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非洲、中东、南亚、欧亚大陆及土耳其2型糖尿病相关资源利用情况:国际糖尿病管理实践研究(IDMPS)结果

Resource use associated with type 2 diabetes in Africa, the Middle East, South Asia, Eurasia and Turkey: results from the International Diabetes Management Practice Study (IDMPS).

作者信息

Gagliardino Juan J, Atanasov Petar K, Chan Juliana C N, Mbanya Jean C, Shestakova Marina V, Leguet-Dinville Prisca, Annemans Lieven

机构信息

CENEXA. Centro de Endocrinología Experimental y Aplicada (UNLP-CONICET) , La Plata , Argentina.

Amaris , London , UK.

出版信息

BMJ Open Diabetes Res Care. 2017 Jan 17;5(1):e000297. doi: 10.1136/bmjdrc-2016-000297. eCollection 2017.

Abstract

OBJECTIVE

Type 2 diabetes (T2D) and its complications form a global healthcare burden but the exact impact in some geographical regions is still not well documented. We describe the healthcare resource usage (HRU) associated with T2D in Africa, the Middle East, South Asia, Eurasia and Turkey.

RESEARCH DESIGN AND METHODS

In the fifth wave of the International Diabetes Management Practices Study (IDMPS; 2011-2012), we collected self-reported and physician-reported cross-sectional data from 8156 patients from 18 countries across 5 regions, including different types of HRU in the previous 3-6 months. Negative binomial regression was used to identify parameters associated with HRU, using incidence rate ratios (IRRs) to express associations.

RESULTS

Patients in Africa (n=2220), the Middle East (n=2065), Eurasia (n=1843), South Asia (n=1195) and Turkey (n=842) experienced an annual hospitalization rate (mean±SD) of 0.6±1.9, 0.3±1.2, 1.7±4.1, 0.4±1.5 and 1.3±2.7, respectively. The annual number of diabetes-related inpatient days (mean±SD) was 4.7±22.7, 1.1±6.1, 16.0±30.0, 1.5±6.8 and 10.8±34.3, respectively. Despite some inter-regional heterogeneity, macrovascular complications (IRRs varying between 1.4 and 8.9), microvascular complications (IRRs varying between 3.4 and 4.3) and, to a large extent, inadequate glycemic control (IRRs varying between 1.89 and 10.1), were independent parameters associated with hospitalization in these respective regions.

CONCLUSIONS

In non-Western countries, macrovascular/microvascular complications and inadequate glycemic control were common and important parameters associated with increased HRU.

摘要

目的

2型糖尿病(T2D)及其并发症构成了全球医疗负担,但在某些地理区域的确切影响仍未得到充分记录。我们描述了非洲、中东、南亚、欧亚大陆和土耳其与T2D相关的医疗资源使用情况(HRU)。

研究设计与方法

在国际糖尿病管理实践研究(IDMPS)的第五波研究(2011 - 2012年)中,我们收集了来自5个地区18个国家的8156名患者的自我报告和医生报告的横断面数据,包括前3 - 6个月不同类型的HRU。使用负二项回归来确定与HRU相关的参数,用发病率比(IRR)来表示关联。

结果

非洲(n = 2220)、中东(n = 2065)、欧亚大陆(n = 1843)、南亚(n = 1195)和土耳其(n = 842)的患者年住院率(均值±标准差)分别为0.6±1.9、0.3±1.2、1.7±4.1、0.4±1.5和1.3±2.7。糖尿病相关住院天数的年数(均值±标准差)分别为4.7±22.7、1.1±6.1、16.0±30.0、1.5±6.8和10.8±34.3。尽管存在一些区域间的异质性,但大血管并发症(IRR在1.4至8.9之间变化)、微血管并发症(IRR在3.4至4.3之间变化)以及在很大程度上血糖控制不佳(IRR在1.89至10.1之间变化),是这些各自区域与住院相关的独立参数。

结论

在非西方国家,大血管/微血管并发症和血糖控制不佳是与医疗资源使用增加相关的常见且重要的参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/667d/5253437/66f1e64dd1b2/bmjdrc2016000297f01.jpg

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