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Corresponding Author

Caitlyn S. White. Email: caitlyn.white@ahcwa.org

Abstract

Objective
Aboriginal communities are impacted by high rates of diabetes, however these are currently underestimated by national data sources used by policy and decision makers to inform allocation of health resources. We aimed to estimate diabetes prevalence and screening coverage using primary care electronic medical record data.

Methods
A cross-sectional audit was conducted using primary care data from Aboriginal regular Aboriginal Community Controlled Health Service (ACCHS) clinic attendees aged 15 years and over (n=1763) in five remote communities in the Kimberley region. Main outcome measures were overall diabetes prevalence; age-specific diabetes prevalence; prevalence of pre-diabetes; and screening rates among patients without diabetes in the previous 12 and 24 months.

Results
The overall diabetes prevalence was 29.2%. An additional 8.6% had pre-diabetes on screening in the last 12 months. Prevalence exceeded overall nationally reported figures even in the youngest age group (15–34 years, 9.7%) and increased with age. Over a third (42.5%) of those without diabetes had been screened with an HbA1c test in the previous 12 months. This increased to 60.4% when analysed over a 24-month period.

Conclusions
The prevalence of diabetes in Kimberley remote communities is five times higher than that reported by the National Diabetes Services Scheme (NDSS), the most widely used national data source for diabetes prevalence. The excess prevalence begins from a young age and supports regional guidelines commencing screening from 15 years of age. Screening rates compared favourably with other available studies. ACCHS are well placed to meaningfully monitor diabetes prevalence to inform effective local prevention strategies.

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