Age and cohort rise in diabetes prevalence among older Australian women: Case ascertainment using survey and healthcare administrative data

Wubishet, Befikadu Legesse; Harris, Melissa L.; Forder, Peta; Byles, Julie

doi:10.1371/journal.pone.0234812

Cited by 7 publications

(11 citation statements)

References 38 publications

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“…Importantly, when we compared women between cohorts at roughly the same age, we found that women from the 1989–95 cohort had higher prevalence of diabetes and cardiac disease (which was largely driven by hypertension), with the prevalence of both conditions continuously increasing with age across the observation period. A similar age-wise trend for diabetes has been demonstrated with the two oldest cohorts of the ALSWH [ 17 ]. While some of the increase in prevalence at earlier ages for these conditions may be attributed to improved diagnostic techniques and early detection, findings from the U.S. suggest that even among adults with regular primary care access, those aged 18–39 were unlikely to receive a hypertension diagnosis compared to adults at least 40 years old despite meeting criteria for diagnosis [ 56 ].…”

Section: Discussionsupporting

confidence: 71%

Increased chronic disease prevalence among the younger generation: Findings from a population-based data linkage study to inform chronic disease ascertainment among reproductive-aged Australian women

Egan

Forder

2021

PLoS ONE

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Background Chronic disease represents an ongoing public health challenge in Australia with women disproportionately affected and at younger ages compared to men. Accurate prevalence and ascertainment of chronic disease among women of reproductive age at the population level is essential for meeting the family planning and reproductive health challenges that chronic diseases pose. This study estimated the prevalence of chronic disease among younger Australian women of reproductive age, in order to ascertain key conditions that would benefit from targeted family planning support strategies. Methods and findings Population-level survey data from the 1973–78 and 1989–95 cohorts of the Australian Longitudinal Study on Women’s Health were linked to health service use, pharmaceutical, cancer and cause of death data to ascertain the prevalence and chronic disease trends for ten chronic health conditions associated with poor maternal and foetal outcomes. Individual chronic disease algorithms were developed for each chronic disease of interest using the available linked datasets. Lifetime prevalence of chronic disease varied substantially based on each individual data source for each of the conditions of interest. When all data sources were considered, all conditions with the exception of mental health conditions were higher among women in the 1973–78 cohort. However, when focused on point prevalence at similar ages (approximately 25–30 years), the chronic disease trend for women in the 1989–95 cohort was substantially higher, particularly for mental health conditions (70.4% vs 23.6%), diabetes (4.5% vs 1.3%) and multimorbidity (17.9% vs 9.1%). Conclusions Given the low concordance between individual data sources, the use of multiple data sources are recommended for chronic disease research focused on women of reproductive age. In order to reduce the increasing chronic disease and multimorbidity trend among women, strategic chronic disease interventions are required to be implemented in childhood and adolescence to ensure the long-term health of not only current but also future generations.

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Section: Discussionsupporting

confidence: 71%

Increased chronic disease prevalence among the younger generation: Findings from a population-based data linkage study to inform chronic disease ascertainment among reproductive-aged Australian women

Egan

Forder

2021

PLoS ONE

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“…Among critically ill patients in India, 13.9% of the 1283 admissions in ICU over 4 years were established cases of diabetes, with 5.0% diagnosed as diabetes after admission. Past studies [ 17 , 31 ] have also reported significant interaction between pre-existing hyperglycaemia and the association between acute glycaemia and mortality among people with diabetes in ICU [ 17 ]. In-hospital control of glucose in people with diabetes receiving ICU care is associated with a reduced length of hospital stay and lower mortality rate [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…People were coded by their place of residence rather than admission hospital [16]. Since acute hospital admissions in Australia mainly occur in public hospitals, for this study, only public hospital APDC data of episodes of care was used, which has previously been validated in people with diabetes, and other populations [17][18][19][20].…”

Section: Methodsmentioning

confidence: 99%

Factors associated with long intensive care unit (ICU) admission among inpatients with and without diabetes in South Western Sydney public hospitals using the New South Wales admission patient data collection (2014–2017)

