Huge spike in diabetes diagnoses in past two decades

There has been a sharp rise in the number of diabetes diagnoses since the turn of the century, according to new figures released by the Australia Institute of Health and Welfare (AIHW).
 
From 2000 to 2020 the number of people confirmed with the condition rose from around 460,000 to 1.3 million, the AIHW states in an analysis of data from the National Diabetes Services Scheme and Australasian Paediatric Endocrine Group.
 
The AIHW reports that age-standardised figures show around 4.3% of the population has now been diagnosed with the condition – again a very sharp increase on the proportion of 2.4% registered in 2020.
 
The number has stabilised in the past decade, according to AIHW spokesperson Richard Juckes. However, he highlighted that the figures represent around one in 20 of every Australians.
 
More than 90% of those – or 1.2 million people in total – are attributed to type 2 diabetes, which accounted for 48,000 diabetes diagnoses in 2020.
 
The figures were released during National Diabetes Week, which runs until 16 July. On 13 July, the RACGP called for the Federal Government to support longer consultations of more than 60 minutes to help general practices to manage the condition.
 
RACGP President Adjunct Professor Karen Price also said a 10% increase to rebates for consultations lasting longer than 20 minutes would help GPs provide care to patients with diabetes.
 
‘GPs and general practice teams play a vital role helping people manage chronic conditions like diabetes,’ Professor Price said.
 
‘With the right kind of investment, we can do even more.’
 
She highlighted the potential benefits of coordinating care using funds from the Workforce Incentive Program (WIP), which would allow practices to engage other health professionals such as nurses and allied health professionals, as well as Aboriginal and Torres Strait Islander health workers and practitioners.
 
Diabetes educators and general practice-based pharmacists could assist management of the condition, Professor Price said, adding that the college had ‘long championed’ coordinated care to reduce fragmentation and costs.
 
National Aboriginal Community Controlled Health Organisation (NACCHO) Director, Medicines Policy and Programs, Mike Stephens cited an existing project as an example of how more coordinated approaches can have a positive impact on conditions such as diabetes.
 
He described the Integrating Pharmacists within Aboriginal Community Controlled Health Services to Improve Chronic Disease Management (IPAC) project as ‘effective’.
 
‘We are encouraged by the Medical Services Advisory Committee’s recent appraisal in June 2022 of IPAC: “an excellent example of an integrated, collaborative, patient-centred approach to primary care which has the potential to have a meaningful societal impact by improving equity of health outcomes for Aboriginal and Torres Strait Islander peoples”,’ he said.
 
Mr Stephens called for ‘sustained investment’ to help integrate pharmacists into primary care settings, including Aboriginal Community Controlled Health Organisations.
 
Dr Gary Deed, Chair of RACGP Specific Interests Diabetes, said he would also welcome more help for the rising number of patients with diabetes.
 
‘This is a national problem, and, with greater support, practices can help people take charge of their health and get a better handle on conditions like diabetes,’ he said.
 
‘If a patient doesn’t have the right kind of support and isn’t managing their condition properly, the consequences can prove dire.
 
‘As an example, untreated or poorly managed diabetes can quickly lead to severe complications that involve almost all every part of your body, including your heart, eyes, blood vessels, kidneys, nerves, and more.’
 
The college states the likely number of people living with diabetes as more likely to be 1.8 million, including those with silent, undiagnosed type 2 diabetes.
 
According to the AIHW, clinical outcomes also vary significantly in different settings.
 
Those in remote and very remote areas are 1.3 times more likely to be living with diabetes, with residents having a 1.8 times greater chance of dying from diabetes compared to those in major cities.
 
There were 5100 deaths directly caused by diabetes in 2020, according to the AIHW, while the condition was an underlying cause in approximately 12,300 further mortalities that year.
 
Diabetes is also among the conditions linked to greater health risks for COVID-19 cases. The AIHW states that of 4700 patients hospitalised with COVID-19 in 2020–21, around one in five (20%) of those patients also had type 2 diabetes.
 
The RACGP has clinical guidelines for the management of type 2 diabetes available on its website.

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