Diabetes: Australian facts

Australia uses the International Statistical Classification of Diseases and Related Health Problems (ICD) to code causes of death (WHO 2019). In this report, deaths were coded using the 10th Revision (ICD-10) (Table 1).

Source: WHO 2019.

For hospital diagnoses and procedures, a classification modified for Australia is used. Hospital data were coded using the ICD-10-AM classification (International Statistical Classification of Diseases and Related Health Conditions, 10th Revision, Australian Modification).

Diagnosis and procedure data for 2013–24 were reported to the NHMD using the 12th edition of the ICD-10-AM (IHACPA 2022a), incorporating the Australian Classification of Health Interventions (ACHI) (Tables 2 and 3). For emergency department diagnoses, a classification modified for Australia, the ICD-10-AM (12th Revision) shortlist was used (IHACPA 2022b) (Table 2).

Source: IHACPA 2022a, IHACPA 2022b.

Source: IHACPA 2022b.

Two sets of diabetes codes in ICD-10-AM have been taken into account: diabetes ‘E-codes (E10, E11, E13 and E14)’ and diabetes in pregnancy ‘O24-codes’. The matrix below shows the method used to assign diabetes in pregnancy status to records from the NHMD, where a record also includes an outcome of delivery code (Z37) (Table 4).

The method uses a hierarchy, whereby a record with any E-code is assigned to pre-existing diabetes in pregnancy status first and the remaining records are assigned a status based on the diabetes in pregnancy O24-codes. Gestational diabetes is only assigned where an O24.4 code exists in the absence of any E-code.

Anatomical Therapeutic Chemical (ATC) classification codes are used in this report to classify medicines. This classification groups medicines according to the body organ or system they act upon, their therapeutic characteristics, and their chemical characteristics.

A list of the medicine groups included in this report is shown in Table 5.

More information on the ATC classification system can be found at the WHO Collaborating Centre for Drug Statistics Methodology.

Source: WHO 2022.

The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) code changes in Chapter IV Endocrine, nutritional and metabolic disease and Australian Coding Standards (ACS) 0401 Diabetes mellitus and intermediate hyperglycaemia have affected the ability to monitor trends for diabetes hospitalisations. Transition between ICD-10-AM/Australian Classification of Health Interventions (ACHI)/ACS classification editions has resulted in differences in how diabetes was recorded, when it had a direct relationship with the principal reason for the episode of care, or when it might be recorded as an additional diagnosis in any hospitalisation.

The coding practice for classifying diabetes under ICD-10-AM 6th edition (used 1 July 2008 to 30 June 2010) was largely consistent with previous editions of ICD-10-AM. However, clarification of how the coding standard for additional diagnoses should be applied (ACS 0002) meant that conditions would only be coded as an additional diagnosis if they were ‘significant in terms of treatment required, investigations needed, and resources used in each episode of care’. While this clarification resulted in a decrease in the number of conditions being coded as additional diagnoses for all hospitalisations, it had a particularly significant impact on the reporting of diabetes as an additional diagnosis.

The coding practice for classifying diabetes under ICD-10-AM 7th edition (used from 1 July 2010) changed again due to changes made to ACS 0401. The changes resulted in a further decrease between 2009–10 and 2010–11 in the reporting of diabetes-related conditions, due to the condition not meeting the criteria for being assigned as either the principal or additional diagnosis.

Following investigation into the effect of these changes to diabetes coding, an additional change to ACS 0401 that ‘when documented, diabetes mellitus should always be coded’ was implemented in July 2012.

The impact on reported diabetes hospitalisations: 

• Between 2009–10 and 2010–11, the number of hospitalisations reported for diabetes decreased by 41% from around 442,000 in 2009–10 to 263,000 in 2010–11.
• Between 2010–11 and 2011–12, there were increases in the number of hospitalisations reported for diabetes that may be unrelated to coding changes.
• Between 2011–12 and 2012–13, the number of hospitalisations for which diabetes was recorded as either the principal and/or additional diagnoses increased – 8% increase where diabetes was recorded as the principal diagnosis, and a 250% increase where it was recorded as an additional diagnosis.

IHACPA (Independent Hospital and Aged Care Pricing Authority) (2022a), ICD-10-AM/ACHI/ACS, IHACPA, accessed 27 March 2026.

IHACPA (2022b), Emergency Department ICD-10-AM Principal Diagnosis Short List, IHACPA, accessed 27 March 2026.

WHO (World Health Organization) (2019), International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), WHO, accessed 27 March 2026.

WHO (2022), ATC/DDD Index, WHO Collaborating Centre for Drug Statistics Methodology, WHO, accessed 27 March 2026.