All diabetes

How many people are living with diabetes in Australia?

Almost 1.3 million (1 in 20) Australians were living with diabetes and currently registered with the linked National Diabetes Services Scheme (NDSS) and Australasian Paediatric Endocrine Group (APEG) state-based registers in 2020. This includes people with type 1 diabetes, type 2 diabetes and other diabetes, but excludes gestational diabetes.

Limitations of estimating diabetes prevalence

Data presented from the linked NDSS and APEG data (Figure 2) and Australian Bureau of Statistics (ABS) National Health Survey (NHS) (Figure 3) are likely to underestimate the true prevalence of diabetes in the Australian population. This is because:

  • both data sources are based on people who have received a formal medical diagnosis of diabetes. However, Australian studies have shown that many people are living with undiagnosed type 2 diabetes. For example, in the 1999–2000 AusDiab Study half of all diabetes was undiagnosed (Dunstan et al. 2001). In the 2011–12 Australian Bureau of Statistics (ABS) Australian Health Survey (AHS), which collected blood glucose data, 20% of participating adults aged 18 and over had undiagnosed type 2 diabetes prior to the survey (ABS 2013a)
  • registration with the NDSS is voluntary and people with type 2 diabetes are more likely to register if they access diabetes consumables to monitor their diabetes at home or require insulin. Some people may be diagnosed with diabetes and choose not to register with the scheme.

Despite these limitations, these data sources provide the best picture into the number of people living with diabetes in Australia to monitor changes in populations in risk and trends over time.

Further research is required to examine whether the proportion of people with undiagnosed type 2 diabetes in Australia has changed over time and the impact of this on the prevalence of disease in Australia.

Variation by age and sex

In 2020, the prevalence of diabetes, according to linked NDSS and APEG data, increased with increasing age:

  • almost 1 in 5 (19.4%) Australians aged 80–84 were living with diabetes in 2020, which was almost 30 times as high as those aged under 40 (0.7%)
  • diabetes was 1.3 times more common in males than females, after controlling for age (Figure 1).

Figure 1: Prevalence of diabetes, by age and sex, 2020

The chart shows the increasing prevalence of diabetes in 2020 by 5-year age groups, peaking in the 80–84 age group for both males and females (22.1% and 17.1%, respectively). The prevalence of diabetes is consistently higher among males than females from age 35 and over.

Trends over time

The number of people living with diabetes in Australia increased by almost 2.8-fold between 2000 and 2020, from 460,000 to 1.3 million.

Based on linked NDSS and APEG data, the age-standardised prevalence rate of diabetes increased from 2.4% in 2000 to 4.3% in 2020. The diabetes rate peaked in 2016 and remained stable between 2016 and 2020 (Figure 2).

Figure 2: Prevalence of diabetes from linked NDSS and APEG data, by sex, 2000–2020

This chart shows the estimated age–standardised proportion of people with diabetes based on data from the linked National Diabetes Services Scheme and Australasian Paediatric Endocrine Group between 2000 and 2020. The proportion increased from 2.4% in 2000 to 4.3% in 2020 but remained relatively stable between 2015 and 2020.

Similar patterns were found in the ABS NHS. The age-standardised rate of diabetes increased from 3.3% in 2001 to 4.4% in 2017–18. The rate of self-reported diabetes remained stable between 2014–15 and 2017–18 (Figure 3).

Note: The most recent NHS was conducted in 2020–21. However, the survey was collected during the COVID-19 pandemic, via an online, self-complete form, which significantly changed the data collection and survey estimates. It is important to note that the 2020–21 NHS data should be considered a break in time series from previous NHS collections and used for point-in-time national analysis only.

Figure 3: Prevalence of self-reported diabetes from the National Health Survey, by sex, 2001 to 2017–18

The chart shows the prevalence of self-reported diabetes, by sex from 2001 to 2017–18 based on data from the ABS National Health Surveys. After adjusting for differences in the age structure of the populations, the prevalence of diabetes increased from 3.3% in 2001 to 4.7% in 2014–15 while dropping slightly to 4.4% in 2017–18. While the overall trend is similar among males and females, the prevalence of diabetes is consistently around 1.3 times higher among males than females.

