Following the recent release of research showing there are an estimated 4,400 diabetes-related amputations performed in Australia annually, hospital data shows people living in regional and remote parts of Australia are up to 11 times more likely to be hospitalised for diabetes-related amputations than people living in affluent metropolitan areas.

A/Professor Greg Johnson said the regional amputations data, gathered by the Australian Com-mission on Safety and Quality in Health Care, showed the clear need for the Australian Government, and the states and territories, to collaborate to implement a Diabetes Amputation Prevention Initiative.

“The data clearly shows people in regional and remote communities are more likely to have limbs amputated as a result of diabetes,” A/Professor Johnson said.

“It is alarming that people in the regional and remote parts of the Northern Territory are 11 times more likely to be admitted for a diabetes-related amputation than people living on the wealthy north shore of Sydney.

“The other hot spots for diabetes-related amputations included Outback Queensland, Darwin, Outback South Australia and Outback West Australia.

“In contrast the places with the lowest rate of admissions for diabetes-related amputations are the Sydney regions of North Sydney and Hornsby and Baulkham Hills and Hawkesbury, the Sunshine Coast, Melbourne’s Inner East and Brisbane East.

“It is clear some regions are doing a much better job of reducing the risk of diabetes-related amputations.”

The top 10 locations with the highest rates of hospital admissions for diabetes-related amputations (all per 100,000 people):

1. Northern Territory (Outback) – 91 admissions
2. Queensland (Outback) – 73 admissions
3. Darwin – 48 admissions
4. South Australia (Outback – 40 admissions
5. Western Australia (Outback) – 40 admissions
6. Cairns – 37 admissions
7. Illawarra – 35 admissions
8. Blacktown – 35 admissions
9. Darling Downs/Maranoa – 32 admissions
10. Townsville – 32 admissions
     

By contrast the locations with the lowest rates of hospital admissions for diabetes-related amputations are all in primarily metropolitan locations (all per 1000,000 people):

1. North Sydney and Hornsby – 8 admissions
2. Sunshine Coast – 11 admissions
3. Brisbane East – 11 admissions
4. Baulkham Hills and Hawkesbury – 12 admissions
5. Melbourne Inner East – 14 admissions
6. Brisbane Inner City – 15 admissions
7. Sydney Northern Beaches – 15 admissions
8. Mid North Coast – 15 admissions
9. Coffs Harbour/Grafton – 15 admissions
10. Adelaide Central and Hills – 17 admissions

A/Professor Johnson said the need for action was heightened by the fact the overwhelming majority of amputations are preventable.

“Up to 85 per cent of these amputations are preventable and we need a national initiative with the objective to reduce the number of amputations everywhere – but this data makes it clear that we need a particular focus on regional and remote Australia,” A/Professor Johnson said.

“It is far more cost effective to provide prevention focused primary care than to go on amputating toes and feet and limbs at the rate of 12 amputations every day.

“We can prevent the majority of amputations through better risk assessment of people with diabetes, earlier intervention and optimal management of problems.

“Diabetes amputation prevention should be a priority for every Primary Health Network (PHN) in Australia.

“Every person with diabetes in a PHN catchment should be risk assessed for foot problems and plans should be in place for early intervention to prevent problems from escalating to a point where an amputation is necessary.

“PHN’s should be tasked to ensure that every person with diabetes is receiving structured self-management education and appropriate support from a team of health professional including the GP, diabetologists, credentialed diabetes educators, podiatrists, vascular specialists and other allied health professionals.”

The data, gathered by Australian Commission on Safety and Quality in Health Care, uses the Australian Bureau of Statistics Statistical Area Level 4 to determine regional boundaries. It excludes the following regions because of privacy concerns relating to the size of the data set: Murray, Sydney – Ryde, Ballarat, Brisbane – West, Perth – Inner, South East, West and North West and Other Territories. You can find the boundaries here.

