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People with known diabetes were further classified as having Type I, Type II or Type unknown, based on the type of diabetes that a doctor or nurse told them they had. Women with gestational diabetes were excluded.
In the NHMS, the following definitions were used for fasting plasma glucose levels and glycated haemogloblin (HbA1c) levels:
Cut off points for Diabetes in the NHMS
(b) An HbA1c level of greater than or equal to 6.5% is the WHO recommended cut off point for diabetes.4
The NHMS diabetes classification outlined in Figure 1, illustrates how the combination of self reported diabetes data and diabetes test results has been used to define, known diabetes, newly diagnosed diabetes, persons at high risk of having diabetes and persons who do not have diabetes.
Figure 1: 2011–12 NHMS diabetes classification
* Cut off points for FPG: Indicates diabetes ≥7.0 mmol/L; At high risk of diabetes 6.1 to <7.0 mmol/L; Does not indicate diabetes <6.1 mmol/L.
Cut off points for HbA1c: Indicates diabetes ≥6.5%; At high risk of diabetes 6.0% to <6.5%; Does not indicate diabetes <6.0%.
In the National Health Measures Survey (NHMS), information on diabetes management is presented for those with known diabetes. See Figure 1 above for information on how this population is defined.
Goals for optimum diabetes management, as defined by the 2012–13 Diabetes Management in General Practice Guidelines5, are as follows:
**Note information on 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 NHMS. However, this information can be sourced from the National Health Survey.
Comparability with other surveys
The NHMS is the first ABS survey to collect biomedical data on diabetes.
Diabetes biomedical data has been collected in other non-ABS surveys. However, caution must be taken when interpreting results due to the differences in scope, assay and the instrument used, and any thresholds applied in the final analysis. Further information about these comparisons is available from the Comparisons with other Australian surveys section of the Biomedical Results for Chronic Diseases, 2011-12 publication.
More information regarding the biomedical tests and cut off points can be found in the relevant subsections.
1 Diabetes Australia 2011, What is Diabetes?, <http://www.diabetesaustralia.com.au/en/Understanding-Diabetes/What-is-Diabetes/>, Last accessed 02/07/2013.
2 Australian Bureau of Statistics 2013, Causes of Death Australia, ABS cat. no. 3303.0, <http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/3303.0Chapter42011>, Last accessed 02/07/2013.
3 World Health Organization 2006, Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia, <http://www.who.int/diabetes/publications/Definition%20and%20diagnosis%20of%20diabetes_new.pdf>, Last accessed 16/07/2013.
4 World Health Organization 2011, Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus, <http://www.who.int/diabetes/publications/report-hba1c_2011.pdf>, Last accessed 16/07/2013.
5 Diabetes Australia 2012, Diabetes Management in General Practice. Guidelines for Type 2 Diabetes. <http://www.diabetesaustralia.com.au/Documents/DA/What's%20New/12.10.02%20Diabetes%20Management%20in%20General%20Practice.pdf>, Last accessed 20/06/2013.