Variation between population groups

Aboriginal and Torres Strait Islander people

Around 7.9% of Indigenous Australians (64,100 people) were living with diabetes according to self-reported data from the ABS 2018–19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) (ABS 2019b). This is similar to the 7.7% reported in the equivalent survey in 2012–13 (ABS 2014).

After controlling for differences in the age structure of the populations, based on self-reported and measured results, Indigenous Australians were almost 3 times as likely to have diabetes as their non-Indigenous counterparts.

Using the NDSS for reporting on Indigenous Australians

The representation and accuracy of data relating to Aboriginal and Torres Strait Islander people on the NDSS is influenced by a range of factors, which may reduce the accuracy of reporting on these communities and prevent the use of the NDSS for reporting on prevalence by Indigenous status.

  • Before 2005, data entry for the NDSS registration form for Indigenous status coded all ‘unknown’ or ‘not stated’ responses to the Indigenous status question as ‘non-Indigenous’. In 2005, the NDSS database was amended to add an extra value to the Indigenous status variable to indicate ‘inadequate/not stated’ where Indigenous status was not known. As a result of this issue, Indigenous status cannot be determined for 98% of people registered on the NDSS prior to 2005.
  • Indigenous Australians may not register with the NDSS at all. Where Indigenous people live in rural, remote and very remote locations, NDSS Access Points may be limited, or consumables may be obtained through bulk supplies provided to health services through the NDSS. Diabetes-related products can also be accessed through other programs. These issues may result in lower registration rates for the NDSS among Aboriginal and Torres Strait Islander people. For example, programs operating under Section 100 of the National Health Act 1953 – such as Aboriginal Medical Services and the National Aboriginal Community Controlled Health Organisation – provide Indigenous Australians access to free and subsidised products that people with insulin-treated diabetes need.

Socioeconomic area

The age-standardised prevalence rate of diabetes according to linked NDSS and APEG data was around 1.9 times as high among those living in the lowest socioeconomic areas as in the highest socioeconomic areas (Figure 4).

Remoteness area

In 2020, the age-standardised prevalence rate of diabetes according to linked NDSS and APEG data was highest in Remote and very remote areas where people were 1.3 times more likely to be living with diabetes than those in Major cities (Figure 4).

Figure 4: Prevalence of diabetes, by selected population groups and sex, 2020

The chart shows the prevalence of diabetes by selected population groups and sex in 2020. After controlling for differences in the age structures of the population, diabetes prevalence increased with increasing remoteness and socioeconomic disadvantage. Those living in Remote and very remote areas were 1.3 times as likely to have diabetes than those living in Major cities. People living in the most disadvantaged areas were 1.9 times as likely to have diabetes as those living in the least disadvantaged areas.

How many people are newly diagnosed with diabetes in Australia?

Over 1.34 million people, newly diagnosed with diabetes (incidence), were registered on the linked NDSS and APEG data between 2000 and 2020, including type 1 diabetes, type 2 diabetes and other diabetes but excluding gestational diabetes. This was around 63,900 people each year – an average of around 175 diagnoses a day. There were 52,400 people newly diagnosed with diabetes and registered on the linked NDSS and APEG data in Australia in 2020, equating to 204 diagnoses per 100,000 population.

Variation by age and sex

In 2020, the incidence of diabetes:

  • increased with increasing age, peaking among people aged 65–69 (478 per 100,000 population)
  • was 1.4 times more common in males than females, after controlling for age (Figure 5).

Figure 5: Incidence of diabetes, by age and sex, 2020

The chart shows the number of new diabetes cases (per 100,000 population) (incidence) of diabetes by 5-year age group and sex in 2020. The incidence of diabetes increased with increasing age, peaking in the 65–69 age group among both males and females (564 and 397 per 100,000 population, respectively).

Trends over time

The diabetes age-standardised incidence rate decreased by 39% between 2000 and 2020 (Figure 6).

Note: Some caution should be used when interpreting these trends. The NDSS is estimated to capture 80–90% of all people with diagnosed diabetes in Australia (AIHW 2009). It is uncertain how many people with diagnosed diabetes are not registering with the NDSS and how these numbers may have changed over time.

