Type 2 diabetes in australia statistics 2011 nepal,reversing diabetes raw for 30 days' promise,diabetes medication uptodate 19.3 - PDF Review

Latests numbers released by the International Diabetes Federation have revealed that the number of Australian adults diagnosed with diabetes has reached almost 1.7 million - or one in ten.
The data also estimates that at the end of 2012, over 46 per cent of type two diabetes patients people with type two diabetes were not achieving their blood glucose goals.
Poor blood glucose control can lead to a variety of serious diabetes complications, such as cardiovascular disease, blindness, kidney failure and amputation of limbs. The latest IDF numbers support the data in an Australian report released last year, entitled Diabetes: the silent pandemic and its impact on Australia. It is expected that by 2025, type 2 diabetes - Australia’s fastest growing chronic disease - will triple in prevalence, with three million Australians diagnosed. Some statistics about type 2 diabetes state that 215000 people under 20 will be diagnosed with type one or two diabetes.
Pre-diabetes is also increasing because many of the younger generation have high blood sugar but not enough to really matter or effect the body. The amount of money spent in the United States on diabetic supplies and medications annually is 174 billion dollars, and will only increase as more people are diagnosed with type 2 diabetes.
Indigenous Australians have lower standards of health compared to non-Indigenous Australians.
The majority of the Indigenous population (76%) lives in major cities or regional centres8.
The greatest difference in prevalence between Indigenous and other Australians occurs between the ages of 35-44 and 45-54 years, when rates were approximately 5 times that of non-Indigenous Australians. To put this into perspective, the Indigenous health gap (the difference in Disability-Adjusted Life Years (DALYs) between Indigenous and the total Australian population) accounts for 59% of the total burden of disease for Indigenous Australians (Table 1). Table 1 Rate ratios of Indigenous to total DALYs for Australian population (age-adjusted).
Classically, risk factors for disease have been classified as modifiable (lifestyle) and non-modifiable (age, sex and genetics). Body mass index (BMI) and age are the strongest predictors of diabetes in Indigenous and other Australians14. Prevalence is highest in the middle aged (45-54 years) whilst the oldest age group has a lower prevalence (may be due to a cohort or survivor effect).
At the most basic level, Indigenous Australians do not have the same quality of life or SES as other Australians. Table 2 The demographic and socio-economic characteristics of participants (n=777) with regards to housing tenure, household income or employment status and the relative odds of diabetes.
For all characteristics, groups with lower SES had a higher proportion of individuals with type 2 diabetes. When diabetes was first reported in Indigenous communities, it was attributed to a genetic susceptibility.
In almost all studies on diabetes involving Indigenous Australians, the risk in both sexes is excessive relative to other Australians. At first it may appear to be a complex model but when broken down there are two categories that affect whether the outcome is disease.
Of course, such a multifactorial model does not apply equally to all Indigenous Australians.
Figure 3 Postulated multifactorial model describing the social and environmental determinants of type 2 diabetes in Indigenous Australians. There are many factors operating to cause diabetes, many of which operate beyond the individual from a much wider social and cultural context.
The many risk factors for type 2 diabetes shared with other Australians are only compounded by the social disadvantage experienced by Indigenous Australians. Another important factor affecting the type 2 diabetes health gap is access to and affordability of quality health care. It is important to emphasise that type 2 diabetes is largely preventable and that the health burden can be reduced in the Indigenous population.
However, there are greater socio-economic issues at play that need to be addressed, concerning the children who do not or cannot attend school (who may be at a higher risk of later comorbidity); this lies beyond the scope of this paper. A key factor that would help to reduce the incidence of diabetes would be to encourage weight control.
Indigenous Australians have a chronic disease health burden including type 2 diabetes that is many times greater than that of their non-Indigenous counterparts. An estimated 917,000 (5.4%) Australian adults aged 18 years and over had diabetes in 2011–12, based on self-reported and measured data, from the ABS 2011–12 Australian Health Survey.
Approximately 1% of the adult population did not report that they had diabetes, which may indicate they were unaware that they had the condition, compared with 4% who were aware of it and reported their diabetes.
