Socioeconomic Relationship Trends Between Diabetes and Postcodes in NSW, Australia

Diabetes prevalence is increasing in Australia. The Ausdiab Study 2001 found diabetes affected 7.4% of adults >25y with 0.7% of Australians diagnosed yearly. The distribution of diabetes and standard of care however is not nationally uniform. Health disparities may be due to social disadvantage, ethnicity, age distribution and services access. We examined the distribution of diabetes and level of control based on postcode in NSW at two time periods, to determine if the relationship between the level of care (defined by HbA1c) and geographical distribution had changed with time. Data was sourced from a pathology company performing the bulk of testing, capturing the majority of subjects with diabetes. Subjects were identified by HbA1c measurement. Two periods were examined, 20and 2013. For each subject who had an HbA1c collected, data was extracted for gender, age, postcode, eGFR, lipids and urine microalbumin. Mann Whitney U tests compared differences in parameter medians between the two periods. Spearman correlations and linear regression assessed relationships between socioeconomic disadvantage scale based on postcode (SEIFA), and diabetes control. Data was available for 119018 subjects in 20and 185954 subjects in 2013. During both years, the number of diabetes cases was higher in areas of greater disadvantage and HbA1c was correlated with higher disadvantage score (p<0.01). Control significantly improved over time (Mdn HbA1c 6.5% vs. 6.3%) and the proportion of patients with poor control (HbA1c >7.0%) also improved (36.5% vs. 31.7%) (p<0.01). SEIFA significantly predicted diabetes control in both 20(F (1,119016) =907.4 p<0.01, r2=0.01) and 2013 (F (1,185952)=1940.3 p<0.01, r2=0.01). Control improved within 9/10 SEIFA categories over time (p<0.05) though the gap between socioeconomic tiers remained. Health inequalities in diabetes control parallel socioeconomic disadvantage levels in NSW. Despite an 8 year interim disparities in HbA1c between socioeconomic tiers have not changed. Disclosure K. Burns: None. T. Hng: None. N. Cheung: None.