Figure 6: Incidence of diabetes, by sex, 2000–2020

The chart shows the decreasing trend in the incidence of diabetes between 2000 and 2020, for both males and females. Incidence rates peaked in 2008 at 354 per 100,000 population per year and had declined to 188 per 100,000 population in 2020.

Variation between population groups

Aboriginal and Torres Strait Islander people

In 2020:

  • there were around 2,400 new cases of diabetes among Aboriginal and Torres Strait Islander people – a rate of 281 per 100,000 population
  • incidence rates increased with increasing age up to 50–54
  • incidence rates were similar for Indigenous males and females (Figure 7). 

After adjusting for differences in the age structure of the populations, the incidence of diabetes was higher among both Indigenous males and females than non-Indigenous males and females (1.9 times and 2.7 times higher, respectively) (Figure 8).

Figure 7: Incidence of diabetes for Aboriginal and Torres Strait Islander people, by age and sex, 2020

The chart shows the incidence of diabetes for Aboriginal and Torres Strait Islander people by 5-year age group and sex in 2020. The number of new diabetes diagnoses (incidence) per 100,000 population was highest among males aged 70–74 and females aged 50–54 (841 and 836 per 100,000 population, respectively).

Socioeconomic area

In 2020, age-standardised diabetes incidence rates increased with increasing levels of socioeconomic disadvantage. Persons living in the lowest socioeconomic areas were 2.2 times as likely to be diagnosed with diabetes as those living in the highest socioeconomic areas (Figure 8).

Remoteness area

In 2020, age-standardised diabetes incidence rates were higher in Outer regional areas compared with Major cities, Inner regional and Remote and very remote areas (Figure 8).

Figure 8: Incidence of diabetes, by selected population group and sex, 2020

The chart shows the incidence of diabetes by selected population group and sex in 2020. Age-standardised diabetes incidence rates were 2.2 higher among those living in the most disadvantaged areas compared to those living in the most advantaged areas and were slightly higher among people living in Outer regional areas compared with Major cities, Inner regional and Remote and very remote areas. Incidence rates were 2.2 times higher among Indigenous Australians compared with non-Indigenous Australians.

How many deaths are associated with diabetes in Australia?

Diabetes was among the 10 leading causes of death of Australians, contributing to about 17,500 deaths in 2020 (10.8% of all deaths) according to the AIHW National Mortality Database. Diabetes was the underlying cause of death in around 5,100 deaths (29% of diabetes deaths). It was an associated cause of death in a further 12,300 deaths (71% of diabetes deaths).

Diabetes is far more likely to be listed as an associated cause of death than as the underlying cause of death. This is because it is often not diabetes itself that leads directly to death, but one of its complications that will be listed as the underlying cause of death on the death certificate. When diabetes was examined as an associated cause of death, the conditions most commonly listed as the underlying cause of death were cancer, coronary heart disease and stroke.

Where diabetes was listed as the underlying and/or associated cause of death:

  • 3.8% were due to type 1 diabetes (670 deaths)
  • 57% were due to type 2 diabetes (9,900 deaths)
  • 40% were due to other or unspecified diabetes (6,900 deaths).

Note: Examining only the underlying cause of death can underestimate the impact of diabetes on mortality (Harding et al. 2014). Further, deaths from diabetes are known to be under-reported in national mortality statistics, as diabetes is often omitted from death certificates as a cause of death (McEwen et al. 2011; Whittall et al. 1990).

Variation by age and sex

In 2020, mortality rates for diabetes (as the underlying and/or associated cause):

  • increased with increasing age, with rates 2.1 times as high in those aged 85 and over (1,400 and 1,100 per 100,000 population for males and females, respectively) compared with those aged 70–79 (Figure 9)
  • after controlling for age, were 1.7 times as high in males compared with females.

Figure 9: Diabetes death rates, by cause of death type, age and sex, 2020

The chart shows the diabetes death rates by cause of death type age and sex in 2020. Diabetes death rates (as any cause of death) were highest among males in each age group from 50 and over and increased with increasing age, peaking among those aged 85 and over.

