026). Between 2011 and 2022, there was a 28% decrease in the age-standardised DALY rates attributed to type 2 diabetes among First Nations people, from 23 to 16 DALY per 1,000 population.

Gestational diabetes

In 2023–24, based on the NHMD data:

  • around 2,400 First Nations women were diagnosed with gestational diabetes, equating to 16% of those who gave birth in hospital
  • incidence of gestational diabetes increased with age and was highest in the 40–49 age group at 31% which is about 2.9 times that of those aged 15–24 (11%) (Figure 9).

Figure 9: Incidence of gestational diabetes among First Nations women by age, 2023–24

The chart shows incidence of gestational diabetes in First Nations women increases with age, peaking at 31% in the 40–49 age group.

Notes

  1. Population (First Nations women aged 15–49 who gave birth in Australian hospitals) based on ICD-10-AM diagnosis codes.
  2. Excludes persons whose Indigenous status was not stated or inadequately described.

Source: AIHW National Hospital Morbidity Database. | Data source overview

Comparison with non-Indigenous population

First Nations people disproportionately have high rates of diabetes morbidity and mortality compared to non‑Indigenous Australians. The determinants of health for First Nations people are multifaceted, including socio-economic and environmental factors, historical context with ongoing inter-generational impacts and prevalence of health risks (AIHW 2024).

Data show that after adjusting for differences in the age structure of the populations, compared to non-Indigenous Australians:

  • First Nations adults were 3.2 times as likely to be living with diabetes in 2022–24 (ABS 2025a and ABS 2025e) 
  • incidence of diabetes was twice as high among First Nations males and 2.4 times as high among First Nations females in 2021 (linked NDSS and APEG data)
  • the hospitalisation rate for all diabetes was 3.5 times as high among First Nations people in 2023–24 (NHMD data)
  • the ED presentation rate for diabetes was 5.6 times as high among First Nations people in 2024–25 (NNAPEDC data)
  • the death rate for diabetes was 4.0 times as high among First Nations people in 2024 (NMD data)
  • health system expenditure on potentially preventable hospitalisations per person was 2.6 times as high for First Nations people in 2022–23 (AIHW and NIAA 2025).

For type 1 diabetes, after adjusting for differences in the age structure of the populations, compared to non-Indigenous Australians:

  • First Nations children and young adults were 21% less likely to be living with type 1 diabetes in 2021 (NDR data)
  • incidence was 1.2 times as high among First Nations people in 2021 (NDR data)
  • the hospitalisation rate was 1.8 times as high among First Nations people in 2023–24 (NHMD data).

For type 2 diabetes, after adjusting for differences in the age structure of the populations, compared to non-Indigenous Australians:

  • First Nations adults were 2.3 times as likely to be living with type 2 diabetes in 2022–23 (ABS 2025c and ABS 2023)
  • incidence was 2.2 times as high among First Nations people in 2021 (linked NDSS and APEG data)
  • the hospitalisation rate was 3.8 times as high among First Nations people in 2023–24 (NHMD data)

See the supplementary data tables for further information on estimates for diabetes by Indigenous status.

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