Incidence of insulin-treated diabetes in Australia

Incidence of insulin-treated diabetes in Australia 1

Incidence of insulin-treated diabetes in Australia

Web report | Last updated: 25 Mar 2020 | Author: AIHW | Cat no: CDK 11

Citation: Australian Institute of Health and Welfare 2020. Incidence of insulin-treated

diabetes in Australia. Cat. no. CDK 11. Canberra: AIHW.

The Incidence of insulin-treated diabetes in Australia web report presents the

latest available data on new cases of type 1 diabetes and insulin-treated type

2 diabetes. It is part of the ongoing national reporting using the National

(insulin-treated) Diabetes Register (NDR). The NDR is a linked data set,

which includes data from the:

National Diabetes Services Scheme (NDSS)

Australasian Paediatric Endocrine Group (APEG)

National Death Index.

The data are presented by age, sex, trends, population groups and geographic areas.

Key findings 1. In 2018, about 31,300 people began using insulin to treat their diabetes in Australia.

2. Just over 2,800 people were diagnosed with type 1 diabetes—12 cases per 100,000

population.

3. 17,000 people started insulin to manage their type 2 diabetes—4,200 cases per

100,000 people with type 2 diabetes.

4. 1,700 (60%) people diagnosed with type 1 diabetes were aged under 25.


Incidence of insulin-treated diabetes in Australia Diabetes is a chronic condition marked by high levels of glucose (sugar) in the blood. This is

caused by the body being unable to produce insulin (a hormone made by the pancreas to

control blood glucose levels) or to use insulin effectively, or both.

An estimated 1 in 20 (4.9% or 1.2 million) Australians had diabetes in 2017–18, based on

self-reported data (ABS 2019).

All people with type 1 diabetes, and some with type 2, gestational or other forms of diabetes

will require insulin replacement therapy to manage their condition.

This web report presents the latest available data on new cases of insulin-treated diabetes,

with a focus on type 1 diabetes and insulin-treated type 2 diabetes, in Australia. Data are

from the 2018 National (insulin-treated) Diabetes Register (NDR).

New cases of insulin-treated diabetes in 2018

In 2018, about 31,300 people registered on the NDR began using insulin to treat their

diabetes. Of these:

just over 2,800 (9.0%) people were diagnosed with type 1 diabetes, and began using

insulin to treat it

17,000 (54%) people began using insulin to treat type 2 diabetes

10,800 (34%) females began using insulin to treat gestational diabetes

about 600 (2.0%) people began using insulin to treat other forms of diabetes.

Proportions were calculated excluding those for whom diabetes type was unknown (143

cases or 0.5% of total insulin-treated diabetes).

Due to rounding, percentages do not sum to 100.


References

ABS (Australian Bureau of Statistics) 2019. Microdata: National Health Survey, 2017–18.

ABS cat. no. 4324.0.55.001. Findings based on detailed microdata file analysis. Canberra:

ABS.


Type 1 diabetes incidence Type 1 diabetes is a lifelong autoimmune disease that often has onset in childhood or early

adulthood, but can occur at any age. The cause is unknown, but it is believed to be an

interaction of genetic and environmental factors. All people with type 1 diabetes need insulin

to manage their condition.

In 2018:

just over 2,800 people were diagnosed with type 1 diabetes—12 cases per 100,000

population, or about 1 in every 8,000 Australians

the incidence rate was higher in males (14 per 100,000) than females (10 per

100,000)

about 1,700 (60%) people diagnosed with type 1 diabetes were aged under 25, with

the highest rate of diagnosis among those aged 10–14 (34 cases per 100,000

population)

the incidence rate was lower in Remote and very remote areas (9 cases per 100,000

population) compared with other areas (12–14 cases per 100,000)—rates in Remote

and very remote areas might be influenced by the potentially lower capture on the

NDR of people living in these areas (see Methods and classifications)

incidence rates across socioeconomic areas varied, at 11–14 cases per 100,000

population.

Aboriginal and Torres Strait Islander people

In 2018, 129 Aboriginal and Torres Strait Islander people were diagnosed with type 1

diabetes (16 cases per 100,000 population).

After adjusting for differences in the age structures between the populations, the incidence

rate of type 1 diabetes was similar among Indigenous Australians and non-Indigenous

Australians (12 and 11 cases per 100,000 population, respectively).

