title: Undiagnosed diabetes from cross-sectional GP practice data: an approach to identify communities with high likelihood of undiagnosed diabetes.
abstract: OBJECTIVE
  To estimate undiagnosed diabetes prevalence from general practitioner (GP) practice data and identify areas with high levels of undiagnosed and diagnosed diabetes.
  
  
  METHODS
  Data from the North-West Adelaide Health Survey (NWAHS) were used to develop a model which predicts total diabetes at a small area. This model was then applied to cross-sectional data from general practices to predict the total level of expected diabetes. The difference between total expected and already diagnosed diabetes was defined as undiagnosed diabetes prevalence and was estimated for each small area. The patterns of diagnosed and undiagnosed diabetes were mapped to highlight the areas of high prevalence.
  
  
  METHODS
  North-West Adelaide, Australia.
  
  
  METHODS
  This study used two population samples-one from the de-identified GP practice data (n=9327 active patients, aged 18 years and over) and another from NWAHS (n=4056, aged 18 years and over).
  
  
  METHODS
  Total diabetes prevalence, diagnosed and undiagnosed diabetes prevalence at GP practice and Statistical Area Level 1.
  
  
  RESULTS
  Overall, it was estimated that there was one case of undiagnosed diabetes for every 3-4 diagnosed cases among the 9327 active patients analysed. The highest prevalence of diagnosed diabetes was seen in areas of lower socioeconomic status. However, the prevalence of undiagnosed diabetes was substantially higher in the least disadvantaged areas.
  
  
  CONCLUSIONS
  The method can be used to estimate population prevalence of diabetes from general practices wherever these data are available. This approach both flags the possibility that undiagnosed diabetes may be a problem of less disadvantaged social groups, and provides a tool to identify areas with high levels of unmet need for diabetes care which would enable policy makers to apply geographic targeting of effective interventions.
authors: Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia.
authors: Nasser
authors: N
authors: Bagheri
authors: Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia.
authors: Ian
authors: I
authors: McRae
authors: Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia.
authors: Paul
authors: P
authors: Konings
authors: Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia.
authors: Danielle
authors: D
authors: Butler
authors: Department of General Practice, School of Medicine, Australian National University, Canberra, Australia.
authors: Kirsty
authors: K
authors: Douglas
authors: Healthfirst Network, Adelaide, Australia.
authors: Peter
authors: P
authors: Del Fante
authors: School of Medicine, University of Adelaide, Adelaide, Australia.
authors: Robert
authors: R
authors: Adams
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D058006:General Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Epidemiology; Primary Care; Public Health