Latest information and statistics on Diabetes

Diabetes is a chronic disease marked by high levels of glucose in the blood, caused by the pancreas not producing enough insulin or not being able to use the insulin effectively, or both [44997].

There are several types of diabetes. The most frequently occurring are type 1, type 2 and gestational diabetes mellitus (GDM) [45520]. Type 1 diabetes is usually diagnosed in people aged under 30 years but can develop at any age. Type 2 diabetes is the most common form and is largely preventable by maintaining a healthy lifestyle. GDM is a form of diabetes that can occur in pregnancy [29667].

Diabetes can cause life-threatening complications [44997], and reducing its impact among Aboriginal and Torres Strait Islander people is one of the key goals of the Australian national diabetes strategy 2021-2030 [44185]. Type 2 diabetes occurs at earlier ages for Aboriginal and Torres Strait Islander people [44997]and is often undetected and untreated [30593]. Complications from diabetes may occur within months of diagnosis, while others may develop over several years [28843]. Aboriginal and Torres Strait Islander people with diabetes tend to have higher levels of risk factors such as smoking [44997][31982][45876] and may show signs of other chronic conditions, including chronic kidney disease (CKD), cardiovascular disease (CVD), liver disease and anaemia [28856].

Extent of diabetes among Aboriginal and Torres Strait Islander people

Prevalence

In the 2018-19 NATSIHS, 7.9% of Aboriginal and Torres Strait Islander people reported having diabetes [39231]. Prevalence was similar among Torres Strait Islander people (7.9%) and Aboriginal people (7.8%) [39231]. The prevalence of diabetes among Aboriginal and Torres Strait Islander males and females was 7.6% and 8.2% respectively. Diabetes levels increased with age, with the prevalence among those aged 55 years and over (35%) being 14 times higher than those aged 25-34 years (2.5%). The proportion of people with diabetes was highest in WA and the NT (both 11%), followed by Qld (8.7%), SA (8.6%), NSW (6.3%), Vic (5.5%), the ACT (5.2%) and Tas (4.7%). Prevalence was higher in remote areas (12%) than non-remote areas (7.0%).

The 2021 Census measured the number of people who had a long-term health condition [45577]. Diabetes (excluding GDM) was reported by 5.9% of Aboriginal and Torres Strait Islander people.

In 2021, there were 587 Aboriginal and Torres Strait Islander children and young adults aged 0-19 years known to be living with type 1 diabetes[1] [45543]. The crude prevalence of type 1 diabetes among this group was 158 per 100,000.

A 2021 study using cross-sectional data from primary healthcare services found that in northern Australia, the crude prevalence of youth-onset type 2 diabetes in Aboriginal and Torres Strait Islander people aged 24 years or younger was 6.7 per 1,000 [44101]. A large study using linked data from 51 of the 84 health centres that serve the NT’s remote Aboriginal communities found that the prevalence of diabetes among Aboriginal adults aged ≥20 years in these communities was 29% in 2018-2019 [45240].

Incidence

In 2021, the crude rate of all new diabetes diagnoses (diabetes incidence) among Aboriginal and Torres Strait Islander people was 256 per 100,000 [45543]. Rates differed by diabetes type and sex (Table 1).

Table 1. Incidence of diabetes, by diabetes type and sex, Aboriginal and Torres Strait Islander people, 2021

	Number			Crude rate
Diabetes type	Males	Females	Persons	Males	Females	Persons
Type 1	84	67	151	19	15	17
Type 2	1,009	968	1,977	230	220	225
All diabetes[2]	1,156	1,091	2,248	263	248	256

Notes:

• Rates are per 100,000 population.
• Rates may be influenced by the low capture on the National Diabetes Services Scheme of Aboriginal and Torres Strait Islander people living in places classified as remote and very remote.
• Excludes persons whose Indigenous status was not stated or inadequately described.

Source: AIHW, 2023 [45543]

In 2021-22, there were 2,465 new cases of GDM among Aboriginal and Torres Strait Islander women aged 15-49 years, with a crude incidence proportion of 16% [45543]. Incidence increased with age, from 11% in the 15-24 years age-group to 31% in the 40-49 years age-group.

