20/08/2014 1 Diabetes in the Loddon Mallee Region Some of what we know from the available data Dougal Strachan Data and Information Analyst LMMML dstrachan@lmmml.org.au Kevin Masman Business Analyst, Data Analyst CHERC, Bendigo Health kmasman@bendigohealth.org.au
There were 356,807 people with diabetes who required insulin therapy registered on the NDSS. This is 31% of all people with diabetes & 1.6% of the overall population 20/08/2014 2 NDSS national registrants & insulin requirements Prevalence Nationwide: T1 Diabetes registrants 117,368 (10.8%) T1/(T1+T2) People With Diabetes Requiring Insulin by Diabetes Type T2 Diabetes registrants 965437 (89.2%) T2/(T1+T2) Total T1 & T2: 1,082,805 registrants ABS population clock: there were 23,545,655 Australian residents as of 28 July 2014 at 10:42:10 AM - one more person every 1 minute and 20 seconds People With Diabetes Requiring Insulin by Age Group
20/08/2014 3 NDSS registrants - National T1 & T2 age profiles & Gest Diab trend Nationally, median age of mothers increased 1970-2008, but now flat People with Type 1 Diabetes by Age Group People with Type 2 Diabetes by Age Group http://www.abs.gov.au/... Women Newly Registered with Gestational Diabetes Year Ending 31/March, not an age profile 14% p.a. increase. Mini-baby boom? Overweight? Change of diagnostic threshold? All three? Further analysis required! As of 20/07/2014 A 2010 study showed that 43% of pregnant women are obese or overweight Athukorala C, Rumbold AR, Willson KJ, Crowther CA. BMC Pregnancy Childbirth 2010; 10: 56
20/08/2014 4 NDSS registrants, Loddon Mallee Relative % T1 & T2 LGA T1 T2 SUM T1% T2% Bendigo 676 4361 5037 13.42% 86.58% Loddon 38 459 497 7.65% 92.35% Nationally: T1 = 10.8% T2 = 89.2% Mt Alexander 108 843 951 11.36% 88.64% Central Goldfields 82 940 1022 8.02% 91.98% Macedon Ranges 198 1525 1723 11.49% 88.51% Campaspe 211 2063 2274 9.28% 90.72% Gannawarra 53 715 768 6.90% 93.10% Buloke 28 396 424 6.60% 93.40% Swan Hill 117 1055 1172 9.98% 90.02% Mildura 299 2855 3154 9.48% 90.52% SUM 1810 15212 17022 10.63% 89.37%
20/08/2014 5 NDSS registrants, Victoria & southern NSW, all types Relative prevalence, all diabetes registrants, Victoria, southern NSW By LGA Kerang (Ganawarra) and Maryborough (Central Goldfields) Very High in LMR Very High in LMR circled Mildura Swan Hill Kerang http://www.ndss.com.au/en/research/australian-diabetes-map/map/ Maryborough Bendigo
20/08/2014 6 NDSS registrants, Victoria & southern NSW, T1 & T2 Type 1, relative prevalence Type 2, relative prevalence Relative prevalence: Type 1 Greater Bendigo is High in LMR circled Mildura Swan Hill Kerang Maryborough Bendigo Mildura Swan Hill Kerang Maryborough Bendigo Relative prevalence Type 2 Gannawarra & Buloke & Murray are Very High, Loddon, Campaspe, Central Goldfields are High in LMR circled
20/08/2014 7 A health profile summary of Gr Bendigo LGA - health conditions, some risk factors NDSS has a lower figure Data is available for all LGAs LGA Rank is out of 85 Boxed: Some rankings of risk factors for Greater Bendigo LGA
20/08/2014 A health profile summary of Gr Bendigo LGA - health conditions and health behaviours 8 http://docs.health.vic.gov.au/docs/doc/ce93cd79edda0114ca257852000719f0/$file/loddon%20mallee%20region_final.pdf LGA Rank is out of 85 Boxed: Some more rankings of risk factors for Greater Bendigo LGA
20/08/2014 Gannawarra, Central Goldfields risk factors - health conditions and health behaviours 9 Gannawarra (Kerang) LGA Central Goldfields (Maryborough) LGA Health factors LGA Rank is out of 85 Health factors LGA Rank is out of 85 Health behaviours LGA Rank is out of 85 Health behaviours LGA Rank is out of 85
20/08/2014 10 Diabetes coded inpatients in Bendigo Health Note: Patients deceased since 2000 are included Type 1 Inpatients Type 2 Inpatients Gestational Diabetes Inpatients/outpatients 1036 Pts (12%) T1/(T1 + T2) 7871 Pts (88%) T2/(T1 + T2) 784 Pts As of 15 July, 10,075 Diabetes Patients in total have been coded out of a total of 384,201 registered patients (2.6%). Patients record since 1976, coding record only after 1/1/1998. About 36% of all inpatients are people with diabetes (source: Diabetes Educator long term stats) About a third of these require insulin, ie 10% inpatients About 25% of inpatients require other diabetes awareness/obs/care/management
