Prevalence of diabetes in rural Victoria

https://doi.org/10.1016/j.diabres.2005.04.004Get rights and content

Abstract

Aims

To compare the prevalence of diabetes in adults in small and medium sized towns in a part of rural Victoria

Materials and methods

Participants were usual residents, aged ≥25 years, from randomly selected households in the crossroads undiagnosed disease study (CUDS: six small rural towns and their regional center in rural Victoria). Response rates to an initial census at the household and attendance at a subsequent biomedical examination involved were 70% and 61% (1454), respectively. All non-diabetic participants had an oral glucose tolerance test.

Results

Prevalence of diabetes, IGT, IFG were 7.3 (5.5–9.5)%, 6.9 (5.1–9.9)% and 3.2 (2.0–4.7)% respectively in the regional center and 8.9 (6.9–11.1)%, 4.9 (3.5–6.7)%, 3.0 (1.9–4.5)% in the Shire Capitals. Overall, 31/118 (26.3%) of those with diabetes were previously undiagnosed. Most (83.9%) of those with undiagnosed diabetes remembered having been screened for diabetes in the previous 2 years. Overall screening rates for diabetes were higher than across Victoria as a whole.

Conclusions

The prevalence of diabetes has probably doubled over the last 15 years in this area. Undiagnosed diabetes is less common than expected, possibly as a result of a more vigorous approach to screening in general practice and in spite of the lower numbers of GPs in the area.

Section snippets

Materials and methods

Households were randomly selected from residential address lists, stratified to provide half from the regional center and a sixth from each Shire Capital. Household leafleting and media releases took place to maximise local awareness of the study. Household visits occurred between June 2001 and March 2003 with revisits (including evenings and weekends) until a response was received. A census of household residents, including questions relating to known diabetes were completed for all occupants

Results

The response to the initial census was 70.3%, with 61.3% (n = 1454) of these attending the “clinic”. Proportions by gender and ethnicity and prevalence of known diabetes, were similar in the census and those attending the “clinic”. Those refusing to attend the undiagnosed disease study were younger (49 ± 18 years versus 53 ± 16 years, p < 0.001). Table 1 shows the age-specific, crude and age-standardised prevalences by gender. The age-standardised prevalence of diabetes was 8.7% (men) and 7.5% (women).

Discussion

We have found that while the high prevalence of diabetes among Australian adults also exists in these small rural towns (consistent with rates found in AusDiab [1], Europe [9], [10] and the US [11]), the proportion with undiagnosed diabetes was lower. We originally expected more undiagnosed diabetes with the poorer access to primary care and find this result difficult to explain. Whether rural-urban differences in turnover of GPs, GP attitudes, awareness of diabetes in the general population or

Acknowledgements

We thank the crossroads team for their work and the local communities for their support. Contributors: DS conceived and designed the study and analysed the data. AM and SE managed the study. All authors interpreted the data and wrote the paper. Source of funding: The International Diabetes Institute and the University of Melbourne. The Department of Rural Health is funded under the Department of Health and Ageing Rural Health programme. Competing interests: None.

References (14)

There are more references available in the full text version of this article.

Cited by (23)

  • The diagnosis and management of diabetes in Australia: Does the “Rule of Halves” apply?

    2020, Diabetes Research and Clinical Practice
    Citation Excerpt :

    From these, 123 studies met the inclusion criteria and were included in the review (Supplementary File 2). Nine sources of data were included [3,20–27], of which four reported diagnosed diabetes in the Indigenous (Aboriginal and Torres Strait Islander) community (Supplementary File 3, Table 1) [24–27]. All were cohort studies of individuals aged ≥ 15 years.

  • Changes in prevalence of diabetes over 15 years in a rural Australian population: The Crossroads Studies

    2020, Diabetes Research and Clinical Practice
    Citation Excerpt :

    Ethics was granted by the Goulburn Valley Research Ethics Committee (GVH20/16). Households were randomly selected from residential address lists from local government organisations in the Goulburn Valley [12]. In Crossroads-II, additional households were randomly selected from housing developments since 2000.

  • Increased red cell count in diabetes and pre-diabetes

    2010, Diabetes Research and Clinical Practice
    Citation Excerpt :

    We wondered if other pre-diabetic states also had an increased RCC. The “Crossroads study” was carried out between June 2001 and March 2003 across seven Australian towns as previously described [8–10]. Briefly, an initial census of 2376 randomly selected households (half in the regional centre, a twelfth in each of the six smaller towns) was undertaken.

View all citing articles on Scopus
View full text