Hospitalisation

For 2021-22, hospitalisations for Aboriginal and Torres Strait Islander people with diabetes as an additional diagnosis[3]included:

• 81,402 hospitalisations with diabetes as a principal and/or additional diagnosis, with a crude rate of 9,171 per 100,000 (age-standardised rate 14,433 per 100,000)
• 3,202 hospitalisations with type 1 diabetes as a principal and/or additional diagnosis, with a crude rate of 361 per 100,000 (age-standardised rate 409 per 100,000)
• 73,167 hospitalisations with type 2 diabetes as a principal and/or additional diagnosis, with a crude rate of 8,243 per 100,000 (age-standardised rate 13,440 per 100,000) [45543].

For 2017-19, 7,664 Aboriginal and Torres Strait Islander people were hospitalised for a principal diagnosis of diabetes, at a crude rate of 4.6 per 1,000 [42101]. Rates were similar for Aboriginal and Torres Strait Islander males (4.5 per 1,000) and females (4.7 per 1,000). Age-specific hospitalisation rates increased with age, from 0.3 per 1,000 for those aged 0-4 years to 18 per 1,000 for those aged 65 years and over.

The age-standardised hospitalisation rates varied by jurisdiction and were lowest in Tas (4.4 per 1,000) and highest in Vic and WA (8.5 per 1,000). In the same period, the age-standardised rate was highest for Aboriginal and Torres Strait Islander people living in remote areas (10 per 1,000) and lowest for those living in major cities (5.0 per 1,000) [42101].

In 2017-19, there were 2,150 hospitalisations (24% of all diabetes hospitalisations) with a principal diagnosis of type 1 diabetes. The age-standardised hospitalisation rate was 1.3 per 1,000, with higher rates among females than males (1.4 per 1,000 and 1.2 per 1,000 respectively) [35608]. There were 5,389 hospitalisations (60% of all diabetes hospitalisations) with a principal diagnosis of type 2 diabetes. The age-standardised hospitalisation rate was 5.3 per 1,000, with higher rates among males than females (5.8 per 1,000 and 4.9 per 1,000 respectively). There were 1,291 hospitalisations (14% of all diabetes hospitalisations) with a principal diagnosis of diabetes during pregnancy among Aboriginal and Torres Strait Islander women.

In 2021-22, there were 4,850 potentially preventable hospitalisations of Aboriginal and Torres Strait Islander people for a principal diagnosis of diabetes [48392].

Mortality

Diabetes was the second leading specific cause of death among Aboriginal and Torres Strait Islander people in NSW, Qld, SA, WA and the NT combined in 2022, accounting for 329 deaths (7.2% of all deaths) [47832]. The age-standardised mortality rate was 86 per 100,000 (crude rate 42 per 100,000). Age-standardised rates were higher among females (91 per 100,000) than males (79 per 100,000). In 2018-2022, diabetes was a major cause of death for older Aboriginal and Torres Strait Islander people; age-specific mortality rates ranged from 51 per 100,000 for those aged 45-54 years to 596 per 100,000 for those aged 75 years and over. In 2022, the age-standardised diabetes mortality rate was highest in the NT (185 per 100,000) and lowest in NSW (56 per 100,000)[4].

Burden of disease

In 2018, endocrine disorders accounted for 3.3% of total disease burden, 3.0% of fatal burden and 3.6% of non-fatal burden among Aboriginal and Torres Strait Islander people [44827]. The majority of total endocrine disease burden was caused by diabetes (type 2: 87%; type 1: 7%). Of total endocrine disease burden, 43% was fatal and 57% was non-fatal.

[1] There is no national data available for the prevalence of type 2 diabetes.

[2] Including type 1, type 2 and other diabetes, but excluding GDM [45543].

[3] Diabetes that co-exists with the patient’s main condition, or that arises during the patient’s time in hospital [45543].

[4] Of those four jurisdictions for which separate jurisdictional data were available (NSW, Qld, WA and the NT) [47832].