Small geographic areas

Over the five year period 2014–2018, incidence rates for type 1 diabetes were:

highest (15–16 cases per 100,000 population) in the Primary Health Network (PHN)

areas of:

o Nepean Blue Mountains (New South Wales)

o Murray (Victoria)

o Central Queensland

o Wide Bay (Queensland)

o Sunshine Coast (Queensland)

o Western Victoria

lowest in the PHN areas of Northern Territory (6 cases per 100,000 population), and

Central and Eastern Sydney (New South Wales) (8 cases per 100,000 population)


highest in the smaller geographical areas (statistical area level 3; SA3) of Bundaberg

(Queensland), Barwon-West (Victoria), and Moira (Victoria) (18–19 cases per

100,000 population)

lowest in the SA3 of Hurstville, Sydney Inner City, and Fairfield (New South Wales)

(about 4–5 cases per 100,000 population).

To explore the type 1 diabetes data by trends and demographics, see data visualisation

‘Type 1 diabetes’.

To explore type 1 diabetes data by geographic areas, see data visualisation ‘Type 1

diabetes: geographical areas’.


Insulin-treated type 2 diabetes incidence Type 2 diabetes is a progressive condition that occurs when the body becomes resistant to

insulin, or insulin production is inadequate. The cause is unknown, but it is believed to be an

interaction of genetic and environmental factors.

Type 2 diabetes tends to develop over a long period of time, and generally has onset later in

life. When blood glucose levels can no longer be maintained at optimum levels through diet,

exercise and other medications, insulin replacement might be required. Some people newly

diagnosed with type 2 diabetes need insulin replacement from diagnosis.

Change in method for insulin-treated type 2 diabetes

The method used to calculate the incidence rates of insulin-treated type 2 diabetes has changed in recent years.

In reports before 2019, incidence rates of insulin-treated type 2 diabetes were calculated based on the Australian Bureau of Statistics (ABS) estimated resident population.

For this web update, incidence rates were calculated based on the population including all people with type 2 diabetes who have never used insulin, and are registered with the National Diabetes Services Scheme.

This change means that results presented in this report and cannot be compared with earlier publications or results based on earlier NDR data.

As the NDR potentially underestimates the number of Aboriginal and Torre Strait Islander registrants with diabetes, the incidence of insulin-treated type 2 diabetes based on the prevalent type 2 diabetes population by Indigenous status has not been reported. This is an important data gap for future development. For more information, see the Methods and classifications.

In 2018:

about 17,000 people began using insulin to manage their type 2 diabetes—4,200

cases per 100,000, or about 1 in every 24 registrants with type 2 diabetes not

previously using insulin

the incidence rate was 1.7 times higher in females (5,400 per 100,000) than in males

(3,200 per 100,000)

incidence rates for insulin-treated type 2 diabetes were twice as high among those

living in Major cities (4,300 cases per 100,000 registrants with type 2 diabetes not

previously using insulin) as those in the Remote and very remote areas (2,000 cases

per 100,000)—rates in Remote and very remote areas might be influenced by the

potentially lower capture on the NDR of people living in these areas (see Methods

and classifications)

incidence rates across socioeconomic areas varied, at 4,000–4,500 per 100,000 type

2 diabetes registrants


Small geographic areas

– Over the five year period 2014–2018, incidence rates for insulin-treated type 2

diabetes were:

highest (5,400–6,000 per 100,000 NDR registrants with type 2 diabetes not

previously using insulin) in the Primary Health Network (PHN) areas of:

o Western Queensland (Queensland)

o Hunter New England (New South Wales)

o Central Coast (New South Wales)

o Darling Downs (Queensland)

o West Moreton (Queensland)

o Tasmania

lowest incidence in the PHN areas of Northern Territory (2,100 cases per 100,000

NDR registrants with type 2 diabetes not previously using insulin), Country Western

Australia (3,700), and Perth North (Western Australia) (3,900).

highest in the smaller geographical areas (statistical area level 3; SA3) of Botany

(New South Wales) (8,100 cases per 100,000 NDR registrants with type 2 diabetes

not previously using insulin), Port Stephens (New South Wales) (8,400) and Huon–

Bruny Island (Tasmania) (9,600)

lowest in the Northern Territory SA3 of Daly-Tiwi West Arnhem (965 cases per

100,000 NDR registrants with type 2 diabetes not previously using insulin) and

Katherine (412).

