Ruqayyah Snyder
Diabetes is a serious condition that affects a significant number of people in Australia. It is the leading cause of preventable blindness in working-age Australians and is the fastest-growing chronic condition in the country. The impact of diabetes is felt not only by those diagnosed but also by their family members and carers, resulting in a substantial annual cost to the Australian economy. With the prevalence of diabetes on the rise, understanding its scope and impact is crucial for addressing this pressing health challenge.
| Characteristics | Values |
|---|---|
| Total number of people with diabetes | 1.2 million (2017-18) |
| Type 1 diabetes | 144,800 |
| Type 2 diabetes | 998,100 |
| Gestational diabetes | 43,100 women (2017-18) |
| Deaths from diabetes (Jan-Nov 2021) | 4,535 |
| Deaths from diabetes (Jan-Nov 2020) | 4,515 |
| Deaths from diabetes (2015-19 average) | 4,113 |
| Hospitalisations for diabetes and kidney disease per year | 250,000+ |
| People with diabetes on dialysis or with a kidney transplant | 12,400 |
| People with diabetes living with kidney disease | 280,000 |
| People hospitalised with diabetes-related foot ulcers per year | 27,600 |
| People with diabetes and a disability | 10.8% |
| People with diabetes not in the labour force | 13.2% |
| People with diabetes with a low education level (Year 10 or below) | 12.4% |
| Aboriginal and Torres Strait Islander Australians with type 2 diabetes | 3 times more likely than non-Indigenous Australians |
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What You'll Learn
Type 1 and Type 2 diabetes prevalence
Diabetes is an epidemic and the biggest challenge confronting Australia's health system. It is the seventh most common cause of death by disease in the country and the leading cause of non-traumatic lower-limb amputation. In 2017-18, 1 in 20 Australians were estimated to have diabetes, which is about 4.9% or 1.2 million people. The number of people with diabetes in Australia is likely underestimated because self-reported data does not include undiagnosed cases. The ABS 2011-12 Australian Health Survey, which included measured and self-reported data, showed one undiagnosed case for every four adults diagnosed with diabetes.
Type 2 diabetes is the most common form of the disease, accounting for 85% of all diabetes cases in Australia and is largely preventable. It is characterised by the underproduction of insulin and/or the body's inability to use insulin effectively. In 2017-18, close to 1 million Australian adults, or 5.3% of over-18-year-olds, had type 2 diabetes, according to self-reported data from the ABS National Health Survey. Type 2 diabetes is often linked to lifestyle factors such as physical inactivity, poor diet, obesity, and smoking. It can be managed with changes to diet and exercise, insulin injections, glucose-lowering medications, or a combination of these methods.
Type 1 diabetes accounts for 10% of all diabetes cases in Australia and is increasing. It requires insulin replacement therapy for all people with this type of diabetes. Hospitalisation rates with type 1 as the principal diagnosis were highest among people aged 10 to 19 years, at 96 and 118 per 100,000 for males and females, respectively. There are currently 134,000 Australians living with type 1 diabetes, up from 144,800 people in 2017-18.
Gestational diabetes is also a form of diabetes that affects women during pregnancy, and those who have had it are at greater risk of developing type 2 diabetes later in life. In 2017-18, around 1 in 6 women aged 15-49 who gave birth in hospital were diagnosed with gestational diabetes, according to the National Hospital Morbidity Database.
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Diabetes and death rates
Diabetes is the seventh most common cause of death by disease in Australia. In 2021, there were 4,535 deaths from diabetes between January and November, a figure comparable to the same period in 2020, but 10.4% higher than the 2015-19 average. The age-standardised mortality rate for diabetes was 1.6-1.7 times as high among males as females. Mortality rates for diabetes also increased with age, with rates 2.3 times as high in those aged 85 and over compared to those aged 80-84, and 4.2 times as high as those aged 75-79.
The death rate from diabetes among First Nations people was 4.6 times that of non-Indigenous people. Aboriginal and Torres Strait Islander Australians are four times more likely to die from type 2 diabetes than non-Indigenous Australians. People with diabetes are also between two and four times more likely to develop heart disease, which is the number one cause of death for people with type 2 diabetes. It contributes to almost two-thirds of all deaths in people with diabetes.
Hospitalisation and death rates from diabetes are also higher in lower socioeconomic areas. People living with a disability, in lone-person households, outside the labour force, and with lower educational attainment are also more likely to have diabetes. Diabetes is more prevalent among those born overseas than those born in Australia.
Type 2 diabetes is the most common form of the disease, affecting 87.6% of diabetics, while type 1 diabetes affects 9.6%. In 2017-18, close to 1 million Australian adults, or 5.3% of over-18-year-olds, had type 2 diabetes. Overall, in 2017-18, 4.9% of Australians, or 1.2 million people, were estimated to have diabetes.
