Diabetes prevalence underestimated in Australia: Study

There could be up to 35% more people living with diabetes in Australia than registered on the National Diabetes Services Scheme (NDSS), according to researchers at the University of Sydney.
 
In an article published this month in the Diabetes Research and Clinical Practice journal, authors suggest there could be two million people in Australia aged over 45 living with the condition.
 
Currently, estimates based on the NDSS indicate around 1.3 million Australians in that age bracket are living with diabetes.
 
The new research linked data for 266,414 individuals from The 45 and Up Study, led by the Sax Institute, to administrative health data sets.
 
Researchers used an algorithm to identify people with diabetes based on claims for dispensed insulin and glucose lowering medicines, as well as diabetes-related hospital admissions, and diabetes-specific Medicare claims.
 
It found 53,669 people identified with ‘certain’ diabetes, of whom only 34,864 were registered to the NDSS.
 
Registration with the NDSS is voluntary, and the authors suggest that if the levels of non-registration reported in their study occur nationally, there may be closer to two million people aged 45 and older living with diabetes.
 
For Dr Gary Deed, Chair of RACGP Specific Interests Diabetes, the research has worrying implications.
 
‘These figures, if accurate, give rise to further concern about the burden placed upon GPs and primary care, as diabetes and its accompanying illnesses, such as heart disease, obesity, and kidney and eye disease, require multidisciplinary care models to support people living with this illness,’ he told newsGP.
 
‘It means further investment is needed in general practice to address these alarming statistics.’ 
 
The study’s researchers also say their work shows the value in using linked administrative data for diabetes monitoring.
 
‘Compared with the NDSS the algorithm detected a greater proportion of diabetes amongst individuals aged 75 years and over, living in remote/very remote areas, from [culturally and linguistically diverse] backgrounds, and with a history of comorbidities, indicating targeted strategies may be needed to improve NDSS registration rates,’ they wrote.
 
They added that their work showed the complexities in using the NDSS and other routine administrative data to classify diabetes by type.
 
Lead author Emma Cox, a PhD Candidate from University of Sydney’s Leeder Centre for Health Policy, Economics and Data, described the findings as a public health issue as well as a data issue.
 
‘A significant number of Australians are missing from national statistics,’ she said. ‘That makes it harder to plan services, allocate funding, and deliver prevention strategies where they’re most needed.’
 
Professor Grant Brinkworth, Director of Research at Diabetes Australia, said the findings indicate the exact picture of diabetes is yet to be seen.
 
‘Understanding the true scale is essential if we want to improve outcomes for individuals and manage the national impact of this condition,’ he said.
 
The authors acknowledge the study’s limitations, including that the algorithm may need updating to reflect the introduction of new diabetes-specific MBS items; and that diabetes medicines such as SGLT2-inhibitors and GLP-1 receptor agonists are now also used for other conditions.
 
They also note the age of the study cohort means they are ‘more likely to be engaging with the healthcare system’ and that the findings may differ in a younger population.
 
Data recently published by the Australian Bureau of Statistics indicates diabetes diagnoses are on the rise, with a reported 6.6% of adults now living with the condition compared to 5.1% a decade ago.
 
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diabetes National Diabetes Services Scheme University of Sydney