Burden of diabetes

What is burden of disease?

Burden of disease is a measure of the years of healthy life lost from living with or dying from disease and injury. The measure used is the ‘disability-adjusted life year’ (DALY). This combines health loss from living with illness and injury (non-fatal burden, or YLD) and dying prematurely (fatal burden, or YLL) to estimate total health loss (total burden, or DALY). Burden of disease estimates seek to capture both the quantity and health-related quality of life, and to reflect the magnitude, severity and impact of disease and injury within a population. Burden of disease does not quantify the social or financial consequences of disease and injury. Further information can be found in Australian Burden of Disease Study: impact and causes of illness and death in Australia 2018.

Type 1 diabetes burden  

In 2018, type 1 diabetes was responsible for around 17,000 DALY in Australia – equating to 0.7 DALY per 1,000 population.

The proportion of fatal and non-fatal burden was similar with 48% (8,100 YLL) attributed to fatal burden, with the remaining 52% (8,800 YLD) categorised as non-fatal burden.

Variation by age and sex

The overall burden attributed to type 1 diabetes was higher in males and older Australians. In 2018:

  • DALY were highest among males aged 45–49 and females aged 50–54 (924 and 756 DALY, respectively)
  • DALY rates were highest among those aged 90–94 (1.35 DALY per 1,000 population) (Figure 1).

Figure 1: Type 1 diabetes total burden (DALY), by age group and sex, 2018

The bar chart shows the burden of type 1 diabetes in 2018 was higher among males than females and older Australians. DALY were highest among males aged 45–49 and females aged 50–54 (924 and 756 DALY).

Trends over time

Between 2015 and 2018, there was a 1.7% increase in non-fatal burden (YLD) attributed to type 1 diabetes. This further coincides with an increase of 17.2% in the rate of fatal burden from years of lost life (YLL).

Variation between population groups

The overall burden of type 1 diabetes was higher among those living in lower socioeconomic areas and in Inner regional areas. In 2018, after adjusting for different population age structures:

  • rates were 1.5 times as high amongst those living in Inner regional areas compared with those living in Major cities 
  • rates were over 2 times as high amongst those living in the lowest socioeconomic area (highest disadvantage) compared with those living in the highest socioeconomic area (Figure 2).

Figure 2: Type 1 diabetes total burden (DALY), by select population groups, 2018

The horizontal bar chart shows that the burden of type 1 diabetes for males and females were highest among people living in inner regional areas, and people living in the lowest socioeconomic areas.

Aboriginal and Torres Strait Islander people

In 2018, type 1 diabetes was responsible for 596 DALY among Aboriginal and Torres Strait Islander people in Australia – equating to 0.7 DALY per 1,000 population.

The proportion attributed to fatal burden was higher (58%, or 343 YLL) than that attributed to non-fatal burden (42% or 253 YLD).

Between 2003 and 2018, there was a 57% decrease in the age-standardised DALY per 1,000 population, attributed to type 1 diabetes among Aboriginal and Torres Strait Islander people (AIHW 2022).

Type 2 diabetes burden  

In 2018, type 2 diabetes was the 12th highest disease-specific cause of DALY at 4.5 per 1,000 population (AIHW 2021a).

Sixty-one per cent (68,100 YLD) of burden attributed to type 2 diabetes was non-fatal. With the remaining 39% (44,300 YLL) of the total burden being fatal.

Variation by age and sex

The overall burden attributed to type 2 diabetes was higher in males and older Australians. In 2018:

  • 51% (57,300 DALY) of total disease burden attributed to type 2 diabetes occurred in persons aged 65–84
  • In the 65–84 age group, DALY in males were over 1.5 times higher than in females (34,500 and 23,800, respectively)
  • females aged 85 and over had 1.4 times more DALY attributed to type 2 diabetes than males aged 85 and over (6,600 and 4,600, respectively) (Figure 3).

Figure 3: Type 2 diabetes total burden (DALY), by age group and sex, 2018

The bar chart shows the burden of type 2 diabetes in 2018 was higher among males and older Australians. DALY were highest among males and females aged 70–74 (10,446 and 6,516 DALY).

Trends over time

Between 2003 and 2018, there was a 24% increase in non-fatal burden, from 1.9 years lived with disability (YLD) per 1,000 to 2.3 YLD per 1,000 in 2018. However, there was a 24% decrease in the rate of fatal burden from years of life lost (YLL) for the same time period (2.0 per 1,000 and 1.3 per 1,000 population, respectively).

Variations between population groups

The overall burden of type 2 diabetes was higher amongst those living in lower socioeconomic areas and in Remote and very remote areas. In 2018, after adjusting for different population age structures:

  • rates in Remote and very remote areas were 2 times as high as Major cities
  • rates were 2.4 times as high as those living in the lowest socioeconomic group compared with those living in the highest socioeconomic area (Figure 4).

Aboriginal and Torres Strait Islander people

In 2018, type 2 diabetes was responsible for around 7,000 DALY among Aboriginal and Torres Strait Islander people in Australia – equating to 8.4 DALY per 1,000 population.

The proportion attributed to fatal burden (46% or 3,000 YLL) was slightly lower than that attributed to the non-fatal burden (57% or 4,000 YLD).

Between 2003 and 2018, there was a 42% decrease in the age-standardised DALY per 1,000 attributed to type 2 diabetes among Aboriginal and Torres Strait Islander people (AIHW 2022).

Figure 4: Type 2 diabetes total burden (DALY), by selected population groups, 2018

The horizontal bar chart shows that the burden of type 1 diabetes for males and females were highest among people living in remote and very remote areas, and people living in the lowest socioeconomic areas.

Risk factors for type 2 diabetes burden

Behavioural, environmental and biomedical risk factors commonly impact an individual’s health and increase the risk of disability, injury or death. In 2018:

  • over one-third of type 2 diabetes total burden was attributable to overweight and obesity (37% in males and 35% in females)
  • around 19% of type 2 diabetes total burden was attributable to dietary risk factors for both males and females
  • physical inactivity attributed a larger proportion of total burden for type 2 diabetes in females than males (14.8% and 12.8%, respectively)
  • tobacco use attributed a larger proportion of total burden for type 2 diabetes in males than females (3.7% and 1.0%, respectively) (AIHW 2021b).

References

Australian Institute of Health and Welfare (2021a) Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2018, AIHW, Australian Government, accessed 25 May 2022.

Australian Institute of Health and Welfare (2021b) Australian Burden of Disease Study 2018: Interactive data on risk factor burden, AIHW, Australian Government, accessed 08 June 2022.

AIHW (2022) Australian Burden of Disease Study: impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2018, AIHW, Australian Government, accessed 25 May 2022.