The coverage of the National Diabetes Services Scheme may be lower in SA3 areas with

remote communities or communities with large Aboriginal and Torres Strait Islander

populations. This might influence estimates on the number of people with insulin-treated

diabetes in these areas on the NDR. For more information, see Methods and classifications.


To explore the insulin-treated type 2 diabetes data by trends and demographics, see data

visualisation ‘Insulin-treated type 2 diabetes’

To explore insulin-treated type 2 diabetes data by geographic areas, see data visualisation

‘Insulin-treated type 2 diabetes: geographical areas’.


Time to first insulin use The majority of type 2 diabetes cases can be initially managed through a combination of diet,

exercise, and medication (RACGP 2016).

However, some people newly diagnosed with type 2 diabetes need insulin replacement from

diagnosis. While insulin treatment in a newly diagnosed patient is less common, it might be

used in patients with type 2 diabetes in hyperglycaemic emergencies.

When blood glucose levels can no longer be maintained at optimum levels through diet,

exercise, and other medications, insulin replacement might be required (RACGP 2016).

Eventually, many people with type 2 diabetes will need insulin as well as other treatments.

Between 2012 and 2018, the median time to first insulin use for people with insulin-treated

type 2 diabetes remained relatively unchanged, at about 7–8 years after diagnosis.

The proportion of people with insulin-treated type 2 diabetes, who began using insulin

immediately (that is, less than a year) after diagnosis remained relatively unchanged

between 2012 and 2017 at around 18–19%, with a slight rise to 21% in 2018.

Between 2012 and 2018, the proportion of people with insulin-treated type 2 diabetes who

began using insulin:

decreased from 23% to 19% for those who started insulin 1–5 years after diagnosis

decreased from 31% to 22% for those who started insulin 6–10 years after diagnosis

peaked in 2016 at 24% for those who started using insulin 11–15 years after

diagnosis, before falling to 21% in 2018

increased from 3% to 13% for those who started insulin 16–20 years after diagnosis

remained similar at about 3%–4% for those who started insulin 21 years or more after

diagnosis.

Data should be interpreted with caution. Many factors influence the timing of insulin initiation.

They include the benefits of early effective glycaemic control, the number of non-insulin

treatments available, glycaemic target used for individual patients, and the availability of

insulin supplies and monitoring equipment (RACGP 2015).

Data presented for time to first insulin use might include people who are prescribed insulin

treatment only once or for a short period of time, who might no longer be using insulin.



Age and sex

Between 2012 and 2018, the median time to first insulin use for people with insulin-treated type 2 diabetes was similar for males and females, at about 7–8 years.

In 2018, the median time to first insulin use increased with age, peaking among those aged 40–54 (10 years), and then decreasing. The median time among those aged 75 and over was 1 year.


Population groups

Between 2012 and 2018, the median time to first insulin use for people with insulin-treated

type 2 diabetes was similar across remoteness and socioeconomic areas.

References

RACGP 2015. The introduction of insulin in type 2 diabetes mellitus. East Melbourne:

RACGP.

RACGP 2016. General practice management of type 2 diabetes: 2016–18. East Melbourne:

RACGP.


Incidence of insulin-treated diabetes data

visualisation In this visualisation, you can explore the data for type 1 diabetes and insulin-treated type 2

diabetes by:

trends (calendar years)

age at first insulin use

population groups (Indigenous status, remoteness area, and socioeconomic area)

geographic areas (state and territory, Primary Health Network, and statistical area

level 3).




Data sources

National (insulin-treated) Diabetes Register

The National (insulin-treated) Diabetes Register (NDR) collects information about people

who began using insulin as part of their treatment for diabetes since 1999.

The register includes most people diagnosed with type 1 diabetes since this time, as well as

those with type 2 diabetes, gestational diabetes, and other less common forms of diabetes

who use insulin to manage their condition.

The Australian Institute of Health and Welfare (AIHW) maintains the NDR, which is derived

from 2 primary data sources:

The National Diabetes Services Scheme (NDSS)

Established in 1987, the NDSS is an initiative of the Australian Government,

administered with the assistance of 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.

Australasian Paediatric Endocrine Group (APEG) state-based registers

The 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 capture of insulin-treated diabetes on the NDR depends on the coverage of these 2

primary data sources.

For more information see the NDR data quality statement.

https://meteor.aihw.gov.au/content/index.phtml/itemId/727476


Methods and classifications

Comparison with previous reports

The methods to create the National (insulin-treated) Diabetes Register (NDR) have changed

in recent years. These include:

the way data are processed

how eligibility for the NDR is determined

changes to the method used to calculate the incidence of insulin-treated type 2

diabetes.

