The Australian National Diabetes Audit - Australian Quality Clinical Audit (ANDA-AQCA, previously ANDIAB) is a well-established, important biennial, quality activity led by the National Association of Diabetes Centres (NADC), in specialist diabetes centres across Australia, in all States and Territories. Participating specialist diabetes services receive an individualised report of their diabetes practice processes and patient outcome data compared with their peers. In addition the pooled national report is an important source of cross-sectional data on the clinical status and outcomes of individuals attending specialist diabetes services across the country during the audit period.
Volunteer centres conducted the ANDA-AQCA 2013 survey of all consecutive patients attending their service over a 4 week period, during the month of May or June 2013. Doubly deidentified data was collated and processed at the ANDA central coordinating/reporting centre based at Monash Health, Diabetes and Vascular Unit, Victoria. Information collected included patient demographics, type of diabetes, management methods, smoking status, presence of diabetes complications, cardiovascular risk factors and glycaemic control. Data analysis and reporting included descriptive statistics and comparative statistics, by site, year of collection and location.
Data for 3843 patients from 30 Diabetes Centres and 1 private Endocrinologist was collected. All states and territories were represented. The mean age of participants was 57.1 (±17.1 years). There was a slight preponderance of males (52.3%). The majority of patients had type 2 diabetes (71.7%). The mean duration of diabetes was 14.2 years (+/- 11.0). Mean HbA1c was 8.1%±1.8%. Of those patients with T2DM the majority were on insulin, with or without oral hypoglycaemics (59.7%). With respect to complications, 12.3% reported myocardial infarction, 5.5% stroke, 4.7% end stage renal disease, 2.3% lower limb amputation and 24.1% of males erectile dysfunction. Less than half of patients had seen an ophthalmologist or podiatrist in the preceding year (40%, 42.1% respectively). Of patients with retinal assessment a diabetes abnormality was identified in 26.1%.
The Australian National Diabetes Audit – Australian Quality Clinical Audit 2013 shows that patients with diabetes being managed in Diabetes Centres around Australia have a high prevalence of complications. This demonstrates a need for greater resourcing of diabetes services so they may optimise glycaemic control, intensify management of cardiovascular risk factors and increase screening to minimise the impact of complications.