How many people with Type 1 Diabetes in Australia? After some frustrating research this morning, I still don’t know the answer.

The Australian Government’s Institute of Health and Welfare (AIHW) published figures from 2008, which they claim to be estimates.

Here’s what the AIHW say:

In 2007–08, an estimated 898,800 Australians had been diagnosed with diabetes (excluding gestational diabetes) at some time in their lives.
87,100 had been diagnosed with Type 1 diabetes.
787,500 had been diagnosed with Type 2 diabetes.
(http://www.aihw.gov.au/publication-detail/?id=10737419311)

The Garvan Institute, one of the more well-known private research bodies in Australia say:

Type 1 diabetes affects over 140 000 children and adults in Australia…
(http://www.garvan.org.au/pdfs/factsheets/foundation_2007/type1_diabetes_07.pdf)

JDRF in Australia say:

Using data from 2006 the Australian Institute of Health and Welfare (AIHW) estimated that there were 122,300 Australians living with type 1 diabetes, with over 2,000 new cases diagnosed every year.

Australia has one of the highest numbers of new cases annually per capita in the world: Australia is in the top-ten countries worldwide for incidence of type 1 diabetes in children under 15…

The rates of diabetes per Australian state also varies. Interestingly, Tasmania, our coldest state has the highest incidence. The Northern Territory, our hottest state, has the least. Queensland, also a relatively hot state, comes in after Victoria (colder). So, no conclusions can be drawn about climate.

(All JDRF references from: http://www.jdrf.org.au/s/media/documents/australiantype1diabetesresearchagenda_web.pdf)

Seems a bit odd that from 2006 and 122,300 cases of Type 1 (JDRF quoting AIHW, 2006), it’s also 140,000 people in 2006 (Garvan Institute) and to 87,100  cases in 2008 (AIHW). The Better Health Channel, Victoria, probably has it right: “estimates vary”.
(http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Diabetes_Type_1_or_juvenile_diabetes)

If you need insulin in this country, you have to register with the NDSS – the National Diabetes Services Scheme. You also have to specify what kind of diabetes you have. I don’t understand why the numbers vary so much!

I’m not even going to begin to write about the difference in estimates of Type 2 diabetes in Australia!

What we do know is that about 10% of people diagnosed with diabetes in Australia, have Type 1, although JDRF say it’s 13%. That doesn’t seem to vary much with numbers elsewhere in the western world.

The government via NDSS subsidises insulin pump consumables – insulin cartridges (box of 10 is AU$9.60) and infusion sets (box of 10 is AU$14.50). It also subsidises test strips and insulin. Syringes are free as are insulin pen needles. The subsidies vary but the most any eligible person (all Australian residents with diabetes) will pay for 100 test strips is AU$14.70 (exchange rates close to USD) and the least is AU$1.20, or even free. Criteria is varied and includes anyone with a Health Care Card (usually low-income people, pensioners etc) to veterans. If you have reached what we call the Safety Net for out-of-pocket costs (approved items only), test strips are free.

More info about Medicare Safety Net:
http://www.medicareaustralia.gov.au/public/services/msn/index.jsp#N10059

More info about PBS Safety Net:
http://www.medicareaustralia.gov.au/public/services/scripts/pbs.jsp#N100D3

Now here’s what interests me from JDRF:

The high use of hospital care by people with type 1 diabetes is a major contributor to cost burden, with hospitalisation accounting for nearly half the direct health care costs incurred by people with the disease. In a recent survey of people with type 1 diabetes, more than a third of respondents indicated they had been admitted to hospital emergency departments in the year prior to survey. 

Improving resources for managing diabetes in Australia would go a very long way to reducing the cost of hospital admissions. How? One way is by more easily allowing into Australia the various types of insulin pumps and Continuous Glucose Monitors (CGM) that are already available in the USA and Europe, for years… ones that are already being used and have proven to improve diabetes management, AND making them more affordable!

We don’t have many choices in Australia. Animas, Medtronic and Accu-Check sell and support insulin pumps here. Medtronic has CGMs here, hellishly expensive too and not covered by insurance – not the CGMS and not the sensors at $70 each. Insulin pumps are covered only by private health insurance, which most people here don’t have, and there is a scheme for kids of low-income earners to be subsidised to buy an insulin pump. Half of $7,500 for a low income earner is still out of reach for most.

