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| Journal of the New Zealand Medical Association,
05-March-2010, Vol 123 No 1310
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This Issue in the Journal
Implication of using estimated glomerular filtration
rate (GFR) in a multi ethnic population of diabetes patients in general
practice
Grace Joshy, Tesa Porter, Clem Le Lievre, Jane Lane, Mike Williams, Ross Lawrenson This study looked at the prevalence of chronic kidney
disease among diabetes patients in New Zealand. Estimated Glomerular Filtration
Rate (eGFR) is increasingly used as a marker for identifying early renal
failure. This study measured the agreement between two equations commonly used
in the calculation of eGFR. There were significant differences in agreement
between the two equations: the MDRD and the CG. While CG equation identifies
more European of both genders, more Māori females were identified by MDRD.
MDRD equation may be overestimating CKD among Māori females. Each ethnic
subpopulation may need to be validated separately, and by gender.
Ethnic disparities in causes of death among diabetes
patients in the Waikato region of New Zealand
Grace Joshy, Chanukya Kamalinie Colonne, Peter Dunn, David Simmons, Ross Lawrenson Maori diabetes patients experienced significantly higher
risk of mortality compared with Europeans with diabetes. Compared with European
diabetes patients, Maori diabetes patients are more likely to die from
cardiovascular disease, cancer and renal disease. Maori with diabetes are more
likely than Europeans with diabetes to have diabetes reported on death
certificates. The results suggest that the under-coding of diabetes on death
certificates in New Zealand has not improved and continues to be a major
limitation for routine mortality analysis solely based on these codes. Mortality
among diabetes patients in New Zealand would need to be compared with that among
people without known diabetes, to estimate the true burden due to
diabetes.
Exploring physical and psychological wellbeing among
adults with Type 2 diabetes in New Zealand: identifying a need to improve the
experiences of Pacific peoples
Charlotte A M Paddison In this study we explored levels of physical and
psychological wellbeing among adults with Type 2 diabetes in New Zealand. Our
results showed that the majority (58%) of people in this study had difficulty
achieving good control of their diabetes and did not meet the clinical targets
set by health professionals. We already know that physical health outcomes for
people with Type 2 diabetes vary by ethnicity; our study shows that
psychological outcomes such as diabetes-related distress also differ across
ethnic groups—with Pacific peoples worst affected. Our findings show that
we need to improve the experiences of Pacific peoples with Type 2 diabetes. This
includes improving metabolic control, and also working with Pacific patients to
address any concerns about medication and to reduce emotional distress about
diabetes.
Standardisation of reporting haemoglobin A1c:
adoption of the New Zealand Society for the Study of Diabetes (NZSSD) position
statement
Chris Florkowski, Michael Crooke New Zealand, in line with other countries has now
implemented a system of new units for reporting HbA1c for monitoring long-term
glucose control in diabetes. Our paper traces the background and rationale for
this important change.
How well does routine hospitalisation data capture
information on comorbidity in New Zealand?
Diana Sarfati, Sarah Hill, Gordon Purdie, Elizabeth Dennett , Tony Blakely Comorbidity refers to diseases or disorders that coexist
with a disease of interest. Comorbidity is common and it is being increasingly
recognised as being important in health-related research and policy. This paper
compares routinely collected comorbidity data (collected by coders based in
District Health Boards and sent electronically to NZ Health Information Systems)
with comorbidity data collected directly from patients’ hospital notes by
a physician. We found that although (expected) differences in these two sources
of data exist, administrative data provides a useful and relatively accessible
source of information on comorbidity in New Zealand.
A population-based approach to the estimation of
diabetes prevalence and health resource utilisation
James Smith, Gary Jackson, Brandon Orr-Walker, Rod Jackson, Siniva Sinclair, Simon Thornley, Tania Riddell, Wing Cheuk Chan This study showed that diabetes is common in Counties
Manukau and throughout the northern region, particularly in Māori and
Pacific communities. It combined data that is normally used for administrative
purposes with two other sets of data, to look at diabetes rates and the use of
healthcare resources. All data were adjusted to avoid identification of
individuals. This method has the advantage of providing comprehensive
information about diabetes in a way that is timelier and less expensive than
traditional survey methods, allowing better planning for the diabetes
epidemic.
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