A landmark study that changed what we know about diabetes in Australia
When AusDiab launched in 1999, no one had ever systematically measured the true burden of diabetes across the Australian population. What followed was more than a decade of groundbreaking research that reshaped national health policy, informed clinical practice, and gave science an unprecedented window into how diabetes, heart disease and kidney disease develop over time.
Coordinated by the Baker Heart and Diabetes Institute, AusDiab (the Australian Diabetes, Obesity and Lifestyle Study) remains the largest longitudinal, population-based study of its kind ever conducted in Australia. Its findings continue to inform research and policy today.
The study's data remains active and available to researchers. If you are interested in accessing the AusDiab dataset, visit the AusDiab project page for more information.
About the study
AusDiab was designed to establish, for the first time, national benchmark data on the prevalence of diabetes, obesity, hypertension and kidney disease among Australian adults. The study used a field survey model combining physical testing and detailed questionnaires, conducted at 42 randomly selected sites across the country.
In 1999–2000, a team of Baker Institute researchers individually tested 11,247 participants aged 25 and over — the baseline study. In 2004–2005, 6500 of those original participants returned for a five-year follow-up, with a further 2000 providing self-reported health data. A third survey was completed in 2011–2012, providing an unprecedented 12-year picture of how chronic disease had developed, progressed or been prevented across the cohort. Results from the 12-year follow-up were released in August 2013.
Together, these three surveys created the first-ever longitudinal data on the incidence of diabetes, cardiovascular disease and kidney disease in Australia — not just how many people had these conditions, but how and in whom they developed over time.
The AusDiab Study was awarded the 2006 Victorian Department of Human Services Public Health Research Award for Excellence.
Key findings
From the baseline 1999–2000 study
The baseline survey revealed the scale of a crisis that many had underestimated. At the turn of the century, almost one million Australians had diabetes — and for every known case, there was another that had never been diagnosed. In people aged 75 and over, almost one in four had the condition. Nearly 60% of Australian adults were overweight or obese, more than double the rate recorded in 1980, and the number of Australians living with diabetes had trebled since a comparable survey in 1981.
Almost one in four adults aged 25 and over had either diabetes or pre-diabetes (elevated blood sugar not yet at diagnostic levels), with pre-diabetes carrying substantially elevated risk of both heart disease and future diabetes. Around 16% of the population had some form of kidney damage, placing them at risk of renal disease — a condition that at the time consumed 5.7% of the national healthcare budget.
From the five-year follow-up in 2004–2005
The follow-up painted a picture of a population moving in the wrong direction. Every day in Australia, approximately 275 adults were developing diabetes. People with pre-diabetes were 15 times more likely to develop diabetes than those with normal blood glucose, while obese people were four times more likely than those of a healthy weight. Physical inactivity doubled the risk — those who did no exercise were twice as likely to develop diabetes as those meeting the recommended 150 minutes per week. On average, Australian adults had gained 2.1cm in waist circumference over just five years.
From the 12-year follow-up in 2011–2012
The 12-year data confirmed the long-term consequences of the trends identified in earlier surveys. Every year, approximately 0.7% of adults developed diabetes, 3% developed high blood pressure, and 0.4–0.7% developed early signs of kidney damage. Living in Australia's most socially disadvantaged areas doubled the risk of developing diabetes. People with previously diagnosed diabetes had a mortality risk comparable to that of smokers. Among people over 60, having diabetes, obesity or kidney disease significantly increased the risks of cognitive impairment, physical disability and depression, and made hospital admission substantially more likely.
The 12-year data also highlighted a significant finding about how we measure physical activity: people reported doing roughly 50% more physical activity than objective measures recorded, while their estimated sitting time was approximately half what was measured. This has important implications for how population health surveys interpret self-reported data.
Sister studies
AusDiab was designed to be representative of the general Australian population aged over 25. Two related studies used similar methods to examine populations not included in the main AusDiab cohort.
The DRUID Study (Diabetes and Related disorders in Urban Indigenous people in the Darwin region) was the first population-based longitudinal cohort study of diabetes and related conditions in an urban Indigenous population in Australia. Conducted in groundbreaking partnership with researchers, health service providers and the local Indigenous community, the study aimed to accurately assess the burden of diabetes, renal and cardiovascular disease in this population, while building community capacity to prevent and manage these conditions. Several of the AusDiab principal investigators also participated in DRUID.
The Crossroads Undiagnosed Disease Study examined health and wellbeing among adults over 25 in rural Victoria, using physical testing methods closely aligned with AusDiab. Between 2001 and 2003, household questionnaire data was gathered from 10,000 households in a large Victorian rural centre and 10,000 in surrounding smaller towns, with a subset invited for physical testing. The study explored the impact of the health and resource gap between rural and metropolitan populations on chronic disease outcomes. It was a collaboration between the International Diabetes Institute and the University of Melbourne's Department of Rural Health.
Funding and acknowledgements
AusDiab was funded through a National Health and Medical Research Council (NHMRC) grant, with additional support from the Australian Government Department of Health and Ageing, state and territory governments, academic institutions and a wide range of industry partners.
The Baker Institute gratefully acknowledges the support of all those who made the study possible, including the 11,247 Australians who gave their time to participate — without whom none of this would have been possible.
A full list of sponsors and supporters
Government and peak bodies
National Health and Medical Research Council, Australian Government Department of Health and Ageing, Australian Institute of Health and Welfare, City Health Centre Diabetes Service (Canberra), Department of Health New South Wales, Department of Health South Australia, Department of Health Western Australia, Department of Health and Community Services Northern Territory, Department of Health and Human Services Tasmania, Department of Human Services Victoria, Department of Human Services South Australia, Queensland Health, Victorian Government's OIS Program, Diabetes Australia, Diabetes Australia (Northern Territory), Australian Kidney Foundation, Kidney Health Australia, Menzies Research Institute (Hobart), Royal Prince Alfred Hospital (Sydney)
Foundations and trusts
Estate of the Late Edward Wilson, Jack Brockhoff Foundation, Marian and E.H. Flack Trust, Pratt Foundation
Industry partners
Abbott Australasia, Alphapharm, Amgen Australia, AstraZeneca, Aventis Pharmaceutical, Bio-Rad Laboratories, Bristol-Myers Squibb Pharmaceuticals, Eli Lilly Australia, GlaxoSmithKline, Impeto Medical, Janssen-Cilag, Merck Lipha s.a., Merck Sharp and Dohme, Novartis, Novo Nordisk, Pfizer, Pharmacia and Upjohn, Roche Diagnostics, Sanofi Aventis, Sanofi Synthelabo, Servier Laboratories
People behind the study
AusDiab was made possible by the expertise and dedication of a large team of researchers, field staff, coordinators and support staff.
Principal investigators
Professor Robert Atkins AM (Monash University), Associate Professor Jonathan Shaw (Baker Institute), Professor Timothy Welborn AO (University of Western Australia), Professor Paul Zimmet AO (Baker Institute)
Associate investigators
Stan Bennett, Stephen Colagiuri, Max De Courten, David Dunstan, Terry Dwyer AM, Damien Jolley, Kerin O'Dea, Pat Phillips
Key Baker Institute staff
Elizabeth Barr, Adrian Cameron, David Dunstan, Dianna Magliano, Shirley Murray (Project manager), Richard Sicree, and many others across coordination, epidemiology, data management and field operations.
A full list of collaborators, field staff, pathology staff and other contributors is available upon request.
