Diabetes: 175 diagnoses a day, least recognised complication revealed

More than 1.3 million Australians received a diabetes diagnosis between 2000 and 2020, almost tripling case numbers during the period, according to ‘Diabetes: Australian facts’ from the Australian Institute of Health and Welfare (AIHW).

In 2020, one in 20 Aussies had the condition, and around 63,900 people are diagnosed with diabetes each year — an average of 175 a day, the report said.

Diabetes is a chronic condition caused either by the inability to produce insulin (a hormone made by the pancreas to keep blood glucose levels in range) or by the body not being able to use insulin effectively, or both. For the first time, linked National Diabetes Services Scheme and Australasian Paediatric Endocrine Group state-based registry data has been used to show the sheer impact of diabetes on the Australian population by capturing a clear time series from 2000 to 2020.

“The report primarily covers type 1, type 2 and gestational diabetes. Overall, the number of people living with diabetes almost tripled between 2000 and 2020 from 460,000 to 1.3 million representing 2.4% to 4.3% of the population (age-standardised). Numbers have stabilised in the last decade; however, 1 in 20 Australians were living with the condition in 2020,” said AIHW spokesperson Richard Juckes.

Type 2 diabetes comprises over 90% of diabetes cases in Australia, for which there were more than 48,000 people diagnosed in 2020 and 1.2 million (4.5%) Australians living with the condition.

A challenging yet least recognised complication

Latest data from Diabetes Australia reveals that almost 700,000 people living with diabetes experience a mental or emotional health challenge every year.

Diabetes Australia Group CEO Justine Cain said diabetes mental health challenges are the most prevalent, yet least recognised diabetes complication.

“Concerningly, the latest figures show that about 400,000 people living with diabetes report difficulties accessing mental health care. That’s a lot of people who aren’t getting the help and support they need,” she said.

The new data has prompted Diabetes Australia to launch its new Let’s Rethink Diabetes campaign as part of National Diabetes Week (10–16 July).

Cain said there is an urgent need for change to both community attitudes and the way Australia’s health system delivers diabetes mental health support.

“Diabetes mental health challenges are widespread, but they are rarely discussed as part of routine diabetes care. They really are a silent diabetes complication,” Cain said.

Cain said there was no silver bullet but there were some key areas of action that could significantly improve outcomes for people with diabetes: better awareness of diabetes mental health issues like diabetes distress and burnout; putting mental health support at the centre of diabetes healthcare; calling out diabetes-related stigma wherever it happens.

Leading GP Dr Gary Deed, who specifically is involved in providing health care to people living with diabetes, said he was seeing more people with diabetes experiencing mental and emotional health challenges.

“Living with diabetes can be complex and unrelenting. That daily management, on top of the worry about long-term diabetes-related complications, can become a real burden,” Dr Deed said.

“It’s important that health professionals understand the reality of living with diabetes and I’d encourage people working in the field to undertake relevant training to support all people with diabetes.”

Other complications

“Diabetes increases the risk of health complications, including heart disease, stroke, kidney disease, blindness and lower limb amputation. It is also frequently associated with other chronic health conditions,” Juckes said.

In 2020, diabetes was the underlying cause of death in around 5100 deaths (29% of diabetes deaths). In a further 12,300 deaths (71% of diabetes deaths), diabetes itself did not lead directly to death, but was one of the complications of other diseases, such as cancer, coronary heart disease and stroke.

Diabetes is one of many conditions correlated with greater health consequences for people with COVID-19. Of the 4700 hospitalisations involving a COVID-19 diagnosis in 2020–21, 20% of admitted patients had type 2 diabetes. Similarly, diabetes was a pre-existing condition in 20% of the 3600 deaths due to COVID-19 between January 2020 and March 2022, according to the AIHW.

“The prevalence of diabetes varies depending on where people live. After adjusting for age, Australians living in Remote and Very remote areas were 1.3 times more likely to be living with diabetes and 1.8 times more likely to die with diabetes compared to those living in major cities,” Juckes said.

An estimated $3.0 billion of health system expenditure was attributed to diabetes in 2018–19, representing 2.3% of total disease expenditure in Australia.

Image credit: ©stock.adobe.com/au/zlikovec