Detecting the hidden burden of pre-diabetes and diabetes in Western Sydney

Gideon Meyerowitz-Katz; Shanthini Seelan; Pankaj Gaur; Rona Francisco; Shahana Ferdousi; Thomas Astell-Burt; Xiaoqi Feng; Stephen Colagiuri; Glen Maberly; Tien-Ming Hng

doi:10.1016/j.diabres.2019.04.019

Detecting the hidden burden of pre-diabetes and diabetes in Western Sydney

Diabetes Res Clin Pract. 2019 May:151:247-251. doi: 10.1016/j.diabres.2019.04.019. Epub 2019 Apr 18.

Authors

Affiliations

¹ Western Sydney Local Health District, Australia; Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Australia; School of Public Health, Peking Union Medical College, Tsinghua University and the Chinese Academy of Medical Sciences, China.
² Bridgeview Medical Practice, Australia; School of Public Health, Peking Union Medical College, Tsinghua University and the Chinese Academy of Medical Sciences, China.
³ Western Sydney Local Health District, Australia; School of Public Health, Peking Union Medical College, Tsinghua University and the Chinese Academy of Medical Sciences, China.
⁴ School of Public Health, Peking Union Medical College, Tsinghua University and the Chinese Academy of Medical Sciences, China; Wentwest, Western Sydney Primary Health Network, Australia.
⁵ Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Australia; Menzies Centre for Health Policy, University of Sydney, Australia; School of Public Health, Peking Union Medical College, Tsinghua University and the Chinese Academy of Medical Sciences, China.
⁶ School of Public Health, Peking Union Medical College, Tsinghua University and the Chinese Academy of Medical Sciences, China; Boden Institute, University of Sydney, Australia.
⁷ Western Sydney Local Health District, Australia; University of Sydney, Australia; School of Public Health, Peking Union Medical College, Tsinghua University and the Chinese Academy of Medical Sciences, China.
⁸ Western Sydney Local Health District, Australia; University of Western Sydney, Australia; School of Public Health, Peking Union Medical College, Tsinghua University and the Chinese Academy of Medical Sciences, China.

PMID: 31004674
DOI: 10.1016/j.diabres.2019.04.019

Abstract

Aims: Examining pre-diabetes and diabetes rates using glycated haemoglobin (HbA_1c) in emergency department (ED) and in general practice (GP) in western Sydney.

Methods: Epidemiological study of HbA1c measurements in individuals ≥18 years receiving a blood test (1) in the hospital setting of the ED at Blacktown/Mt Druitt hospital (1/06/2016 to 31/05/2018) and (2) in primary care involving Bridgeview Medical Practice (BVMP) (1/03/2017 to 01/02/2018) as well as other general practices (June 2018 only).

Results: Totals of 55,568 individuals from ED and 5911 individuals from GP. The prevalence of diabetes in tested individuals was 17.3% (n = 9704) in ED and 17.4% (n = 1027) in GP. The prevalence of pre-diabetes in ED was 30.2% (n = 16,854) and 26.6% (n = 1576) in GP. Regression controlling for age, season, and gender revealed a weekly increase of 1.1% in odds for diabetes and 1.5% for pre-diabetes (p < 0.001), in line with the yearly absolute increase of 1% in rate for both tested and coded hospital patients. In BVMP the rate of diabetes rose by 22% during the testing period from 8.9% to 11%.

Conclusions: There exists a high burden of diabetes both in hospitals and general practice. Testing in ED and general practice revealed similarly high burdens of diabetes across different areas of the healthcare system. In the appropriate hospital and primary care setting, HbA1c can be used to identify individuals with diabetes that may benefit from targeted intervention.

Keywords: Community; Diabetes; Epidemiology; General Practice; Hospital; Testing.

MeSH terms

Australia
Diabetes Mellitus / diagnosis*
Diabetes Mellitus / epidemiology*
Diabetes Mellitus / pathology
Female
Glycated Hemoglobin / analysis
Glycated Hemoglobin / metabolism*
Humans
Male
Prediabetic State / diagnosis*
Prediabetic State / epidemiology*
Prediabetic State / pathology
Prevalence

Substances

Glycated Hemoglobin A