Insulin trends revealed for type 2 diabetes

Type 2 diabetes now accounts for almost 60% of patients being initiated on insulin, Australian figures show.

Latest available data from the National (insulin-treated) Diabetes Register shows almost 30,000 Australians started using insulin in 2017 to manage their diabetes.

More than half (58%) had type 2 diabetes, 30% had gestational diabetes, 9% had type 1 diabetes and 2% had other forms of diabetes or their status was unknown.

In 2017, 17,358 people began using insulin to manage their type 2 diabetes, representing 4,121 cases per 100,000 population, or around 1 in every 25 registrants with type 2 diabetes.

The Australian Institute of Health and Welfare (AIHW) report showed that the median time from diagnosis to first insulin use for people with type 2 diabetes remained relatively stable between 2012–2017 at about 7-8 years.

However median time to first insulin use increased with age, with the median time among over 75 year-olds at least 10 times higher than in younger people 10–39 years of age.

The AIHW data also showed the proportion of people with type 2 diabetes who began using insulin more than 10 years after diagnosis had increased between 2012 and 2017.

Insulin usage in people with type 2 diabetes increased from 20% to 22% for those who started insulin 11–15 years after diagnosis; 8% to 12% for those who started insulin 16–20 years after diagnosis; and from 3% to 6% for those who started insulin 21 years or more after diagnosis.

In contrast, the proportion of people with type 2 diabetes, who began using insulin 1–5 years after diagnosis decreased from 23% to 20% and from 29% to 23% for those who started insulin 6–10 years after diagnosis.

The proportion of people with type 2 diabetes, who began using insulin immediately after or within a year of diagnosis remained relatively stable at about 17%.

Incidence rates for insulin-treated type 2 diabetes were similar across socioeconomic groups but were twice as high in major cities compared to rural areas and 1.6 times higher in females than males.

It was not possible to compare current rates of insulin use for type 2 diabetes with previous years because of a change in the recording method, the AIHW report said.

For type 1 diabetes, incidence rates were higher in males than females, were relatively similar for socioeconomic groups and comparable between Indigenous and non-Indigenous Australians.

Incidence rates were again lowest in remote and very remote areas.

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