Diabetes is a chronic condition where insulin, a hormone that controls blood glucose levels, is no longer produced or not produced in sufficient amounts by the body.1 If left undiagnosed or poorly managed, diabetes can lead to coronary heart disease, stroke, kidney failure, limb amputations or blindness.2 In 2012, diabetes was the second leading cause of death for Aboriginal and Torres Strait Islander people. The age standardised death rate for diabetes was seven times higher for Aboriginal and Torres Strait Islander Australians compared with non-Indigenous Australians.3
The National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS) provides an objective measurement of the number of Aboriginal and Torres Strait Islander people with diabetes in Australia. It included two tests to measure diabetes: a fasting plasma glucose test and a glycated haemoglobin test (commonly referred to as HbA1c).
Fasting plasma glucose measures the level of sugar in the person's blood at the time of testing. Participants were required to fast for 8 hours prior to the test in order to get an accurate reading. HbA1c, on the other hand, measures what the person's average blood glucose level has been in the previous three months. Participants were not required to fast for this test. A set of cut-offs are used for each test to determine whether a person has diabetes or is at high risk of diabetes. The cut-offs used in the NATSIHMS are shown below.
Cut-offs for Diabetes in the NATSIHMS
(a) Based on World Health Organization cut-offs for fasting plasma glucose.4
(b) An HbA1c level of greater than or equal to 6.5% is the WHO recommended cut-off point for diabetes.5
|Fasting plasma glucose|
|At high risk of diabetes||6.1 to <7.0||6.0 to <6.5|
. Diabetes Australia, Sept 2011, What is Diabetes?
The Royal Australian College of General Practitioners and Diabetes Australia, 2014, General practice management of type 2 diabetes - 2014–15
. Australian Bureau of Statistics 2014, Causes of Death, Australia 2012 <https://www.abs.gov.au/AUSSTATS/abs@.nsf/mf/3303.0/
World Health Organization 2006, Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia
World Health Organization 2011, Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus