Prevalence and incidence of diabetes among Aboriginal people in remote communities of the Northern Territory, Australia: a retrospective, longitudinal data-linkage study

Abstract

ObjectivesTo assess the prevalence and incidence of diabetes among Aboriginal peoples in remote communities of the Northern Territory (NT), Australia.DesignRetrospective cohort analysis of linked clinical and administrative data sets from 1 July 2012 to 30 June 2019.SettingRemote health centres using the NT Government Primary Care Information System (51 out of a total of 84 remote health centres in the NT).ParticipantsAll Aboriginal clients residing in remote communities serviced by these health centres (N=21 267).Primary outcome measuresDiabetes diagnoses were established using hospital and primary care coding, biochemistry and prescription data.ResultsDiabetes prevalence across all ages increased from 14.4% (95% CI: 13.9% to 14.9%) to 17.0% (95% CI: 16.5% to 17.5%) over 7 years. Among adults (≥20 years), the 2018/2019 diabetes prevalence was 28.6% (95% CI: 27.8% to 29.4%), being higher in Central Australia (39.5%, 95% CI: 37.8% to 41.1%) compared with the Top End region (24.2%, 95% CI: 23.3% to 25.1%, p<0.001). Between 2016/2017 and 2018/2019, diabetes incidence across all ages was 7.9 per 1000 person-years (95% CI: 7.3 to 8.7 per 1000 person-years). The adult incidence of diabetes was 12.6 per 1000 person-years (95% CI: 11.5 to 13.8 per 1000 person-years).ConclusionsThe burden of diabetes in the remote Aboriginal population of the NT is among the highest in the world. Strengthened systems of care and public health prevention strategies, developed in partnership with Aboriginal communities, are needed.

Risk of kidney disease following a pregnancy complicated by diabetes: a longitudinal, population-based data-linkage study among Aboriginal women in the Northern Territory, Australia

“…The Aboriginal population of the NT encompasses numerous distinct people groups. These regions are known to have marked differences in health outcomes [2]. Smoking status during the index pregnancy was missing for 1430 (13.6%) women.…”

“…Indigenous populations impacted by colonisation are disproportionately affected by diabetes and related cardiometabolic conditions [1]. The prevalence of type 2 diabetes in Aboriginal people in the Northern Territory (NT), Australia, is among the highest of any population globally [2]. Onset is occurring at increasingly young ages, especially in women [3].…”

“…The NT spans 1.35 million km 2 (more than twice the size of France) but has a population density of just 0.2 people/km 2 [18]. Almost one-third of the population identify as Aboriginal people and most live in remote communities [18].…”

Pathology Testing at the Point of Patient Care: Transformational Change for Rural Communities

“…[9]. Diabetes and associated renal disease were at the time, and continue to be, a major contemporary health problem for Aboriginal and Torres Strait Islander peoples who experience rates of diabetes that are three times the national average and up to 12% in remote areas [10,11]. In these latter geographically isolated areas, testing through traditional pathology laboratories was characterised by long delays for turnaround of pathology results and high rates of patient loss to follow-up.…”

Surgery for rheumatic heart disease in the Northern Territory, Australia, 1997–2016: what have we gained?

“…The prevalence of diabetes mellitus is rising annually by 2.5% and is now among the highest in the world, while the incidence of end-stage kidney disease increased by 67% between 1996 and 2014. 8 9 There has also been a 24% increase in Aboriginal NT residents’ hospitalisation for respiratory diseases without an improvement in associated mortality. 10 This growing burden of chronic disease is the main contributor to the 15.4 years difference in life expectancy between Aboriginal and non-Aboriginal NT residents.…”