Document Detail


Diabetes in the Torres Strait Islands of Australia: better clinical systems but significant increase in weight and other risk conditions among adults, 1999-2005.
MedLine Citation:
PMID:  17516896     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To (i) assess changes in clinical indicators of adults diagnosed with diabetes and (ii) estimate changes in risk factors and incidence of diabetes among adults without diabetes living in the Torres Strait and Northern Peninsula Area Health Service District in Queensland from 1999 to 2005. DESIGN AND PARTICIPANTS: (i) Annual audit of clinical records of Torres Strait Islander adults on diabetes registers in 21 primary care clinics, and (ii) a 5-year follow up of a community cohort of 207 Torres Strait Islander adults without diabetes who participated in the Well Person's Health Check in 2000-01 and 2005-06. MAIN OUTCOME MEASURES: Weight, height, waist circumference, fasting blood sugar (those without diabetes) and glycated haemoglobin (HbA1c; those with diabetes) levels, blood pressure (BP), fasting triglyceride and high-density lipoprotein cholesterol levels, urinary albumin-to-creatinine ratio and smoking status. RESULTS: The number of adults included on the diabetes register increased from 555 in 1999 to 1024 in 2005. The mean age of patients diagnosed with diabetes decreased from 53.3 to 51.5 years, and their mean weight increased from 86.8 kg to 95.6 kg. Mean HbA1c level remained unchanged at about 9%, but the proportion with HbA1c level < 7% increased from 18.4% to 26.1%, and the proportion prescribed insulin increased from 14% in 2002 to 22% in 2005. The proportion with BP < 140/90 mmHg increased from 40.3% in 1999 to 66.8% in 2005. In the sample of 207 adults without diabetes, from 2000 to 2006, there was a weight gain of about 1 kg per person per year, and an annual increase in waist circumference of 0.8 cm in men and 1.2 cm in women. Crude incidence of diabetes was 29 (95% CI, 19-41) per 1000 person-years. There was a significant increase in diastolic blood pressure and fasting blood sugar levels, and no change in smoking habits. CONCLUSIONS: Clinical care of adults with diabetes has improved and more people with diabetes are being diagnosed. However, weight gain and high rates of glycaemia remain a challenge and will result in a large burden of complications, including renal failure. Incidence data from this sample extrapolate to 120 (95% CI, 103-147) new cases of diabetes in the District each year. Urgent action to improve nutrition, decrease smoking and increase physical activity is required to improve metabolic fitness in younger people.
Authors:
Robyn A McDermott; Bradley G McCulloch; Sandra K Campbell; Dallas M Young
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Medical journal of Australia     Volume:  186     ISSN:  0025-729X     ISO Abbreviation:  Med. J. Aust.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-22     Completed Date:  2007-07-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400714     Medline TA:  Med J Aust     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  505-8     Citation Subset:  IM    
Affiliation:
Division of Health Sciences, University of South Australia, Adelaide, SA, Australia. Robyn.Mcdermott@unisa.edu.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Glucose
Comorbidity
Confidence Intervals
Diabetes Mellitus, Type 2 / complications,  epidemiology*
Female
Health Education / organization & administration
Health Promotion / organization & administration
Health Services, Indigenous / organization & administration*,  statistics & numerical data
Hemoglobin A, Glycosylated
Humans
Male
Middle Aged
Northern Territory / epidemiology
Obesity / complications,  epidemiology*
Oceanic Ancestry Group / statistics & numerical data*
Odds Ratio
Queensland / epidemiology
Retrospective Studies
Risk Assessment
Risk Factors
Rural Health Services / organization & administration*,  statistics & numerical data
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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