QIM 1: Proportion of regular clients with diabetes with an HbA1c result recorded in their GP record within the previous 12 months
Patients with Type 1 and 2 diabetes should have their glycosylated haemoglobin (HbA1c) measured at least every 12 months, or more frequently depending on the level of blood glucose control. The early identification and optimal management of diabetes can delay the progression of disease, improve quality of life, increase life expectancy and decrease the need for high-cost interventions (RACGP 2020b).
Capture of result recorded outside of the general practice setting
Some patients may receive care from other practitioners in addition to a GP, including an endocrinologist/a specialist physician, and/or other health care providers to safely manage their diabetes (RACGP 2020b). Results arising from clinical intervention conducted outside of the service that are known and recorded by the practice are included in the measure. However, sometimes an HbA1c result recorded elsewhere is not captured in the report. For example, this might be a result from a specialist service that is not recorded in the clinical information system of the client’s usual general practice due to an incompatible clinical information system between a practice and a specialist service.
Other sources of relevant data
Data on the prevalence of long-term health conditions like diabetes are captured in the National Health Survey (NHS) conducted by the Australian Bureau of Statistics (ABS). There are other administrative data collections where the data from these client-provider interactions are captured, for example, Medicare Benefits Schedule (MBS), the National Diabetes Service Scheme (NDSS) register and the Australasian Paediatric Endocrine Groups (APEG) state and territory registers.
This indicator reports on the proportion of regular clients of all ages who had a recorded diagnosis of Type 1, Type 2 or undefined diabetes, and who had an HbA1c result recorded within the previous 12 months in their GP record.
QIM 1: Regional proportions
Type 1 diabetes
Type 1 diabetes is a lifelong autoimmune disease that usually has its onset in childhood or early adolescence. The exact cause is unknown, but it is believed to be the result of an interaction of genetic and environmental factors. The management of an individual with Type 1 diabetes requires a multidisciplinary healthcare network delivering integrated clinical care, using a complex array of health care tools (APEG and ADS 2011). A person with Type 1 diabetes requires daily insulin replacement to survive, except in cases where a pancreatic transplant occurs. In 2017–18, around 145,000 people had Type 1 diabetes, of which 20,700 were children and young adults aged 0–24 years. This equates to 261 per 100,000 population, with a slightly higher rate among males compared with females (266 and 256 per 100,000 population, respectively) (AIHW 2020b).
As of July 2022, nationally, 56.9% of regular clients of all ages who had a recorded diagnosis of Type 1 diabetes had an HbA1c result recorded within the previous 12 months in their GP record. This varied from 46.4% to 69.5% across PHNs.
Figure 1: Proportion of regular clients with a recorded diagnosis of Type 1 diabetes and an HbA1c result recorded in their GP record within the previous 12 months, by PHN, July 2022