Cardiovascular disease and diabetes in Australia

Cardiovascular disease and diabetes are significant health concerns for Australians. Heart disease is the leading cause of death in Australia.^[1]

Cardiovascular disease

Cardiovascular disease (CVD) continues to have a major impact on the health of Australians in terms of prevalence, mortality, morbidity, burden of disease and expenditure. From 2007-08, an estimated 3.4 million Australians were diagnosed with CVD.^[2] Cardiovascular disease remains Australia's leading cause of death. In 2009, 46,106 deaths in Australia were directly linked with CVD (21,935 males and 24,171 females); this figure represents a total of 33% of all deaths in Australia.^[3] It was reported in 2010 that almost 16% of the total projected burden of disease was a result of CVD.^[4] This then made individuals with CVD susceptible to co-morbid conditions later in life, making them "at risk" for depression and anxiety.

The number and rate of deaths from CVD have fallen considerably from the peak levels experienced in the late 1960s and early 1970s when CVD was responsible for around 60,000 deaths annually, or roughly 55% of all deaths each year.^[5] These major gains have been attributed to a combination of research, improvements in prevention and detection of cardiovascular disease, and better clinical management of people with the disease. There is a close interrelationship between CVD and other important chronic conditions, including diabetes and chronic kidney disease.^[6]

Cardiovascular disease kills one Australian every 11 minutes, and 3·4 million of the country's population are affected, with the Indigenous Australians having a 30% higher rate. In their lifetime, 1·5 million Australians are estimated to have diabetes and one in six Australians are suspected to have a stroke. The Baker IDI Heart and Diabetes Institute, based in Melbourne, is one of the most well known cardiovascular disease research institutes.

One of the studies directed by an Australian-Dutch research team, led by, Karin Jandeleit-Dahm from Baker IDI and Harald Schmidt from Maastricht University, Netherlands, has identified the role of an enzyme which accelerates the development of diabetic atherosclerosis. Researchers were able to substantially reduce the development of artery plaques by suppressing or inhibiting this enzyme with a new drug, which will allow prevention and treatment of cardiovascular disease in people with diabetes.

Another team, led by Bronwyn Kingwell, Head of Baker IDI's Metabolic and Vascular Physiology, have found a new use for an old drug. The researchers found that after taking the standard anti-hypertensive drug Ramipril, patients with peripheral arterial disease (PAD), which restricts mobility due to leg pain, enjoyed a longer and less painful time on their feet. For some patients, this could be the difference between living independently and living under the care of others for the rest of their lives.^[7]

Diabetes

An estimated 275 Australians develop diabetes every day. The 2005 Australian AusDiab Follow-up Study (Australian Diabetes, Obesity and Lifestyle Study) showed that 1.7 million Australians have diabetes but that up to half of the cases of type 2 diabetes remain undiagnosed.

Type 2

Type 2 diabetes is the most common type of diabetes, and majority of those affected are diagnosed with Type 2. Type 2 diabetes is classified as a lifestyle disease which is impacted by environmental and hereditary factors.^[8] This form of diabetes is significantly affected by the lifestyle the individual has. It is associated with the individuals' diet and activity level. The population who are most at risk are those who adopt a sedentary lifestyle at a young age. some things to take into consideration if you feel that you are at risk of Type 2 diabetes.

Prevention

• Maintaining a healthy weight
• Regular physical activity
• Managing blood pressure
• Managing cholesterol levels
• Quit/ Avoid smoking^[9]

Although there is no direct cure for Type 2 diabetes the Australian Government: Department of Health^[10] has put in place guidelines to assure that children and adolescents receive the suggested period of time engaging in physical activity. Some of their suggestions are as follows:

• shift from a low to moderate activity level
• participate in more vigorous activity rather than moderate intensity exercise- you will save time and therefore have more time for friends and family
• avoid long periods of screen time (devices including TV, Phone, etc.)
• avoid long sitting sessions

Diabetes facts

Other facts about diabetes include:

• Every year 0.8% of adults developed diabetes.
• Every day in Australia approximately 275 adults develop diabetes.
• Those with pre-diabetes were 10-20 times more likely to develop diabetes than were those with normal blood glucose levels.
• Obesity, hypertension, dyslipidaemia, physical inactivity and the metabolic syndrome each increased the risk for developing diabetes.^[11]

In 2007-08 approximately 520,000 people had diabetes and CVD meaning only 42% of diabetics did not have CVD. CVD is the major cause of mortality in people suffering from diabetes with CVD accounting for 80% of deaths.^[12][13]

The International Diabetes Federation has estimated that currently 194 million people worldwide, or 5.1% within the adult population have diabetes; this will jump to 333 million, or 6.3%, by 2025. Type 2 Diabetes makes up approximately 85% to 95% of all diabetes in developed countries, and is even higher in developing countries.

The European Region, with 48 million, and Western Pacific Region, with 43 million, has the most number of people with diabetes currently. In 2025, the region with the largest number of people with diabetes will to change to the South-East Asian Region with approximately 82 million sufferers.

Right now the age group with the greatest number of people suffering from diabetes are the 40- to 59-year-olds. Due to the ageing population, by 2025 there will be 146 million people aged 40–59 and 147 million people aged 60 or older with diabetes.

In 2003, the number of people with diabetes in urban areas was 78 million and by 2025 it is said to increase to 182 million urban and 61 million rural people with diabetes.^[14]

Epidemiology

A University of Alberta study, conducted in 2006, noted that 60% of Aborigines over the age of 35 in Western Australia tested positive for diabetes.^[15]

A study conducted by the International Diabetes Institute at Monash University showed that Asians, Pacific Islanders, and Middle Eastern immigrants who moved to Australia were diagnosed with diabetes at a higher level than the average.^[16] The increase was explained by the adoption of a Western diet in place of a more healthy "traditional" diet more common in their native countries, as well as adopting a more sedentary lifestyle which is ubiquitous in developed countries.^[17]

National Diabetes Services Scheme

The National Diabetes Services Scheme (NDSS) is an institution funded by the Australian Government that delivers diabetes-related products at affordable prices and provides information and support services to people with type 1, type 2, gestational and other types of diabetes; the number one national peak body for diabetes in Australia, Diabetes Australia, runs this scheme. State and territory diabetes organisations are also assisting in the arrangements and planning of services for this scheme. The National Diabetes service aim is to ensure appropriate, reliable and affordable access to diabetes-related products and services to support people suffering from diabetes.^[18]

See also

• Obesity in Australia
• Cardiovascular Disease
• Heart disease in Australia

References