There are currently no national measured data for monitoring trends in diabetes prevalence. Several factors may have contributed to the rise in self-reported diabetes during this period, such as: increased incidence of type 2 diabetes, increased public awareness, better detection of disease, improved survival leading to people living longer with diabetes and an ageing population.
There are currently no national data that capture the prevalence of type 1 diabetes at all ages, but there are estimates for children—over 6,000 children aged 0–14 had type 1 diabetes in 2013.
Note: measured data from the ABS Australian Health Survey can detect signs of diabetes, but it cannot be used to estimate the prevalence of type 1 or type 2 diabetes. The National (insulin-treated) Diabetes Register (NDR) is the most reliable source of information on the incidence (new cases) of type 1 diabetes in Australia. In 2014, there were 2,509 new cases of type 1 diabetes in Australia, equating to 11 cases per 100,000 population.
The incidence of type 1 diabetes remained relatively stable between 2000 and 2014, with 11 to 13 new cases per 100,000 population each year. 7 cases per 100,000 population in Remote and very remote areas and ranged from 11–14 per 100,000 population in other areas of Australia (Figure 5).
9 cases per 100,000 population for Aboriginal and Torres Strait Islander people and 11 cases per 100,000 population for non-Indigenous Australians. Incidence rates of type 1 diabetes may be influenced by the lower capture of Indigenous Australians and people living in Remote and very remote areas on the primary data sources of the National (insulin-treated) Diabetes Register.
Information on the number of adults with type 2 diabetes is only available from self-reported information from the ABS 2011–12 Australian Health Survey.
In 2011–12, an estimated 849,000 adults aged 18 years and over (4.7%) reported that they had type 2 diabetes. Information about insulin use by people with type 2 diabetes is available from the National (insulin-treated) Diabetes Register (NDR). In 2012–13, around 24,100 hospitalisations for women who gave birth were recorded with either a principal or additional diagnosis of gestational diabetes.
In 2009–11, according to the AIHW National Perinatal Data Collection, 5.8% of women who gave birth and who did not have pre-existing diabetes were diagnosed with gestational diabetes.

Total excludes 57 women who gave birth and had missing or not stated diabetes in pregnancy status (2) or missing age (55). According to the National (insulin-treated) Diabetes Register, 6,625 women with gestational diabetes began using insulin in 2014. This rise could reflect greater awareness in the community of the symptoms and consequences of diabetes (leading to increased check-ups and diagnoses); and more people surviving diabetes due to improved medical interventions, as well as an actual increase in cases. In 2007-08, the majority of people with diabetes reported they had Type 2 diabetes (88% or 721,000 people). Around 77% of people with Type 2 diabetes were aged 45 years and over when they were first diagnosed, compared with 16% of people with Type 1 diabetes.
The report was researched and written by Baker IDI Heart & Diabetes Institute in partnership with Diabetes Australia, the Juvenile Diabetes Research Foundation and Novo Nordisk.
Statistic show that diabetes and diabetes type 2 affect 25.8 million people in the United States only, making it one of the worlds (besides AIDs) biggest health concerns.
Type 2 diabetes causes (and is the leading cause) kidney failure, blindness, and lower limb numbness.
Gestational Diabetes occurs when a woman is pregnant and can be dangerous to both child and mother. The poorest people have high levels of illness and premature mortality - but poor health is not confined to those who are worst off.
Apart from genetics and its role in disease aetiology, this poor health is associated with factors not shared by the rest of the population. Significantly, 70% of this health gap is explained by non-communicable diseases11, not seen in Indigenous Australians before European colonisation. Davis and colleagues12 found that the age of diagnosis in Aboriginal patients averaged 14 years younger than Anglo-Celt patients. Increasingly, social determinants have been recognised by epidemiologists as contributing to inequalities of health status. Prior to colonization, Aborigines lived as hunter-gatherers whose diet included a variety of healthy foodstuffs. The basic causes of illness are the same in Indigenous and non-Indigenous peoples, but the burden of disease, disability and death is consistently higher in Indigenous people2. As is the case with any population, there will be a certain amount of heterogeneity with a significant genetic admixture13. Such health inequity in a developed country such as Australia is undeniable and certainly avoidable.
