Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale 8/a, S. Maria Imbaro, Italy.
Nutr Metab Cardiovasc Dis. 2012 Jul;22(7):605-12. doi: 10.1016/j.numecd.2010.10.016. Epub 2011 Feb 17.
To estimate the impact of diabetes and its complications, overall and in different age classes, on the likelihood of hospital admission for specific causes.
We carried out a record-linkage analysis of administrative registers including data on 8,940,420 citizens in 21 Local Health Authorities in Italy. Individuals with pharmacologically treated diabetes (≥2 prescriptions of antidiabetic agents during the year 2008) were paired in a 1:1 proportion with those who did not receive such drugs (controls) based on propensity-score matching. Odds Ratios (ORs) of hospitalization for macro and microvascular conditions in individuals with diabetes as compared to controls were estimated. The system identified 498,825 individuals with diabetes pharmacologically treated (prevalence of 5.6%). Prevalence of diabetes in people aged <14 years, 14-39 years, 40-65 years, and ≥65 years was 0.1%, 0.6%, 6.4%, and 18.2%, respectively. Overall, 23.9% of subjects with diabetes and 11.5% of controls had had at least a hospital admission during 12 months for the causes considered. Diabetes increased the likelihood of hospitalization by two to six times for the different causes examined. In absolute terms, diabetes was responsible for an excess of over 12,000 hospital admissions per 100,000 individuals/year.
Despite the availability of effective treatments to prevent or delay major complications, diabetes still places an enormous burden on both patients and the health care system. Given the continuous rise in diabetes prevalence both in middle-aged and elderly individuals, we can expect an additional, hardly sustainable increase in the demand for health care in the near future.
评估糖尿病及其并发症对特定病因住院可能性的总体影响，以及不同年龄组的影响。
我们对包括意大利 21 个地方卫生局在内的行政登记册中的数据进行了记录链接分析，涉及 8940420 名公民。根据倾向评分匹配，将接受药物治疗的糖尿病患者（2008 年接受≥2 次抗糖尿病药物治疗）与未接受此类药物治疗的患者（对照组）以 1:1 的比例配对。比较糖尿病患者与对照组个体因大血管和微血管疾病住院的比值比（OR）。该系统确定了 498825 名接受药物治疗的糖尿病患者（患病率为 5.6%）。14 岁以下、14-39 岁、40-65 岁和≥65 岁人群中糖尿病的患病率分别为 0.1%、0.6%、6.4%和 18.2%。总体而言，23.9%的糖尿病患者和 11.5%的对照组患者在 12 个月内因考虑的原因至少有一次住院。糖尿病使不同病因的住院可能性增加了两到六倍。从绝对数量上看，糖尿病每年每 10 万人中导致超过 12000 次的住院。
尽管有有效的治疗方法可以预防或延缓主要并发症，但糖尿病仍然给患者和医疗保健系统带来了巨大的负担。鉴于中年和老年人群中糖尿病的患病率持续上升，我们可以预计，在不久的将来，对医疗保健的需求将进一步增加，且这种增加可能难以持续。
