DIABETES MANAGEMENT

Glycated haemoglobin (HbA1c) is used to measure how well a person is managing their diabetes. This test gives an indication of the person's average blood glucose levels over the previous three months. The optimum management target for HbA1c for people with diabetes is a level of 7.0% or less. Maintaining this level decreases a person's risk of developing a range of complications from their diabetes, including problems with their circulation, kidneys, eyes and feet, and lowers the risk of heart attack and stroke. There is also a range of other optimum targets for Type 2 diabetes management, including those for cholesterol levels, Body Mass Index (BMI) and blood pressure.¹ These are listed in the Data source and definitions box below.

Data source and definitions In the National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS), information on diabetes management is presented for those with known diabetes. See the Measuring diabetes - definitions section for information on how this population is defined. The information in this section is based on fasting plasma glucose results only. Information on diabetes management using glycated haemoglobin (commonly referred to as HbA1c) test results is shown in Table 15 on the Downloads page of this publication. Goals for optimum diabetes management, as defined by the 2014–15 General Practice Management of Type 2 Diabetes1 are as follows: Fasting blood glucose levels between 6.0 and 8.0 mmol/L HbA1c levels less than or equal to 7.0% Total cholesterol less than 4.0 mmol/L HDL 'good' cholesterol greater than or equal to 1.0 mmol/L LDL 'bad' cholesterol less than 2.0 mmol/L Non-HDL cholesterol less than 2.5 mmol/L Triglycerides less than 2.0 mmol/L Albumin creatinine ratio (a test relating to level of kidney damage) less than 3.5 mg/mmol for women and less than 2.5 mg/mmol for men Urinary albumin excretion less than 20 mg/L Blood pressure less than or equal to 130/80 mmHg 'Normal' Body Mass Index (i.e. a BMI score of between 18.5 and 24.9)* Non-smoker Normal healthy eating** Alcohol intake less than or equal to 2 standard drinks per day** At least 30 minutes of physical activity per day, most days of the week (total greater than or equal to 150 minutes per week)** Immunisation against influenza, pneumococcal disease, diphtheria, tetanus, and pertussis**. * The Guidelines do not specifically prescribe a normal BMI but rather a ‘healthy’ weight loss goal. Normal BMI is used for this data item as the survey only collected body mass at one time point. The previous guidelines (2012) also prescribed a normal BMI. **Note information on normal eating habits, immunisation, alcohol and physical activity targets have not been included in this release, as data for these variables are not available for all persons in the NATSIHMS. However, some of this information can be sourced from the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) component.

In 2012–13, around two in five (38.9%) Aboriginal and Torres Strait Islander adults with known diabetes were effectively managing their condition, that is, they had an HbA1c test result of 7.0% or less. Overall, Aboriginal and Torres Strait Islander women were more likely than men to be managing their diabetes (47.0% compared with 28.1%).

Based on the HbA1c target, Aboriginal and Torres Strait Islander people with known diabetes were less likely than their non-Indigenous counterparts to be managing their condition (38.9% compared with 55.9%).

As shown in the previous chapters, rates of known diabetes were particularly high for Aboriginal and Torres Strait Islander people living in remote areas (16.0% compared with 8.5% in non-remote areas). Yet people in remote areas were far less likely than those in non-remote areas to be effectively managing their condition (25.1% compared with 43.5%).

Whilst HbA1c is a good indicator for monitoring diabetes, controlling other aspects of health such as blood lipids (fats) and kidney function levels also decreases the risk of diabetes related complications.² In 2012–13, just over half (56.9%) of all Aboriginal and Torres Strait Islander adults with known diabetes met the management target for triglycerides and almost half (44.4%) met the target for albumin creatinine ratio (ACR), which measures levels of kidney damage. However, Aboriginal and Torres Strait Islander people were still less likely than non-Indigenous people to meet these targets, particularly for ACR (44.4% compared with 71.0%).




For more information on diabetes management see Table 14 on the Downloads page of this publication.



ENDNOTES

1 Diabetes Australia, 2014, General practice management of type 2 diabetes – 2014–15. <http://www.diabetesaustralia.com.au/PageFiles/763/UPdated%20GP%20guidelines.pdf>,
2 Australian Diabetes Council, 2011, Reducing the risk of complications in type 2 diabetes, <http://www.australiandiabetescouncil.com/ADCCorporateSite/files/f4/f4940c4e-c5eb-4430-b50f-6724d0f9472d.pdf>, Back to top