Diabetes Fact Sheet

			What is Diabetes? (162 kb)
			This five page fact sheet, written by Diabetes Australia, provides an overview of diabetes and includes sections on: The types of diabetes What are the key signs and symptoms of diabetes? How is diabetes managed? What are the aims of treatment?

Diabetes - Our Community at Risk

An estimated 7.5% of the Australian adult population has diabetes.

One in four people over age 25 have some form of impaired glucose metabolism either in the form of impaired glucose tolerance or impaired fasting glycaemia according to The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) released by the International Diabetes Institute Melbourne in 2001 (Zimmet, Prof P et al 2001). In Australia there are around 1.2 million people with diabetes. However, only half of these people are diagnosed.

Following on the shirt tails of AusDiab came the DiabCost results released by Diabetes Australia in September 2002 which showed that the financial burden of diagnosed Type 2 diabetes is an estimated $3 billion a year, a staggering $1.8 billion more than previously suspected.

Interestingly, diabetes medication to control the disease accounted for only 4% of all healthcare costs. The main component of direct health costs were hospitalisation due to complications.

The Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) demonstrated significant reductions in complications in people with Type 1 and Type 2 Diabetes who were managed by keeping near "non-diabetic" blood glucose levels. These two studies have increased efforts in improving glycaemic control to reduce both the economic and personal burden of diabetes related complications.

People with undiagnosed diabetes are more likely to have complications from their diabetes at an earlier age. This then raises the question of finding those who are undiagnosed with Type 2 diabetes. How should we be screening for those half million undiagnosed cases? Identifying those at risk is the goal, then encouraging them to see their doctor for a fasting venous glucose for a definite diagnosis. Random blood glucose testing (a finger prick test with a hand held meter), is done in some communities, however they are not to be considered diagnostic for diabetes.

Several years ago the Australian Diabetes Educators Association (ADEA) released a recommendation to discontinue public random glucose testing. Some of the reasons for this recommendation were: random blood glucose screening is not diagnostic, too many variables can influence the outcome of public testing, risks are associated with invasive techniques such as transmission of blood-borne viruses, including HIV, and Hepatitis B & C, for both staff and public and others. The ADEA is currently reviewing this recommendation, however the points are worth consideration.

It is now recommended that priority be given to identify individuals at high risk of diabetes through the risk assessment Tick Test. A positive response to any one of the risk statements identifies risk of diabetes.

At risk individuals are then encouraged to have a fasting venous plasma glucose done with their GP to assess their status. Diabetes Australia is promoting a health campaign "Be Well, Know Your BGL" to encourage those with risk factors to see their doctor for proper assessment.

References

1. Diabesity and Associated Disorders in Australia 2000. The Australian Diabetes, Obesity and Lifestyle Study (AusDiab). International Diabetes Institute, Melbourne, 2001.

2. DiabCost Australia: Assessing the Burden of Type 2 Diabetes in Australia . Australian Centre for Diabetes Strategies, Diabetes Australia , M-Tag and Eli Lilly, September, 2002.

3. Diabetes Control and Complications Trial (DCCT) Research Group. (1993). The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The New England Journal of Medicine 329(14) p977-986.

4. UK Prospective Diabetes Study (UKPDS) Group (1998). Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes, Lancet 352(9131), p 837-853.

5. Australian Diabetes Educators Association. Position Paper, 1998.