Nationally: 20/08/2014 11 Bendigo Health diabetes education HARP BH Community Health 1994 Pts T1: 401 Pts (28%) T2: 1021 Pts (72%) 739 Pts in common 1615 Pts T1: 279 Pts (34%) T2: 549 Pts (66%) T1, T2 & Gest
00 05 00 09 00 12 01 03 01 06 01 09 01 12 02 03 02 06 02 09 02 12 03 03 03 06 03 09 03 12 04 03 04 06 04 09 04 12 05 03 05 06 05 09 05 12 06 03 06 06 06 09 06 12 07 03 07 06 07 09 07 12 08 03 08 06 08 09 08 12 09 03 09 06 09 09 09 12 10 03 10 06 10 09 10 12 11 03 11 06 11 09 11 12 12 03 12 06 12 09 12 12 13 03 13 06 13 09 13 12 14 03 14 06 20/08/2014 12 Type 1 diabetes episodes in Bendigo Health Time series: 2000 to June 2014 80 70 60 50 40 30 20 10 0
00 06 00 09 00 12 01 03 01 06 01 09 01 12 02 03 02 06 02 09 02 12 03 03 03 06 03 09 03 12 04 03 04 06 04 09 04 12 05 03 05 06 05 09 05 12 06 03 06 06 06 09 06 12 07 03 07 06 07 09 07 12 08 03 08 06 08 09 08 12 09 03 09 06 09 09 09 12 10 03 10 06 10 09 10 12 11 03 11 06 11 09 11 12 12 03 12 06 12 09 12 12 13 03 13 06 13 09 13 12 14 03 14 06 20/08/2014 13 Type 2 diabetes episodes in Bendigo Health Time series: June 2000 to June 2014 600 It is estimated that Aboriginal Australians are 3-4 times more likely to develop type 2 diabetes than the general population. (http://www.diabetesvic.org.au/type-2-diabetes/aboriginal-and-torres-strait-islander) 500 The change is very approximately 3% increase p.a. Population has increased by about 1.5% p.a. in BH catchment 400 300 200 data artefact/anomaly? 100 0
2000 01 2000 05 2000 08 2000 12 2001 03 2001 06 2001 09 2001 12 2002 03 2002 06 2002 09 2002 12 2003 03 2003 06 2003 09 2004 01 2004 04 2004 07 2004 10 2005 01 2005 04 2005 07 2005 10 2006 02 2006 05 2006 08 2006 11 2007 02 2007 05 2007 08 2007 11 2008 02 2008 05 2008 08 2008 11 2009 02 2009 05 2009 08 2009 11 2010 02 2010 05 2010 08 2010 11 2011 02 2011 05 2011 08 2011 11 2012 02 2012 05 2012 08 2012 11 2013 02 2013 05 2013 08 2013 11 2014 02 2014 05 20/08/2014 14 Gestational diabetes episodes in Bendigo Health Time series: Incidence of gestational diabetes, 2000 to June 2014 30 25 20 The national trend is 16% increase p.a. This more granular data shows more complexity over time 15 10 5 0
(blank) 20/08/2014 15 Inpatient diabetes comorbidities in Bendigo Health 150 130 Time series: 1998-2014 Coded diagnoses positions 3, 4, 5, 6, 7 indicate diabetes comorbidities increasing by approx. 5.0% annually 110 90 70 50 data artefact? data artefact/anomaly? 1 3 4 5 6 7 30 10-10
20/08/2014 16 DKA presentations in Bendigo Health ED Time series: 2011-2014 Coded DKA diagnoses in ED, an example of inaccurate data 12 10 8 6 4 2 0 Feb Mar Apr Jun Jul Aug Oct Nov Dec Feb Mar Apr Jun Jul Aug Oct Nov Dec Feb Mar Apr Jun Jul Aug Oct Nov Dec Feb Mar Apr Jun Jul
20/08/2014 17 LMMML GP Patient Data 16.0% Diabetes Patient Age Profile 14.0% Patients % of total Active Patients (n=85,195) Diabetes Related 143 0.2% Diabetes Type 1 513 0.6% Diabetes Type 2 3,722 4.4% Diabetes Undefined 1,848 2.2% Gestational Diabetes - 0.0% Total 6,226 7.3% 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0%
20/08/2014 18 LMMML GP Patient Data % of Group Diagnosis Group With Diabetes Asthma 15.2% Bone & Joint Diseases 36.9% Cancer 7.4% Cardiovascular Diseases 27.2% Chronic Disease Risk Factor 21.3% Chronic Kidney Disease 6.2% COAD 6.7% Drug Abuse 0.4% Hyperlipidaemia 41.2% Hypertension 63.7% Mental Health 24.0% Sexual Health 0.2% Stroke 5.5%
20/08/2014 LMMML Victorian Admitted Episodes Dataset 19 (VAED) 2012/13 Ambulatory Care Sensitive Conditions VAED LMMML Region 2012/13 Diabetes Complications 2916 17.5% Hypertension 2558 15.4% Pyelonephritis 1914 11.5% Dehydration & Gastroent 1839 11.0% Chronic Obstruct Pulmonary 1538 9.2% Congestive Heart Failure 1039 6.2% Dental Conditions 720 4.3% Cellulitis 662 4.0% Angina 660 4.0% Iron Deficiency Anaemia 632 3.8% Ear Nose & Throat Infection 558 3.4% Asthma 475 2.9% Convulsion & Epilepsy 420 2.5% Nutrition Deficiencies 255 1.5% Pelvic Inflammatory Disease 176 1.1% Influenza 131 0.8% Perforated Bleeding Ulcer 73 0.4% Gangrene 65 0.4% Other Vaccine 18 0.1% 30% 25% 20% 15% 10% 5% 0% VAED - Diabetes Complications Age Profile 00-09 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+
20/08/2014 20 Thank you Dougal dstrachan@lmmml.org.au