This includes poverty secondary to high unemployment, dependency on social welfare, poor educational attainment, overcrowded living conditions and inferior housing, poor community infrastructure and water supply and poor standards of hygiene4.
Such a discrepancy is exacerbated by late presentation, complicated illness, poor compliance and inadequate follow-up2. The most appropriate measures would need to involve a whole government and multiple sector approach, in consultation with Aboriginal elders, their respective communities and Aboriginal organisations6. Children would see the greatest benefit of risk reduction measures (primary prevention) targeting the prevention of obesity with healthy diet and exercise.
Previous studies have found that regular physical activity built into daily routines and selecting foods with good nutritional value are effective measures4. This health inequity stems from fundamental social and environmental determinants superimposed on genetic factors. Closing the gap in a generation: health equity through action on the social determinants of health.
Preventable chronic diseases among indigenous Australians: the need for a comprehensive national approach.
The rising prevalence of diabetes and impaired glucose tolerance: the Australian Diabetes, Obesity and Lifestyle Study. Obesity, diabetes and associated cardiovascular risk factors among Torres Strait Islander people. Burden of disease and injury in Aboriginal and Torres Strait Islander Peoples: the Indigenous health gap. Characteristics and outcome of type 2 diabetes in urban Aboriginal people: the Fremantle Diabetes Study. Diabetes and cardiovascular risk factors in urban Indigenous adults: Results from the DRUID study. Socioeconomic status and diabetes among urban Indigenous Australians aged 15-64 years in the DRUID study. Quantifying the excess risk of type 2 diabetes by body habitus measurements among Australian aborigines living in remote areas. This includes people with type 1 diabetes, type 2 diabetes, and type unknown but excludes gestational diabetes.
Almost 2 in 3 (63%) new cases of type 1 diabetes were among children and young people under 25 years. This was around 2,400 new cases of type 1 diabetes each year—an average of 7 new cases per day.
For more information, please refer to the National (insulin-treated) Diabetes Register 2014 Data Quality Statement. This is likely to underestimate the number of Australians with type 2 diabetes, as many cases remain unreported, due to survey participants either not knowing or accurately reporting their diabetes status. A further 10% (82,000 people) reported they had Type 1 diabetes, while 2% of people with diabetes did not know which type of diabetes they had. Just under a quarter (23%) of people with Type 1 diabetes were diagnosed in childhood (under 15 years), and a further 24% in early adulthood (15 to 24 years).
The vast amounts of diabetes is due to the high sugar amounts in today’s food and medical advances that keep the defective diabetes gene in the population.
People over 65 are 25% of the United States diabetic patients, meaning that more people develop diabetes at a later state. Type 2 diabetes statistics show that two out of ten mothers will develop this during their pregnancy. See if you’re at risk for developing type 2 diabetes by looking up type 2 diabetes statistics and talking to your doctor. Such diseases as type 2 diabetes have a disproportionately high prevalence in Aboriginal and Torres Strait Islanders. With urbanisation and the adoption of more sedentary lifestyles, there has been an upsurge in the prevalence of lifestyle diseases affecting the Indigenous population, including type 2 diabetes mellitus (non-insulin dependent)2.
These criteria describe a group with relative insulin resistance resulting from failure of pancreatic islet b-cells to compensate for hyperglycaemia. There have been no comprehensive national studies, comparable to the 2002 AusDiab Study5 that took blood samples on Indigenous Australians.

Diabetes contributed 12% to the Indigenous health gap, especially in those aged 35 and over. These factors are often superimposed on a background of genetic susceptibility to diabetes.
Diabetes has been found to be considerably more common among those with lower SES status17 (Table 2). An individual’s genetic profile, factors in early life, poverty (and its high associated disease burden) and psychosocial mediators are likely to contribute.
