Simple population health management can result in a 27% increase in the number of people with optimal control of their Diabetes in Australia (#291)
Tight glycaemic control can reduce the rates of diabetic complications. The Mapping Glycaemic Control Across Australia (MGCAA) Project - a population based national diabetes surveillance study - has been monitoring and reporting on HbA1c results for the nation since 2007. The MGCAA Project has reported epidemiological data geographically showing that at a population health level, diabetes control has not changed for the period 2007-2011. This is further supported by the MGCAA Project cohort substudy, where we followed 87000 individuals each year for 4 years showing that there was minimal if any change over this period . In 2012, we report on the percentage of the population with an HbA1c of 7.1% to 7.5% with the suggestion that identifying this group and supporting HealthCare Professionals (HCPs), to work with these patients will very quickly improve the number of people with diabetes living with optimal control from 53.2% to 67.7% within 12 months. This equates with a relative increase of 27% (Table 1). To achieve this change HCPs working in the community, particularly General Practitioners (GP’s) need to, on average, individually assist 7 patients per year improve their control. It is well documented that this 0.5% improvement in HbA1c can be achieved with simple measures such as:- (1) optimising medications (0.5 to 1.2%), (2) team care input from pharmacy with Diabetes Medication Assistance Service [DMAS] (0.6%) , or (3) exercise programmes and lifestyle management programmes (LMP) (0.66%).The treat to target message for those who are easily managed to target is now able to be guided by geo-epidemiological population health data. Best supported and managed at a medicare local level where resources can be optimised this intervention warrants further study and evaluation.
|
< 6.5 |
6.6 to 7 |
7.1 to 7.5 |
7.6 to 8 |
8.1 to 8.5 |
8.6 to 9 |
>9 |
Estimated DM (AusDiab prev) |
Number to assist from 7.5 to <7 |
Number of GP’s |
Number per GP for change |
|
|
ACT |
32.5% |
23.4% |
14.2% |
9.2% |
6.1% |
4.1% |
10.6% |
17600 |
2491 |
365 |
7 |
|
NSW |
31.0% |
24.4% |
14.3% |
9.5% |
6.2% |
4.2% |
10.3% |
360000 |
51512 |
7528 |
7 |
|
NT |
27.6% |
17.9% |
10.5% |
7.6% |
5.5% |
4.4% |
26.5% |
10400 |
1097 |
389 |
3 |
|
QLD |
26.6% |
24.3% |
14.6% |
10.1% |
7.0% |
4.9% |
12.5% |
219400 |
32069 |
4553 |
7 |
|
SA |
26.0% |
25.3% |
15.7% |
10.6% |
6.7% |
4.6% |
11.0% |
83400 |
13119 |
2147 |
6 |
|
TAS |
22.7% |
25.3% |
16.2% |
9.8% |
7.1% |
5.5% |
13.3% |
25400 |
4112 |
597 |
7 |
|
VIC |
28.0% |
23.8% |
15.2% |
10.5% |
7.1% |
4.7% |
10.8% |
276500 |
42019 |
6334 |
7 |
|
WA |
29.6% |
24.8% |
14.0% |
9.1% |
6.1% |
4.2% |
12.2% |
112400 |
15708 |
2298 |
7 |
|
Total |
28.9% |
24.3% |
14.5% |
9.7% |
6.5% |
4.5% |
11.6% |
1105100 |
160421 |
24211 |
7 |