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Testing for type 2 diabetes in Indigenous Australians: guideline recommendations and current practice

Christine L Paul, Paul Ishiguchi, Catherine A D'Este, Jonathan E Shaw, Rob W Sanson-Fisher, Kristy Forshaw, Alessandra Bisquera, Jennifer Robinson, Claudia Koller and Sandra J Eades
Med J Aust 2017; 207 (5): 206-210. || doi: 10.5694/mja16.00769

Abstract

Objectives: To determine the proportion of Aboriginal Controlled Community Health Service (ACCHS) patients tested according to three national diabetes testing guidelines; to investigate whether specific patient characteristics were associated with being tested.

Design, setting and participants: Cross-sectional study of 20 978 adult Indigenous Australians not diagnosed with diabetes attending 18 ACCHSs across Australia. De-identified electronic whole service data for July 2010 – June 2013 were analysed.

Main outcomes measures: Proportions of patients appropriately screened for diabetes according to three national guidelines for Indigenous Australians: National Health and Medical Research Council (at least once every 3 years for those aged 35 years or more); Royal Australian College of General Practitioners and Diabetes Australia (at least once every 3 years for those aged 18 years or more); National Aboriginal Community Controlled Health Organisation (annual testing of those aged 18 years or more at high risk of diabetes).

Results: 74% (95% CI, 74–75%) of Indigenous adults and 77% (95% CI, 76–78%) of 10 760 patients aged 35 or more had been tested for diabetes at least once in the past 3 years. The proportions of patients tested varied between services (range: all adults, 16–90%; people aged 35 years or more, 23–92%). 18% (95% CI, 18–19%) of patients aged 18 or more were tested for diabetes annually (range, 0.1–43%). Patients were less likely to be tested if they were under 50 years of age, were transient rather than current patients of the ACCHS, or attended the service less frequently.

Conclusions: Some services achieved high rates of 3-yearly testing of Indigenous Australians for diabetes, but recommended rates of annual testing were rarely attained. ACCHSs may need assistance to achieve desirable levels of testing.

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  • Christine L Paul1,2,3
  • Paul Ishiguchi4
  • Catherine A D'Este5
  • Jonathan E Shaw4
  • Rob W Sanson-Fisher1
  • Kristy Forshaw1,2
  • Alessandra Bisquera3
  • Jennifer Robinson1
  • Claudia Koller1,2,3
  • Sandra J Eades4

  • 1 University of Newcastle, Newcastle, NSW
  • 2 Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW
  • 3 Hunter Medical Research Institute, Newcastle, NSW
  • 4 Baker IDI Heart and Diabetes Institute, Melbourne, VIC
  • 5 National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT


Acknowledgements: 

The authors gratefully acknowledge the generous support of the staff and patients from the following Aboriginal Community Controlled Health Services (in alphabetical order): Anyinginyi Health Aboriginal Corporation, Bega Garnbirringu Aboriginal Health Service, Danila Dilba Biluru Butji Binnilutum Health Service, Derbarl Yerrigan Health Service, Dhauwurd-Wurrung Elderly and Community Health Service, Kirrae Aboriginal Health Service, Mawarnkarra Health Service, Mildura Aboriginal Corporation, Mitwatj Health Aboriginal Corporation, Pika Wiya Health Service, Riverina Medical and Dental Aboriginal Corporation, South West Aboriginal Medical Service, Sunrise Health Service Aboriginal Corporation, Umoona Tjutagku Health Service, Winnunga Nimmityajah Aboriginal Health Service, Ampilatwatja Health Centre Aboriginal Corporation, Pius X Aboriginal Corporation, and Victorian Aboriginal Health Service.

Competing interests:

No relevant disclosures.

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