The Full List
Ranking State Region Age-adjusted rate of diabetes admissions per 100,000

• 1 NT Northern Territory – Outback 91
• 2 Qld Queensland – Outback 73
• 3 NT Darwin 48
• 4 SA South Australia – Outback 40
• 5 WA Western Australia – Outback 40
• 6 Qld Cairns 37
• 7 NSW Illawarra 35
• 8 NSW Sydney – Blacktown 35
• 9 Qld Darling Downs – Maranoa 32
• 10 Qld Townsville 32
• 11 Qld Mackay 31
• 12 Qld Moreton Bay – South 31
• 13 SA Adelaide – North 31
• 14 SA South Australia – South East 31
• 15 WA Western Australia – Wheat Belt 31
• 16 NSW Sydney – Outer South West 30
• 17 Vic North West 30
• 18 NSW Sydney – City and Inner South 29
• 19 Vic Melbourne – West 28
• 20 Vic Hume 27
• 21 Vic Mornington Peninsula 27
• 22 SA Adelaide – West 27
• 23 SA Barossa – Yorke – Mid North 27
• 24 WA Perth – North East 27
• 25 NSW Sydney – South West 26
• 26 Qld Moreton Bay – North 26
• 27 NSW Central Coast 25
• 28 Vic Latrobe – Gippsland 25
• 29 Qld Fitzroy 25
• 30 WA Mandurah 25
• 31 NSW Far West and Orana 24
• 32 Vic Melbourne – Inner 24
• 33 WA Perth – South West 24
• 34 NSW Central West 23
• 35 NSW Riverina 23
• 36 NSW Sydney – Outer West and Blue Mountains 23
• 37 Vic Melbourne – North West 23
• 38 Qld Logan – Beaudesert 23
• 39 SA Adelaide – South 23
• 40 WA Perth – South East 23
• 41 NSW Richmond – Tweed 22
• 42 NSW Sydney – Parramatta 22
• 43 Vic Melbourne – South East 22
• 44 WA Perth – North West 22
• 45 Tas Hobart 22
• 46 NSW New England and North West 21
• 47 NSW Newcastle and Lake Macquarie 21
• 48 Vic Geelong 21
• 49 Vic Melbourne – North East 21
• 50 Vic Shepparton 21
• 51 Qld Ipswich 21
• 52 NSW Sydney – Inner West 20
• 53 Vic Melbourne – Inner South 20
• 54 Qld Brisbane – North 20
• 55 Qld Toowoomba 20
• 56 WA Bunbury 20
• 57 ACT Australian Capital Territory 20
• 58 NSW Sydney – Eastern Suburbs 19
• 79 Vic Bendigo 19
• 60 Vic Melbourne – Outer East 19
• 61 Qld Gold Coast 19
• 62 NSW Capital Region 18
• 63 NSW Southern Highlands and Shoalhaven 18
• 64 NSW Sydney – Inner South West 18
• 65 NSW Sydney – Sutherland 18
• 66 Qld Wide Bay 18
• 67 Tas Launceston and North East 18
• 68 NSW Hunter Valley exc Newcastle 17
• 69 Vic Warrnambool and South West 17
• 70 Qld Brisbane – South 17
• 71 SA Adelaide – Central and Hills 17
• 72 NSW Coffs Harbour – Grafton 15
• 73 NSW Mid North Coast 15
• 74 NSW Sydney – Northern Beaches 15
• 75 Qld Brisbane Inner City 15
• 76 Vic Melbourne – Inner East 14
• 77 NSW Sydney – Baulkham Hills and Hawkesbury 12
• 78 Qld Brisbane – East 11
• 79 Qld Sunshine Coast 11
• 80 NSW Sydney – North Sydney and Hornsby 8

Diabetes Australia is the national body for people affected by all types of diabetes and those at risk. Diabetes Australia is committed to reducing the impact of diabetes. We work in partnership with diabetes health professionals, researchers and the community to minimise the impact of diabetes.