Therefore, such a model of disease cannot be regarded as universal due to varying genetic predisposition, background and circumstance. Indigenous Australians experience a health disadvantage for almost all diseases and risk factors (like tobacco smoking, high BMI and physical inactivity) at all ages, men and women, in remote and non-remote areas11. These greater socio-economic factors are not seen in the majority of the Australian population and are detrimental to the health and wellbeing of Indigenous people. Many communities of rural Australia struggle with accessibility to health promotion and screening programs. Programs implemented through school canteens can offer healthy options that provide much of the recommended daily intakes for key nutrients. A possible form of secondary prevention could be to have regular, cost-effective diabetes screening, such as fasting blood glucose measurements. Coupled with poor nutritional status and the adoption of western lifestyles, Aboriginal and Torres Strait Islanders experience much higher rates of type 2 diabetes. The reasons for this are many and constitute a multifactorial model of disease that incorporates genetic susceptibility, social disadvantage, inactive lifestyle and poor nutritional status.
This upward trend in recent decades far exceeds the same epidemic seen in the rest of the Australian population. The complications associated with diabetes includes microvascular and macrovascular damage; specifically retinopathy, nephropathy and ischaemic heart disease and stroke3. Such data is needed to accurately assess the health burden associated with diabetes and its complications in Aboriginal and Torres Strait Islanders9.
There is a disproportionate amount of the Indigenous health gap (40%) experienced by those in remote areas (where 24% of the population lives).
There was no significant difference in the proportion of each group that died prior to follow-up but age of death in the Aboriginal group was 18 years younger12. Health and illness seem to follow a social gradient whereby people of a lower socio-economic position have worse health than those of higher socio-economic status (SES)1.
As discussed by Brimblecombe et al16, there seems to be a dose-response relationship between BMI and diabetes risk (Figure 2). With the transition to a western lifestyle comes a diet of inferior nutrient quality that is energy dense, high in fat, salt, sugars and low in fibre2.
However, the study sample was volunteer-based and may have been subject to selection bias if those with low SES and diabetes were more likely to participate. However, it is clear that the coexistence of obesity and type 2 diabetes due to Western lifestyle is not limited to Indigenous people.
However, more distal forces operating at a community or societal level affect these variables.
There are a number of reasons that could explain this situation, that extend beyond the shift towards a more sedentary lifestyle. Other high risk factors such as cigarette smoking and alcohol consumption contribute to the complications of chronic disease and are more prevalent in the Indigenous population6.
Tertiary measures could reduce the likelihood of diabetes progression and the development long-term sequelae through educational programs on drug compliance and ongoing clinical care2. Rather than viewing this situation as a failure, it should be seen as the potential to make leaps and bounds in the way of health gains for Indigenous Australians.
These women also have an increased chance of getting diabetes in the next ten years after the pregnancy.
The burden of type 2 diabetes represents an urgent challenge to be addressed by the government in close consultation with Indigenous communities. Nevertheless, diabetes is known to be a significant health burden in Indigenous and other Australians. Diabetes was nearly twice as prevalent in remote areas (9%) than in non-remote areas (5%) in 2004-510.
It should be noted that in this study there were few (n=18) in the Aboriginal compared to the Anglo-Celt group (n=819) so, the figures may not accurately represent the underlying population.
More recently, Barker and colleagues (1992) showed that poor nutrition and growth in utero or during infancy carries increased risk of developing diabetes later in life19.
Below is a postulated multifactorial model of how such determinants of type 2 diabetes may interact (Figure 3). Historically, Aboriginal people have been subjected to socio-economic and political marginalisation and racial prejudice2.
Psychosocial factors like stress, racism and discrimination and the legacy of dispossession are likely to have further negative impacts on health regardless of SES17. Figures from the National Aboriginal and Torres Strait Islander Health Survey (2004-5) reported an overall prevalence of diabetes to be 6% in the Aboriginal community (Figure 1).
It is evident that Indigenous Australians have more DALYs resulting from diabetes than in the total population. Fresh fruits and vegetables and lean meats have limited availability and are more expensive than calorie rich foods14.
Indigenous children have high rates of low birth weight which (along with obesity in adulthood) is associated with insulin resistance20 although the physiological mechanism remains unclear. These conditions have detrimental flow on effects on education and job opportunity leading to subsequent poverty. Whatever action is taken, it is clear that Indigenous people should be actively encouraged and empowered to take responsibility for their health and wellbeing. Statistics based on self report data showed Indigenous people were 3.4 times more likely to self-report some form of diabetes10.
Limited access to health care facilities and under-investment in infrastructure in rural communities1 only broadens the Indigenous health gap.

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