Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital and University, Taoyuan, Taiwan.
J Formos Med Assoc. 2012 Nov;111(11):637-44. doi: 10.1016/j.jfma.2012.09.006. Epub 2012 Nov 26.
BACKGROUND/PURPOSE: Diabetes is one of the leading causes of dialysis, blindness, and amputation worldwide. However, the prevalence of diabetes-related kidney, eye, and foot diseases has not been investigated in national surveys.
In this study, we reviewed data sets of the National Health Insurance claims for the years 2000-2009. In 2009, the total population of Taiwan was 23 million. We de-identified the data and then analyzed them on inpatients and outpatients with diabetes mellitus, kidney diseases, eye diseases, peripheral vascular diseases (PVDs), and diabetic foot according to the International Classification of Diseases, 9(th) Revision with Clinical Modification diagnosis codes.
The prevalence of diabetic nephropathy increased from 13.32% in 2000 to 15.42% in 2009. The corresponding diabetes dialysis rate increased from 1.5% to 2.46% during the same period (p < 0.001). The prevalence rates of retinopathy and PVD also increased (from 6.17% to 8.91%; p = 0.002 and from 1.87 to 2.47; p < 0.001, respectively). More than 94% of the patients treated for diabetic foot in the hospital had an associated foot infection. The prevalence of in-hospital diabetic foot decreased from 1.68% to 1.02% during the years 2000-2009 (p < 0.001), while the rates of lower extremity amputation as the treatment outcome did not show improvement (mean amputation rate: 28.35%).
During the years 2000-2009, patients with diabetes in Taiwan had an increased risk for kidney, eye, and PVDs. Multidisciplinary teams need to be set up for the treatment of complications related to diabetic foot, and preventions programs that are specifically designed to target these complications should now be made mandatory.
背景/目的：糖尿病是全球导致透析、失明和截肢的主要原因之一。然而，在全国性调查中，尚未调查糖尿病相关的肾脏、眼睛和足部疾病的患病率。
在这项研究中，我们回顾了 2000 年至 2009 年国家健康保险索赔数据集。2009 年，台湾的总人口为 2300 万。我们对数据进行了去识别处理，然后根据国际疾病分类第 9 版临床修订版诊断代码，分析了患有糖尿病、肾脏疾病、眼部疾病、外周血管疾病（PVD）和糖尿病足的住院和门诊患者的数据。
糖尿病肾病的患病率从 2000 年的 13.32%增加到 2009 年的 15.42%。同期糖尿病透析率从 1.5%增加到 2.46%（p < 0.001）。视网膜病变和 PVD 的患病率也有所增加（分别从 6.17%增加到 8.91%，p = 0.002 和从 1.87%增加到 2.47%，p < 0.001）。在医院接受治疗的糖尿病足患者中，超过 94%的患者伴有足部感染。2000 年至 2009 年期间，医院内糖尿病足的患病率从 1.68%下降到 1.02%（p < 0.001），而作为治疗结果的下肢截肢率并没有改善（平均截肢率：28.35%）。
在 2000 年至 2009 年期间，台湾的糖尿病患者患肾脏、眼睛和 PVD 的风险增加。需要成立多学科团队来治疗与糖尿病足相关的并发症，并应强制制定专门针对这些并发症的预防计划。
