Article Text

Undiagnosed diabetes from cross-sectional GP practice data: an approach to identify communities with high likelihood of undiagnosed diabetes
  1. Nasser Bagheri1,
  2. Ian McRae1,
  3. Paul Konings1,
  4. Danielle Butler1,
  5. Kirsty Douglas2,
  6. Peter Del Fante3,
  7. Robert Adams4
  1. 1Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia
  2. 2Department of General Practice, School of Medicine, Australian National University, Canberra, Australia
  3. 3Healthfirst Network, Adelaide, Australia
  4. 4School of Medicine, University of Adelaide, Adelaide, Australia
  1. Correspondence to Dr Nasser Bagheri; nasser.bagheri{at}anu.edu.au

Abstract

Objectives To estimate undiagnosed diabetes prevalence from general practitioner (GP) practice data and identify areas with high levels of undiagnosed and diagnosed diabetes.

Design Data from the North-West Adelaide Health Survey (NWAHS) were used to develop a model which predicts total diabetes at a small area. This model was then applied to cross-sectional data from general practices to predict the total level of expected diabetes. The difference between total expected and already diagnosed diabetes was defined as undiagnosed diabetes prevalence and was estimated for each small area. The patterns of diagnosed and undiagnosed diabetes were mapped to highlight the areas of high prevalence.

Setting North-West Adelaide, Australia.

Participants This study used two population samples—one from the de-identified GP practice data (n=9327 active patients, aged 18 years and over) and another from NWAHS (n=4056, aged 18 years and over).

Main outcome measures Total diabetes prevalence, diagnosed and undiagnosed diabetes prevalence at GP practice and Statistical Area Level 1.

Results Overall, it was estimated that there was one case of undiagnosed diabetes for every 3–4 diagnosed cases among the 9327 active patients analysed. The highest prevalence of diagnosed diabetes was seen in areas of lower socioeconomic status. However, the prevalence of undiagnosed diabetes was substantially higher in the least disadvantaged areas.

Conclusions The method can be used to estimate population prevalence of diabetes from general practices wherever these data are available. This approach both flags the possibility that undiagnosed diabetes may be a problem of less disadvantaged social groups, and provides a tool to identify areas with high levels of unmet need for diabetes care which would enable policy makers to apply geographic targeting of effective interventions.

  • Primary Care
  • Public Health
  • Epidemiology

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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