Oral Presentation The Annual Scientific Meeting of the Australian Diabetes Society and the Australian Diabetes Educators Association 2013

Retrospective study of Type 1 Diabetes in Indigenous Australians in the Top End, Northern Territory (NT) (#111)

Ni Ni Khin 1 , Louise Maple-Brown 1 , Sridhar Chitturi 1
  1. The Endocrinology Department, The Royal Darwin Hospital, Tiwi, NT 0800, Australia

Aim: To describe sociodemographics and clinical characteristics of Indigenous type 1 diabetes mellitus (T1DM) patients in the Top End of Northern Territory, aged 15 years and older, seen at Royal Darwin Hospital (RDH) between January 2010 and December 2011.

Methods: Cases were ascertained from Coding department and Medical records at RDH. Clinical information was collected from hospital medical records and electronic Health records including Primary Care Information System.

Results: We identified 39 patients in total, 22 women (56%) and 17 men (43%) who identified as Aboriginals. Median (range) of HbA1c at diagnosis was 12.1% (7-20%). There was a wide range of disease duration, 1 to 29 years. Of 39 patients, 35 (89%) had improved HbA1c at the most recent follow-up (between 2011-2012). The median (range) HbA1c at the time of follow-up was 10.2% (6.7 - 18.7 %). Twenty-two (56%) patients required at least one admission to RDH within 1st January 2010 and 31st December 2011. Twenty-one patients were hospitalized due to Diabetes KetoAcidosis and or infections. High failure rate (50%) to attend follow-up clinic appointment after hospitalization was observed including those patients from urban Darwin area. In this cohort, 22% had retinopathy, 63% microalbuminuria/proteinuria, 17% peripheral neuropathy. Five patients had end stage renal disease. Five patients had Ischaemic Heart Disease (IHD). In 30 patients who had screening for associated autoimmune diseases, 1 patient had Graves’ disease, 1 had primary hypothyroidism and none had celiac antibodies.

Conclusion: We found female preponderance, more frequent hospital admissions for avoidable reasons, different profile of microvascular complications and associated autoimmune conditions in this cohort compared to Caucasians. Renal complications were more common than retinopathy and IHD in this cohort of Indigenous Australians with T1DM. Further work is required to improve effective utilization of primary health care services, adherence to treatment and addressing complex psychosocial issues in order to prevent significant morbidity associated with T1DM.