Osuagwu

Piya

et al. 2022

BMC Endocr Disord

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Background Long stay in intensive care unit (ICU) is associated with poor outcomes, particularly in people with diabetes. It increases the financial burden of care and this is a challenge to the South Western Sydney region, which is already a hotspot for diabetes in Australia. This study compared ICU admission characteristics of people with and without diabetes and the factors associated with long ICU stay among patients admitted to public hospitals in this metropolitan health district from 2014 to 2017. Methods Cross-sectional datasets on 187,660, including all ICU admissions in the New South Wales Admitted Patient Data Collection (APDC) from June 2014 – July 2017 in public hospital were extracted. Data on demographic and health insurance status, primary admission diagnosis using ICD-10, comorbidities including death among hospital inpatients aged ≥18 years residing in SWS were analysed. The ICU length of stay was the outcome variable and were classified into short stay (≤48 h) and long stay (> 48 h), and were examined against potential confounding factors using bivariate and multiple logistic regression analyses. Results Our results showed higher ICU admissions in patients with diabetes than in those without diabetes (5% vs. 3.3%, P < 0.001) over three years. The median and interquartile range (IQR) of length of the ICU stay were similar in both groups [diabetes: 40 h, IQR = 16–88 h vs. non-diabetes: 43 h, IQR = 19–79 h]. The prevalence of long ICU stays among people with and without diabetes were 44.9% [95% CI 42.1, 47.7%] and 43.6% [95% CI 42.2, 44.9%], respectively. For both groups, increased odds of long ICU stay were associated with death and circulatory system disease admissions, while musculoskeletal disease admissions were associated with lower risk of long ICU stay. In the non-diabetes group, male sex, nervous system disease admissions and living in peri-urban areas were associated with higher odds of long ICU stay. Conclusions The rate of ICU admissions among inpatients remain higher in people with diabetes. One in every two admissions to ICU had a long stay. Additional care for those admitted with circulatory system diseases are needed to reduce long ICU stay related deaths in SWS.

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“…For this study, only public hospital APDC data of episodes of care were used [ 18 ]. The APDC dataset has been previously validated in people with and without diabetes [ 19 – 21 ]. For instance, when APDC was used as a standard for validating self-reported diabetes status of people in the 45 and up study, the authors were able to identify 48.3% more people with diabetes whose status were not previously reported in their dataset [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

Analysis of in-hospital mortality among people with and without diabetes in South Western Sydney public hospitals (2014–2017)

et al. 2021

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Background Diabetes is a major public health problem affecting about 1.4 million Australians, especially in South Western Sydney, a hotspot of diabetes with higher than average rates for hospitalisations. The current understanding of the international burden of diabetes and related complications is poor and data on hospital outcomes and/or what common factors influence mortality rate in people with and without diabetes in Australia using a representative sample is lacking. This study determined in-hospital mortality rate and the factors associated among people with and without diabetes. Methods Retrospective data for 554,421 adult inpatients was extracted from the population-based New South Wales (NSW) Admitted Patient Data over 3 financial years (from 1 July 2014–30 June 2015 to 1 July 2016–30 June 2017). The in-hospital mortality per 1000 admitted persons, standardised mortality ratios (SMR) were calculated. Binary logistic regression was performed, adjusting for potential covariates and co-morbidities for people with and without diabetes over three years. Results Over three years, 8.7% (48,038 people) of admissions involved people with diabetes. This increased from 8.4% in 2014–15 to 8.9% in 2016–17 (p = 0.007). Across all age groups, in-hospital mortality rate was significantly greater in people with diabetes (20.6, 95% Confidence intervals CI 19.3–21.9 per 1000 persons) than those without diabetes (11.8, 95%CI 11.5–12.1) and more in men than women (23.1, 95%CI 21.2–25.0 vs 17.9, 95%CI 16.2–19.8) with diabetes. The SMR for those with and without diabetes were 3.13 (95%CI 1.78–4.48) and 1.79 (95%CI 0.77–2.82), respectively. There were similarities in the factors associated with in hospital mortality in both groups including: older age (> 54 years), male sex, marital status (divorced/widowed), length of stay in hospital (staying longer than 4 days), receiving intensive care in admission and being admitted due to primary respiratory and cardiovascular diagnoses. The odds of death in admission was increased in polymorbid patients without diabetes (28.68, 95%CI 23.49–35.02) but not in those with diabetes. Conclusions In-patients with diabetes continue to have higher mortality rates than those without diabetes and the Australian population. Overall, similar factors influenced mortality rate in people with and without diabetes, but significantly more people with diabetes had two or more co-morbidities, suggesting that hospital mortality may be driven by those with pre-existing health/comorbidities. Urgent measures in primary care to prevent admissions among people with multiple co-morbidities are needed.

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Age and cohort rise in diabetes prevalence among older Australian women: Case ascertainment using survey and healthcare administrative data

Cited by 7 publications

References 38 publications

Increased chronic disease prevalence among the younger generation: Findings from a population-based data linkage study to inform chronic disease ascertainment among reproductive-aged Australian women

Increased chronic disease prevalence among the younger generation: Findings from a population-based data linkage study to inform chronic disease ascertainment among reproductive-aged Australian women

Factors associated with long intensive care unit (ICU) admission among inpatients with and without diabetes in South Western Sydney public hospitals using the New South Wales admission patient data collection (2014–2017)

Analysis of in-hospital mortality among people with and without diabetes in South Western Sydney public hospitals (2014–2017)

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