Trends over time      

Mortality rates for diabetes (as the underlying and/or associated cause) have remained relatively stable since 2000. Between 2000 and 2020:

  • total deaths related to diabetes increased from 8,100 to 10,000 for males and 4,700 to 7,500 for females
  • age-standardised diabetes mortality rates were highest in 2008 (Figure 10).

Figure 10: Diabetes death rates, underlying and/or associated cause of death, 2000–2020

The chart shows the trend in diabetes death rates, by cause of death type between 2000 and 2020. Diabetes death rates (as any cause of death) peaked overall in 2008 and have gradually declined since then with rates in 2020 slightly below those seen in 2008. Though death rates are consistently higher among males, the trends are similar among the sexes.

Variation between population groups

Aboriginal and Torres Strait Islander people

There were 749 deaths from diabetes (as the underlying and/or associated cause) among Aboriginal and Torres Strait Islander people in 2020, a rate of 81 per 100,000 population. Almost two-thirds (61%) of Indigenous deaths from diabetes occurred in those aged under 70. Among Indigenous Australians, males aged 80–84 had the highest mortality rate across all age groups (2,400 cases per 100,000 population) (Figure 11).

After adjusting for differences in the age structure of the populations, diabetes death rates were 5 times as high among Indigenous Australians as non-Indigenous Australians (Figure 12).

Figure 11: Diabetes death rates for Aboriginal and Torres Strait Islander people, underlying and/or associated cause of death, by age group and sex, 2020

The chart shows the diabetes deaths rates as an underlying and/or associated cause of death for Aboriginal and Torres Strait Islander people by age group and sex in 2020. Death rates increased with increasing age peaking among males at age 80–84 and females at age 85 and over (2,444 and 2,201 per 100,000 population, respectively). Rates were higher among males than females from age 65–69 to 80–84, were similar among the sexes for those aged below 60 and higher among females from age 85 and over.

Socioeconomic area

In 2020, diabetes death rates (as the underlying and/or associated cause) increased with increasing levels of socioeconomic disadvantage. After adjusting for differences in the age structure of the populations, rates were 2.4 times as high among those living in the lowest socioeconomic areas as those living in the highest socioeconomic areas (Figure 12).  

Remoteness area

In 2020, after adjusting for differences in the age profile of the populations, diabetes death rates (as the underlying and/or associated cause) were 1.8 times as high in Remote and very remote areas as in Major cities (Figure 12).

Figure 12: Diabetes death rates, underlying and/or associated cause of death, by selected population group and sex, 2020

The chart shows the age-standardised diabetes death rates as the underlying and/or associated cause by selected population group and sex in 2020. Overall, diabetes death rates increased with increasing levels of socioeconomic disadvantage being 2.4 times as higher among those living in the most disadvantaged areas as those living in the least disadvantaged areas. Diabetes death rates also increase with the level of remoteness being 1.8 times as high among those living in Remote and very remote areas as Major cities. Indigenous Australians were 5 times as likely to die from diabetes as non-Indigenous Australians.

Diseases commonly associated with diabetes deaths

Associated causes commonly listed with diabetes deaths, include diseases of the urinary system, coronary heart disease and hypertensive diseases (Table 1).

Table 1: Common associated causes where diabetes is the underlying cause of death, 2020

Associated cause of death

Per cent

Kidney and urinary disease (N00–N49) 33.0
Coronary heart disease (I20–I25) 32.9
Hypertensive diseases (I10–I15) 31.7
Heart failure (I50–I51) 20.4
Symptoms, signs and abnormal clinical and laboratory findings (R00-R99) 18.9
Cardiac arrhythmias (I47–I49) 14.1
Cerebrovascular disease (I60–I69) 11.7
Dementia, incl. Alzheimer's disease (F01, F03 and G30) 11.0
Cardiac arrest (I46) 8.4
Chronic obstructive pulmonary disease (J40–J44) 8.2
Disorders of lipoprotein metabolism and other lipidaemias (E78) 7.8
Sepsis (A40–A41) 7.3
Peripheral arterial disease (I70–I74) 7.1
Influenza, pneumonia (J08–J18) 6.2

Source: AIHW National Mortality Database.