The derivation of the register applied these new methods retrospectively across all years.

Because of these changes, results presented in this report and based on the NDR 2018

cannot be compared with earlier publications, or with results based on earlier NDR data.

Diabetes type on the NDR

A health practitioner classifies diabetes type at the time of NDSS registration. But

misclassification can occur, as the symptoms of type 1 and type 2 diabetes can be similar,

particularly in young adults.

Further, changes in the classification of diabetes type in the NDSS data in 2002–2003 might

have resulted in people with insulin-treated type 2 diabetes being misclassified as having

type 1 diabetes.

So, as part of processing information from the primary data sources to create the NDR, the

reported diabetes type is checked against a set of criteria, and revised where necessary.

This algorithm (a method of calculation) assesses and reclassifies diabetes type for some

registrants on the NDSS. The reclassified diabetes type has been used to calculate

estimates by diabetes type for the NDR 2018.

The algorithm is based on age at diagnosis and the period between diagnosis and first

insulin use, because of the correlation with diabetes type. The algorithm has been

periodically updated in consultation with the AIHW Diabetes Expert Advisory Group. But with

or without the algorithm, there will always be some level of misclassification.

More information on the algorithm is available on request.

Incidence

Incidence is the number of new cases (of an illness or event) occurring in a population during

a given period. Incidence can be described as either a whole number or rate relative to the

total number of people at risk.

Incidence should not be confused with prevalence, which refers to the total number or

proportion of cases (of an illness or event) in a population at a given point in time.

In this report incidence of insulin-treated diabetes is described over the calendar year—that

is, the number of new cases from 1 January to 31 December in the year being reported.


Incidence rates

Throughout this report, incidence rates are calculated and presented based on the number of

cases per 100,000 population.

For example, the incidence rate of:

type 1 diabetes among males is calculated as a rate per 100,000 males in the

Australian population

insulin use among people with type 2 diabetes is calculated as a rate per 100,000

NDR registrants with type 2 diabetes not previously using insulin.

The denominator population used to calculate the incidence rates for insulin-treated type 2

diabetes has changed in recent years. As a result, the incidence rates presented in this web

report cannot be compared with earlier publications or results based on earlier NDR data.

For more information see Type 2 diabetes population.

Estimated resident populations

Population data were used to derive incidence rates of type 1 diabetes. Population data are

sourced from the Australian Bureau of Statistics (ABS), and updated when revised or new

estimates become available.

All population estimates that the ABS currently produces are based on area of usual

residence. These estimated resident populations are derived from the ABS Census of

Population and Housing, and adjusted for deaths, births and net migration.

The estimated resident populations used in this report are based on the population estimates

for 30 June 2018.

The Aboriginal and Torres Strait Islander population is calculated from the Census. Because

of the smaller Indigenous population, it is difficult to measure population changes accurately

between Census years using the same methods as for the Australian population. As a result,

the ABS has developed experimental estimates and projections based on the 2016 Census.

All calculations of rates for Aboriginal and Torres Strait Islander people use:

the estimated resident populations derived from the 2016 Census for 2005–2016

the Series B projected Indigenous populations for 2017 and 2018.

Type 2 diabetes population

All registrants with type 2 diabetes with no record of insulin use were used as the

denominator population to derive the incidence rates of insulin-treated type 2 diabetes.

The NDR derived data from the NDSS and APEG was used to identify the population with

diagnosed type 2 diabetes. As most people with type 2 diabetes registered with APEG are

also registered with the NDSS, the combined NDSS and APEG data are referred to in the

web report as NDSS data.

The population data included all people with type 2 diabetes who were diagnosed between

2000 and 2018 and were still alive on 31 December of each year of analysis.

The coverage of the Australian population with type 2 diabetes registered with the NDSS is

unknown, as not all people with type 2 diabetes need insulin treatment or register with the

NDSS. The NDSS might underestimate people with type 2 diabetes who manage their

diabetes primarily through diet, exercise, and medication.


The population for each year of the analysis was derived based on the diagnosis date of the

registrants recorded on the NDSS and APEG. Although NDSS data are available from 1987,

many people who registered with the NDSS in the early years of operation have a missing

diagnosis date. Where diagnosis date was missing, registration date was used as a proxy to

derive the population.

