Mapping Glycaemic Control Across Australia Project

Background

In 2007, after receiving ethics approval* The Mapping Glycaemic Control Across Australia (MGCAA) project was provided access to de-identified HbA1c data directly from pathology laboratories thereby removing the possibility of transcription errors. The MGCAA was established to review diabetes related biochemical markers across geographic locations at a national, state and territory, Division of Primary Care (PC) and postcode level throughout Australia. Glycaemic Control Cohort Substudy is an extension of this study.

*Bellberry Human Research Ethics Committee approval ref B121/07

Investigator

Dr. Chrys Michaelides

Methodology

Of the original 310000 patient data collected in 2007 MGCAA project, 87552 individuals have been followed each year for 4 years to 31/12/2010. This represents approximately 7 % of the estimated diabetes population of Australia. Although change in national glycaemic control is marginal, there are clear regional differences in both mean HbA1c as well the proportion of patients achieving HbA1c targets at a postcode, division and state/territory level. Within each postcode, data is only provided if the data reports are available for more than 14 (28% of the benchmark sample threshold) individual records. At a division of GP level if data reports available exceed 280 (28% of the benchmark sample threshold) they are reported.

How to use the data

The Glycaemic Cohort Substudy follows the 87,552 individuals with data for each of the 4 years. Following this cohort group, we have established a diabetes surveillance system. With this we can identify trends in glycaemic control and regional differences that may exist. Divisions of GP and the associated postcodes and divisions with the greatest glycaemic improvement as well as those with the greatest need can be identified. Strategic interventions incorporating processes identified from areas with the greatest success can be implemented and effectiveness monitored through prospective surveillance.

Conclusion

It is well documented that diabetes is a progressive disorder requiring frequent review Harris et al1 in 2003, showed that there was a progressive increase in the number of patients with an HbA1c >7% associated with increasing duration of diabetes. However, data from Glycaemic Control Cohort Substudy suggests that nationally this is not the case and that interrogation at a postcode level shows further variability.