학술논문
Prevalence and incidence of diabetes among Aboriginal people in remote communities of the Northern Territory, Australia: a retrospective, longitudinal data-linkage study.
Document Type
Academic Journal
Author
Hare MJL; Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia matthew.hare@menzies.edu.au.; Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia.; Zhao Y; Population and Digital Health, NT Health, Darwin, Northern Territory, Australia.; Guthridge S; Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.; Burgess P; Population and Digital Health, NT Health, Darwin, Northern Territory, Australia.; Primary Health Care Division, Top End Region, NT Health, Darwin, Northern Territory, Australia.; Barr ELM; Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.; Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.; Ellis E; Department of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.; Butler D; Sector and System Leadership Division, NT Health, Darwin, Northern Territory, Australia.; Rosser A; Primary Health Care Division, Central Australia Region, NT Health, Alice Springs, Northern Territory, Australia.; Falhammar H; Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.; Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden.; Maple-Brown LJ; Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.; Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Source
Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: To assess the prevalence and incidence of diabetes among Aboriginal peoples in remote communities of the Northern Territory (NT), Australia.
Design: Retrospective cohort analysis of linked clinical and administrative data sets from 1 July 2012 to 30 June 2019.
Setting: Remote health centres using the NT Government Primary Care Information System (51 out of a total of 84 remote health centres in the NT).
Participants: All Aboriginal clients residing in remote communities serviced by these health centres (N=21 267).
Primary Outcome Measures: Diabetes diagnoses were established using hospital and primary care coding, biochemistry and prescription data.
Results: Diabetes 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).
Conclusions: The 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.
Competing Interests: Competing interests: MJLH has received honoraria for lectures and consultancies from AstraZeneca, Eli Lilly and Novo Nordisk.
(© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Design: Retrospective cohort analysis of linked clinical and administrative data sets from 1 July 2012 to 30 June 2019.
Setting: Remote health centres using the NT Government Primary Care Information System (51 out of a total of 84 remote health centres in the NT).
Participants: All Aboriginal clients residing in remote communities serviced by these health centres (N=21 267).
Primary Outcome Measures: Diabetes diagnoses were established using hospital and primary care coding, biochemistry and prescription data.
Results: Diabetes 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).
Conclusions: The 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.
Competing Interests: Competing interests: MJLH has received honoraria for lectures and consultancies from AstraZeneca, Eli Lilly and Novo Nordisk.
(© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)