Due to concerns with the Aboriginal and Torres Strait Islander population derived from the

NDSS, incidence data for insulin-treated type 2 diabetes by Indigenous status have been

excluded from this report.

The NDSS might underestimate the number of Indigenous registrants because:

identifying as being Aboriginal or Torres Strait Islander is voluntary

people might access diabetes-related products through other programs

the coding of Indigenous status on the NDSS has changed.

For more information, see Indigenous status.

Age-specific rates

Age-specific rates provide information on incidence in an age group relative to the total

number of people at risk in the same age group.

All age-specific rates in this report are presented as new cases per 100,000 population.

Rates were not reported if the number of new cases of insulin-treated diabetes was less than

5.

Age-standardised rates

Age-standardisation is a method used to eliminate the effect of differences in population age

structures when comparing populations with different age structures, and where age affects

the variable being compared.

All incidence rates presented in this report are age-standardised to the 2001 Australian

population, and presented as age-standardised new cases per 100,000 population.

Age-standardised rates were not reported if the number of new cases of insulin-treated

diabetes was less than 20. Age groups were combined where there were less than 30 cases

in any age group to calculate age-standardised rates.

Time to first insulin use

Time to first insulin use is reported for 2012–2018. It was derived from the date of diagnosis

and date of first insulin use recorded on the NDR for people with insulin-treated type 2

diabetes.

Many registrants in the early years of operation of the NDSS have a missing date of

diagnosis. This affects the derivation of the time to first insulin use for people with insulin-

treated type 2 diabetes, as they might have been diagnosed long before starting insulin

treatment and registering with the NDSS.

Looking at missing data for diagnosis date from 2000–2018 showed that the percentage with

a missing date of diagnosis fell from 27% to 10%, stabilising at about 10%–13% in 2012–

2018. So, the analysis for time to first insulin use was restricted to 2012–2018.


Geography

Statistical area level 3

Data presented for smaller geographical areas are based on the area of usual residence,

using the statistical area level 3 (SA3) units defined in the Australian Statistical Geographical

Standard (ASGS) 2016. SA3 are geographical areas built from whole statistical areas level 2

(SA2).

In general, the SA3s are designed to have populations of 30,000–130,000. There are 358

spatial SA3 regions covering the whole of Australia without gaps or overlaps. SA3

correspondence files are sourced from the ABS.

Due to the small number of new cases of insulin-treated diabetes in some SA3s, incidence

rates have been calculated for a combined 5-year reference period (2014–2018).

Data for a SA3 were not reported if the number of new cases of insulin-treated diabetes was

less than 5 for an area.

Incidence rates were not reported if the number of new cases of insulin-treated diabetes was

less than 20 in the reference period; this affected 18% of SA3s for type 1 diabetes, and 1.8%

of SA3s for insulin-treated type 2 diabetes.

Primary Health Network

Primary Health Network (PHN) organisations connect health services across a specific

geographic area (a PHN area). The Australian Government Department of Health defines

the boundaries.

There are 31 PHN areas that cover the whole of Australia. PHNs replaced the previous 61

Medicare Locals on 1 July 2015. The boundaries align with Local Hospital Network (LHN)

boundaries (or equivalent), and take into account population size, LHN alignment, state and

territory borders, patient flow, stakeholder input and administrative efficiencies. Not all PHNs

directly align with the ABS ASGS structure.

Statistical area level 2 (SA2) data was combined up to the PHN area levels, using

concordance files sourced from ABS for the analysis of type 1 diabetes.

PHN correspondence files are sourced from the ABS for the analysis of insulin-treated type 2

diabetes. For this update, statistical information is presented using the 2017 boundaries of

the 31 PHNs.

Table 1.1 shows the number of PHNs by state and territory. Three jurisdictions (Tasmania,

the Northern Territory, and the Australian Capital Territory) are single PHNs. Their size,

particularly in jurisdictions with large Indigenous populations (such as the Northern Territory

and Western Australia), might mask important inter-area variation.