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Diabetes and hospitalisation
Diabetes is a pressing health issue in Australia, with a significant impact on hospitalisation rates. In 2021-22, there were just over 1.2 million hospitalisations associated with diabetes, accounting for 10% of all hospitalisations in the country. This figure rose to 1.3 million hospitalisations in 2020-21, representing 11% of total hospitalisations.
Hospitalisations due to diabetes occur as a result of several factors, including acute or chronic complications, comorbidities, and the need for procedures to manage the condition. Type 2 diabetes, the most common form of the disease, accounts for a significant proportion of these hospitalisations. In 2020-21, there were around 1.1 million hospitalisations with Type 2 diabetes recorded as the principal and/or additional diagnosis. Type 1 diabetes also contributes to hospitalisations, with the highest rates among those aged 15-19.
The impact of diabetes on hospital resources is significant. For example, in 2020-21, there were 6,100 lower limb amputations and 4,500 weight loss procedures undertaken for people with Type 2 diabetes. Additionally, diabetes-related foot ulcers result in over 27,600 hospital admissions annually, many of which lead to limb amputations. Furthermore, diabetes is a leading cause of preventable blindness, with associated vision loss costing Australia an estimated $2.07 billion per year.
Certain demographic groups in Australia are disproportionately affected by diabetes and have higher hospitalisation rates. Aboriginal and Torres Strait Islander people have a higher prevalence of diabetes and are 4.3 times more likely to be hospitalised with Type 2 diabetes than non-Indigenous Australians. Additionally, those living in remote and very remote areas are 2.5 times more likely to be hospitalised for diabetes than those in major cities, due in part to limited access to primary healthcare and diabetes education resources.
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Risk factors for diabetes
Several factors can increase an individual's risk of developing diabetes. These risk factors can be divided into two categories: modifiable and non-modifiable. Modifiable risk factors are those that can be controlled or influenced by lifestyle choices and behaviours, while non-modifiable risk factors are inherent and cannot be changed.
Non-modifiable risk factors for diabetes include:
- Family history and genetics: Those with a family history of diabetes, particularly if a parent or sibling has type 1 or type 2 diabetes, are at an increased risk.
- Age: The risk of developing type 2 diabetes increases with age. While it typically occurs in middle-aged adults, it can also affect younger individuals, with cases reported in children and adolescents.
- Race and ethnicity: Certain racial and ethnic groups have a higher predisposition to developing diabetes. This includes Black Americans, Asian Americans, Latino or Hispanic Americans, Native Americans, Pacific Islanders, and Alaskan Natives.
Modifiable risk factors for diabetes include:
- Weight and body composition: Being overweight or obese is a significant risk factor for type 2 diabetes. Losing weight and maintaining a healthy weight can help reduce this risk. Additionally, waist circumference is an important indicator of abdominal fat and can be a risk factor, even if an individual has a normal BMI.
- Physical activity: A sedentary lifestyle or physical inactivity can increase the risk of developing type 2 diabetes. Engaging in regular physical activity and increasing overall activity levels can help lower this risk.
- Diet: A poor diet can contribute to the development of type 2 diabetes. Adopting a healthy and balanced diet can help manage and reduce the risk.
- Smoking: Smoking is a modifiable risk factor that can increase the chances of developing diabetes. Quitting smoking through available tools, medications, and resources can help mitigate this risk.
- Gestational diabetes: Women who develop gestational diabetes during pregnancy have an increased risk of developing type 2 diabetes later in life. Additionally, their children may be at higher risk of developing type 2 diabetes during their adolescence.
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The cost of diabetes
In 2017–18, 1 in 20 Australians were estimated to have diabetes, which is about 4.9% or 1.2 million of the population. The cost of diabetes to the Australian healthcare system is significant. In 2020-21, an estimated $3.4 billion of expenditure in the Australian health system was attributed to diabetes, representing 2.3% of total disease expenditure. This figure includes spending on medications dispensed through the Pharmaceutical Benefits Scheme ($952.7 million), as well as spending on hospital services ($1.2 billion).
The annual direct per-person costs of diabetes vary depending on weight status and the presence of complications. For example, the annual total direct cost for a person with normal weight and no diabetes was estimated to be $1,998, while for a person with obesity and diabetes, it was $3,131. The presence of micro- and macrovascular complications can also significantly increase costs, with the total annual cost of diabetes in 2005 for Australians aged ≥30 years being $10.6 billion.
In summary, the cost of diabetes in Australia is substantial, both financially and in terms of the impact on individuals' health and well-being. Preventative measures and interventions can play a crucial role in reducing the financial burden of the disease and improving health outcomes for those affected.
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Frequently asked questions
In 2017-18, 4.9% of the population or 1.2 million Australians were estimated to have diabetes.
Type 2 diabetes is the most common form of the disease, with 998,100 people affected compared to 144,800 people with type 1 diabetes.
There are over 250,000 hospitalisations for diabetes and related conditions such as kidney disease each year.
Diabetes is the seventh most common cause of death by disease in Australia, with 4,535 deaths attributed to diabetes between January and November 2021.
