Nordfeldt S, Jonsson D
Division of Child and Adolescent Psychiatry, Faculty of Health Sciences, Linköping, Sweden.
Acta Paediatr. 2001 Feb;90(2):137-42. doi: 10.1080/080352501300049244.
The aim of this study was to describe costs and other short-term effects of severe hypoglycaemia in children and adolescents with type 1 diabetes. The study comprised a geographic population of 129 patients <19 y of age with families prospectively registering detailed data after self-reported severe hypoglycaemia. In the period Jan.-Dec. 1998, 16 events were reported with unconsciousness and 95 events without unconsciousness but needing the assistance of another person. Of all events, 20-30% had effects requiring the assistance of people other than parents, school absence, parents' absence from work, extra transport and/or telephone calls. Patient (family) activities were cancelled after 10% (5%) of events. Increased worry for parents was reported after 8% and poor sleep after 7% of events. Hospital visits took place at 5% and hospitalizations at 3% of all events. Patients with severe hypoglycaemia indicated lower global quality of life (p=0.0114). The average socio-economic burden for events of severe hypoglycaemia was estimated at EURO 17,400 yearly per 100 type 1 diabetes patients. Average cost was estimated at EURO 239 per event of severe hypoglycaemia with unconsciousness or EURO 478 yearly per patient with unconsciousness, and EURO 63 per event of severe hypoglycaemia without unconsciousness but needing assistance from another person or EURO 307 yearly per patient in this category. These are conservative estimates and do not include unpaid time and other intangibles, possible road traffic accidents, disabling or premature deaths.
The results suggest the potential for socio-economic savings and increased quality of life for patients and families from severe hypoglycaemia prevention programs.
本研究旨在描述1型糖尿病儿童和青少年严重低血糖的成本及其他短期影响。该研究纳入了129名年龄小于19岁的患者及其家庭,这些家庭在自我报告严重低血糖后前瞻性地记录详细数据。在1998年1月至12月期间,报告了16起伴有意识丧失的事件和95起虽无意识丧失但需要他人协助的事件。在所有事件中,20% - 30%产生的影响需要除父母之外的其他人协助、缺课、父母缺勤、额外交通和/或打电话。10%(5%)的事件后患者(家庭)活动被取消。8%的事件后报告父母担忧增加,7%的事件后报告睡眠不佳。所有事件中有5%进行了医院就诊,3%进行了住院治疗。严重低血糖患者的总体生活质量较低(p = 0.0114)。严重低血糖事件的平均社会经济负担估计为每100名1型糖尿病患者每年17,400欧元。伴有意识丧失的严重低血糖事件平均成本估计为每次239欧元,或意识丧失患者每年478欧元;无意识丧失但需要他人协助的严重低血糖事件平均成本为每次63欧元,或此类患者每年307欧元。这些是保守估计,不包括无薪时间和其他无形因素、可能的道路交通事故、致残或过早死亡。
结果表明,预防严重低血糖项目有可能为患者及其家庭节省社会经济成本并提高生活质量。