The Dexcom 7+ CGM, the one I’m always complaining isn’t here yet, still isn’t here, despite it already being approved for sale in Australia quite a while ago. Likewise the Omnipod, a tubeless insulin pump, also isn’t here yet (at the time of writing). Likewise various other options that are available in the USA and Europe.

I guess one factor is that we are a country of only 22.2 million people (2010 estimate), a long way from anywhere, and a huge country where distance is an issue. The cost of setting up operations here for say 100,000 people with Type 1 Diabetes (not to mention all the people with Type 2 who would benefit from this technology), not all of whom could afford an insulin pump, is prohibitive. Big Pharma (and this includes diabetes technology manufacturers) has to make profit, right? Pity!

The Big Blue Test is coming up again! Each year, thousands of PWDs (People with Diabetes) test their blood glucose, do some exercise and test again. Then they share their before and after results.

It’s always a fun thing to do, so I encourage you to get the word out to everyone you know with diabetes, and to encourage people to participate.

Here’s how…

From: www.bigbluetest.org

In 2011, with each Big Blue Test, Roche Diabetes Care will make a donation to support humanitarian diabetes programs. When you do 14 to 20 minutes of exercise and share your blood sugar readings before and after getting active, YOU help yourself and you help us get life-saving supplies to OTHER people with diabetes in need.

Having plodded along with my iPhone 3G for a lot longer than I should have, I was waiting for the next incarnation of the iPhone. Getting one on release day posed no problem, with some clever thinking about where to go. There were no queues and just a bit of Telstra provisioning wait time (hundreds of others all over Australia also trying to set up new iPhones with Telstra, one of the big telcos here).

After playing with it for 24 hours, I totally love it! I’ve been having some fun with Siri tonight, asking her (it’s a ‘her’ in Australia) to do all sorts of things.

Siri is an ‘assistant’ of sorts. You speak to your iPhone and tell her what you want. A note? Call someone? A reminder? Some info? An internet search? Someone’s address? Dictation instead of typing? And a whole lot more! You speak in normal language.

Here’s an interesting list of things you can ask Siri.

Some iPhone 4S screen photos of my interactions with Siri…

Carb Counting with Siri

Information is provided via Wolfram Alpha, and other sources.

HbA1C information request

A fictitious note was fun to make. I can’t measure my A1c (no home testing kits in Australia), and I doubt it will ever be 4.6, but that’s what I told Siri to write and she got it right first time!

Siri take a note (totally fictitious of course!)

The note is time-stamped and synced with iCloud. It’s then downloaded to all my Mac computers and devices, so if I’m in the doctors office, for example, with my iPad and not my phone, the note will be there too.

Siri is still learning my voice, my accent and certain words that I will regularly use. I was surprised she got “HbA1C”.

So far, I’ve dictated several SMSs, an eMail and a Facebook reply and the words she got wrong were far less than expected. Sometimes she git everything right!. It gets better every time I use it. She knows what I mean when I say, “Remind me to call my daughter tomorrow afternoon,” and will set a reminder for me. I only had to say daughter and a name one time and Siri asked if I wanted to always associate that contact as my daughter. Cute and amazing!

I can think of so many uses for this technology. Can’t tell you how many times I’ve been driving and needed to write something down, or I think of something and I’m fumbling around for a pen and notepad so I won’t forget. The carb counting is easy and fantastic – no more flipping through books or scrolling through hundreds of food items on an app! I even asked it for nutritional info for a BigMac and the answer was there in seconds.

You can ask Siri to do calculations. Let’s say your insulin to carb ratio is 1:8. You’ve asked for a carb count for that BigMac. Siri comes back with 45 grams. Then you ask Siri, “What’s 45 divided by 8?” She answers with 5.625. Round it and you’ve got how many units of insulin to take!

Siri functionality still has some limitations in Australia – there’s no map interaction, traffic or business lookups (only USA), but apparently that’s coming in 2012. I totally love this technology!