The cost of diabetes-related hospital care to the Southern District Health Board in 2016/17.

AIM: To estimate the cost of diabetes-related hospital admissions to the Southern District Health Board for the year 2016/17. METHODS: Unidentified data with an ICD-10-AM diagnostic code for any type of diabetes were obtained for admissions to Dunedin and Southland Hospitals. Each admission was categorised according to whether the diabetes diagnostic code was listed first, second or subsequently, and by diagnostic group within each of these three categories. The case weight for each admission was multiplied by the 2016/17 cost weight value of NZ$4,824.67. RESULTS: There were 6,994 separate hospital admission events. The total cost was NZ$40,986,618. Admissions where diabetes was the primary, secondary or subsequent diagnosis cost NZ$2,214,172, NZ$8,057,235 and NZ$30,697,210, respectively. More than 80% of admissions were for those aged 55 years and over. Ketoacidosis was the most common primary reason for admission (n=103) among those with type 1 diabetes, costing NZ$349,892. When diabetes was not the primary or secondary diagnosis, the most common primary diagnosis was a circulatory system disease, costing NZ$8,181,324. The mean (SD) cost per admission where the primary diagnosis was coronary artery disease with and without diabetes diagnostic codes was NZ$10,407 ($20,694) and NZ$8,657 ($11,347), respectively. CONCLUSIONS: The annual cost of diabetes-related hospital admissions is substantial. Monitoring the cost of diabetes to DHBs should be prioritised, along with implementation of interventions that reduce preventable diabetes-related hospital admissions, and new diabetes cases.

Dietary glycemic index and glycemic load among Indigenous and non-Indigenous children aged 10-12 years.

OBJECTIVE: This study aimed to estimate the dietary glycemic index (GI) and glycemic load (GL) of Australian Aboriginal and Torres Strait Islander and non-Indigenous rural children and identify the main foods contributing to their GI and GL. METHODS: A cross-sectional analysis of food intake of 215 children (38.1% were Aboriginal and Torres Strait Islanders) 10 to 12 y old obtained by three 24-h recalls was conducted. The foods were ranked according to their total contribution to total carbohydrates, GI, and GL. RESULTS: Aboriginal and Torres Strait Islander participants had a significantly higher dietary GL (155.8 ± 46.8 versus 135.4 ± 31.2, P < 0.001) and GI (58.3 ± 3.9 versus 56.9 ± 3.8, P = 0.008) than the non-Indigenous participants. White breads were the main contributors of GI and GL in both groups and were a main driver for the increasing GI. Fiber was not associated with GI, whereas sugar and starch were positively associated. Subjects with a higher GI tended to be less physically active. CONCLUSION: The quality of carbohydrates in the diets of the participants was low, with poorer dietary items contributing most of the GI and GL. Substituting white breads with low/lower GI alternatives may be a useful strategy.

Poor food and nutrient intake among Indigenous and non-Indigenous rural Australian children.

BACKGROUND: The purpose of this study was to describe the food and nutrient intake of a population of rural Australian children particularly Indigenous children. Participants were aged 10 to 12 years, and living in areas of relative socio-economic disadvantage on the north coast of New South Wales. METHODS: In this descriptive cross-sectional study 215 children with a mean age of 11.30 (SD 0.04) years (including 82 Indigenous children and 93 boys) completed three 24-hour food recalls (including 1 weekend day), over an average of two weeks in the Australian summer of late 2005. RESULTS: A high proportion of children consumed less than the Australian Nutrient Reference Values for fibre (74-84% less than Adequate Intake (AI)), calcium (54-86% less than Estimated Average Requirement (EAR)), folate and magnesium (36% and 28% respectively less than EAR among girls), and the majority of children exceeded the upper limit for sodium (68-76% greater than Upper Limit (UL)). Energy-dense nutrient-poor (EDNP) food consumption contributed between 45% and 49% to energy. Hot chips, sugary drinks, high-fat processed meats, salty snacks and white bread were the highest contributors to key nutrients and sugary drinks were the greatest per capita contributor to daily food intake for all. Per capita intake differences were apparent by Indigenous status. Consumption of fruit and vegetables was low for all children. Indigenous boys had a higher intake of energy, macronutrients and sodium than non-Indigenous boys. CONCLUSIONS: The nutrient intake and excessive EDNP food consumption levels of Australian rural children from disadvantaged areas are cause for concern regarding their future health and wellbeing, particularly for Indigenous boys. Targeted intervention strategies should address the high consumption of these foods.

The reliability and validity of a short FFQ among Australian Aboriginal and Torres Strait Islander and non-Indigenous rural children.

OBJECTIVE: To determine the reproducibility and validity of a short FFQ (SFFQ) for Australian rural children aged 10 to 12 years, particularly Aboriginal and Torres Strait Islander children. DESIGN: In this cross-sectional study participants completed the SFFQ on two occasions and three 24 h recalls. Concurrent validity was established by comparing results of the first SFFQ against food recalls; reproducibility was established by comparing the two SFFQ. SETTING: The north coast of New South Wales in the Australian summer of late 2005. SUBJECTS: Two hundred and forty-one children (ninety-two Aboriginal and Torres Strait Islander children and 100 boys) completed two SFFQ and were included in the reproducibility study; of these, 205 participants with a mean age of 10·8 (sd 0·7) years took part in the validity study. RESULTS: The SFFQ showed moderate to good reproducibility among all children with kappa coefficients for repeated measures between 0·41 and 0·80. Eighteen of twenty-three questions demonstrated good validity against the mean of the 24 h recalls, with statistically significant increasing trends (P ≤ 0·05) for mean daily weight and/or frequency as survey response categories increased. A similar number of short questions showed good validity for Aboriginal and Torres Strait Islander children as for their non-Indigenous counterparts. CONCLUSIONS: Many short questions in this SFFQ are able to discriminate between different categories of food intake and provide information on relative intake within the given population. They can be used to monitor and/or evaluate population-wide health programmes, including those with rural Aboriginal and Torres Strait Islander children.

The validation of a self-report measure and physical activity of Australian Aboriginal and Torres Strait Islander and non-Indigenous rural children.

PURPOSE: To validate a self-report measure of physical activity for both Australian Aboriginal and Torres Strait Islander and non-Indigenous rural children, and to describe their physical activity participation. METHODS: In this cross-sectional study, 84 Aboriginal and Torres Strait Islander and 146 non-Indigenous children aged 10-12 years old completed the Many Rivers Physical Activity Recall Questionnaire (MRPARQ), a modified version of the Adolescent Physical Activity Recall Questionnaire (APARQ). A sub-group (n=86) wore an accelerometer for seven consecutive days in order to validate the instrument. RESULTS: Pearson and Intra Class Correlation coefficients between the survey and acceleromtery for weekdays only are 0.31 and 0.16, respectively, for Aboriginal and Torres Strait Islander children, and 0.38 and 0.31, respectively, for non-Indigenous children, and demonstrate a modest (p<0.05) correlation. Self-reported MVPA for Aboriginal and Torres Strait Islander children is between 162 and 172 minutes/day, and is 125 minutes by accelerometer; for non-Indigenous children MVPA is between 123 and 149 minutes (survey) and 107 minutes (accelerometer). CONCLUSION: Australian Aboriginal and Torres Strait Islander children's self-report of physical activity is at least as valid as non-Indigenous children, given culturally appropriate support; they tend to be more active than non-Indigenous children. IMPLICATIONS: The MRPARQ can be administered with Aboriginal and Torres Strait Islander and non-Indigenous children.