An atlas of diabetes in South Australia: Population patterns of prevention, detection and management

The WHO Global report on diabetes (2016) highlights the scale of diabetes as an important public health problem. The number of adults living with (type 1 and type 2) diabetes has almost quadrupled since 1980 to 422 million adults. This dramatic rise is largely due to the rise in type 2 diabetes and factors driving it include overweight and obesity. For Australia, the scale of the issue is no different. In the 2011 burden of disease study diabetes was ranked the twelfth leading cause of the total burden of disease (eighth for males and fourteenth in females). Diabetes also contributes to coronary heart disease which is the top ranked cause of the total burden of disease. For causes of the fatal burden of disease, diabetes is ranked ninth (eleventh for males and ninth for females) and coronary heart disease is ranked the leading cause. The WHO report calls upon governments to ensure that people are able to make healthy choices and that health systems are able to diagnose, treat and care for people with diabetes. It encourages us all as individuals to eat healthily, be physically active, and avoid excessive weight gain. For Australia, diabetes is ranked the sixth leading cause of death contributing 3% of total deaths [2]. Over one in every 20 (5.1%) people were estimated to have been informed by a healthcare professional that they had diabetes in 2014/15 [3]. The true prevalence is likely to be higher given that there will be a proportion who are undiagnosed. Almost nine out of every 10 (86.3%) of these cases were type 2 diabetes. In addition, (based on 2011/12 data) there are also estimated to be a further 3.1% of adults who are at high risk of type 2 diabetes. With respect to the major risk factors for diabetes, in 2014/15 44.5% of the Australian population were estimated to miss the recommended level of physical activity in the last week, either being inactive or insufficiently active and almost two in every three (63.4%) adults were overweight or obese. Healthcare directly attributable to diabetes costs approximately $1.7 billion per year with the total cost (including reduced productivity and absence from work) estimated to cost up to $14 billion per year. The average annual healthcare cost per person with diabetes is estimated to be $4,025 if there are no associated complications but more than doubles to $9,645 in people with complications. Importantly, Type 2 diabetes is largely preventable [4], and the risk of those with diabetes developing complications can be reduced significantly with appropriate management.