The latest health statistics released by the Australian Institute of Health and Welfare highlight the disastrous impact of type 2 diabetes on the Australian population.
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So bear with me, I'm going to paint a rather gloomy picture.
In 2020, an estimated 1 in 20 (almost 1.3 million) Australians were registered as living with diabetes. About 60,000 people are diagnosed with type 2 diabetes yearly, with an average of 166 new diagnoses daily.
In two decades, the prevalence of type 2 diabetes has almost doubled, from 2.4 per cent of the population in 2000 to 4.3 per cent in 2020.
The frustrating part of all this bad news is that it is possible to drastically reduce the incidence of the various complications of type 2 diabetes by controlling the blood glucose levels.
These prevalence rates are underestimated as they are based on people who have received a formal medical diagnosis of diabetes. However, studies have shown that many people are living with undiagnosed diabetes. In addition, as many as two million Australians are living with pre-diabetes, many of whom will develop type 2 diabetes.
According to the institute, in 2020 diabetes was the underlying cause of about 5100 deaths, which makes it the eighth leading cause of death in Australia.
But this doesn't paint the entire picture. Type 2 diabetes is the indirect cause of many more deaths: 17,500 deaths (10.8 per cent of all deaths) when associated causes are included.
High blood glucose is a silent killer. If left unchecked and untreated, it can cause many serious health problems.
Let's take a closer look:
- People with diabetes are up to four times more likely to suffer heart attacks and strokes. Between one and three per cent of people with type 2 diabetes experience a heart attack yearly. That means that between 11,000 and 33,000 Australians will suffer a diabetes-related heart attack in a given year.
- Kidney failure is three times more likely. More than 12,000 people with diabetes are on dialysis or have received a kidney transplant.
- Diabetes can lead to peripheral artery disease, which causes your blood vessels to narrow and reduces blood flow to the legs and feet. As a result, there are approximately 30,000 hospital admissions for foot ulcers. In addition, thousands of lower leg amputations due to diabetes are performed each year.
- Type 2 diabetes is also the leading cause of preventable blindness in Australia. One in three people with diabetes experience depression, anxiety and distress. At the same time, dementia is so common among those with diabetes that Alzheimer's Disease is sometimes referred to as "type 3 diabetes". Those with diabetes are thought to have a 50 per cent increased risk of dementia.
What else do the institute's health statistics tell us? In 2020-21, more than 16.5 million prescriptions were dispensed for diabetes medicines representing 5.3 per cent of total prescriptions.
In addition, there were almost 1.2 million hospitalisations associated with diabetes in 2019-20, an astonishing 11 per cent of all Australian hospitalisations, including 3500 weight loss procedures and 5200 lower-limb amputations.
When one includes the direct costs (medical, hospital, pharmacy), indirect costs such as transport, supported accommodation and home care and government subsidies, the cost of type 2 diabetes runs to more than $10billion a year for Australians.
The impact of diabetes is greater among Aboriginal and Torres Strait Islander people, those living in lower socioeconomic and remote areas. The diabetes prevalence rate is 2.9 times as high among indigenous Australians as non-Indigenous Australians. Indigenous Australians are more than four times as likely to be hospitalised and nearly five times as likely to die due to diabetes.
The impact increases with increasing remoteness and socioeconomic disadvantage. For example, deaths related to diabetes were 1.9 times as high in remote and very remote areas compared with major cities and 2.4 times as high in the lowest socioeconomic areas compared with the highest.
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The frustrating part of all this bad news is that it is possible to drastically reduce the incidence of the various complications of type 2 diabetes by controlling the blood glucose levels.
For example, research in the United Kingdom at the turn of the century showed that reducing blood glucose could reduce the incidence of heart attack (by more than 50 per cent), stroke (by 44 per cent) and serious deterioration of vision (by up to 33 per cent).
The good news is that we now understand that by reducing the dietary intake of carbohydrates, we can control blood glucose levels.
Programs such as Diabetes.co.uk, the Virta program in the US and Defeat Diabetes in Australia have shown that it is possible to achieve remission.
These low-carb programs report around 50 per cent remission for those diagnosed with type 2 diabetes and improved blood glucose control, reduced medications and weight loss for most others.
There is now hope for those with type 2 diabetes.
- Dr Peter Brukner OAM is a Professor of Sports Medicine at La Trobe University and the founder of Defeat Diabetes.