Incidence rates for PHNs with less than 20 new cases of insulin-treated diabetes in the

reference period were not reported. In 2018, this affected the Northern Territory and Western

Queensland PHNs.

http://www.health.gov.au/internet/main/publishing.nsf/content/phn-maps-aust

http://www.health.gov.au/internet/main/publishing.nsf/Content/PHN-Home


Table 1.1: Number of PHNs, by state and territory

State/territory Number of PHNs

New South Wales 10

Victoria 6

Queensland 7

Western Australia 3

South Australia 2

Tasmania 1

Australian Capital Territory 1

Northern Territory 1

Total 31

Remoteness area

Comparisons of regions in this report use the ABS Australian Statistical Geography Standard

(ASGS) 2016 Remoteness Structure, which groups Australian regions into 6 remoteness

areas: Major cities, Inner regional, Outer regional, Remote, Very remote and Migratory.

These areas are defined using the Accessibility/Remoteness Index for Australia (ARIA),

which is a measure of the remoteness of a location from the services that large towns or

cities provide. Accessibility is based on distance to a metropolitan centre.

A higher ARIA score denotes a more remote location. The category Major cities includes

Australia’s capital cities, except for Hobart and Darwin, which are classified as Inner

regional. Remote and Very remote areas have been combined in this publication,

and Migratory is excluded.

Further information on the ASGS is available on the ABS website.

The coverage of the NDSS might be lower in Remote and very remote areas or across states

and territories with large remote communities. This might influence estimates on the number

of people with insulin-treated diabetes in these areas on the NDR.

The lower coverage might in part be due to the distribution of NDSS access points, which

help deliver support services and products to people with diabetes in all states and territories.

These access points are more limited in rural Australia, and unavailable in some remote

communities, where other programs are sometimes available.

Socioeconomic area

Socioeconomic classifications in this report are based on the ABS Index of Relative Socio-

economic Disadvantage (IRSD). Geographic areas are assigned a score based on social

and economic characteristics of that area, such as income, educational attainment, public

sector housing, unemployment, and jobs in low skill occupations.

https://www.abs.gov.au/AUSSTATS/[email protected]/DetailsPage/1270.0.55.001July%202016?OpenDocument


A low score means an area has, on average, more low-income families, people with less

training, and higher unemployment, and might be considered disadvantaged relative to other

areas with higher scores.

High scores reflect a relative lack of disadvantage, rather than advantage, and the IRSD

relates to the average disadvantage of all people living in a geographical area. It cannot be

presumed to apply to all individuals living in the area.

For this report, the population is divided into 5 socioeconomic groups, with roughly equal

populations (each about 20% of the total), based on the level of disadvantage of the

statistical local area of their usual residence.

The first group includes the 20% of the population living in areas with the highest levels of

relative disadvantage (referred to as Group 1, lowest).

The last group includes the 20% of the population living in areas with the lowest levels of

relative disadvantage (referred to as Group 5, highest).

The IRSD values used in this report are based on the 2016 Census. Further information is

available on the ABS website.

Indigenous status

The NDR might underestimate the number of Aboriginal and Torres Strait Islander registrants

with insulin-treated diabetes. Reasons are as follows:

Indigenous status can only be reported for people who registered on the NDSS after

2005, due to changes in the way this variable is coded. Before 2005, data entry of

Indigenous status coded all ‘unknown’ or ‘not stated’ responses to the Indigenous

status question as ‘non-Indigenous’. In 2005, an extra value was added to indicate

‘inadequate/not stated’ where Indigenous status was not known. As a result,

Indigenous status cannot be determined for 98% of people registered on the NDSS

before 2005.

Identifying as being of Indigenous origin on both data sources of the NDR (NDSS and

APEG) is voluntary.

Other programs that give Indigenous Australians access to diabetes-related products

might result in lower registration rates for the NDSS, and subsequently the NDR,

among Aboriginal and Torres Strait Islander people. For example, programs such as

Aboriginal Medical Services and the National Aboriginal Community Controlled Health

Organisation—provide Indigenous Australians access to free and subsidised products

that people with insulin-treated diabetes need. In addition, NDSS access points are

not always available in remote areas.

These factors might lead to an underestimation of the incidence of type 1 diabetes among

Aboriginal and Torres Strait Islander people.

As a result of the classification changes in 2005 on the NDSS, it is not possible to derive the

prevalent type 2 diabetes population for Aboriginal and Torres Strait Islander people. So the

rates of insulin use among Indigenous type 2 diabetes have not been reported. The reporting

of insulin-treated type 2 diabetes in Aboriginal and Torres Strait Islander people is an

important data gap that requires future data development work.

https://www.abs.gov.au/AUSSTATS/[email protected]/DetailsPage/2033.0.55.0012016?OpenDocument

Documents

Incidence of insulin-treated diabetes in Australia