Minnesota Department of Health, Division of Health Promotion and Chronic Disease, St. Paul, Minnesota.
Minnesota Department of Health, Diabetes Unit, Division of Health Promotion and Chronic Disease, 85 E Seventh Pl, PO Box 64882, St. Paul, MN 55164. Email:
Prev Chronic Dis. 2018 Nov 21;15:E142. doi: 10.5888/pcd15.180255.
Of more than 300,000 adult Minnesotans who have received a diagnosis of diabetes, 16% are younger than 45 years; however, state diabetes surveillance data primarily describe older adults. National reports suggest adults younger than 45 years are less likely than older adults with diabetes to meet blood glucose (hemoglobin A [HbA]) goals. For this study on age-specific differences, we examined Minnesota data sets to determine if younger adults (ie, aged 18-44 y) are less likely to meet HbA goals and if hospitalization patterns differ from older adults (ie, aged 45-74 y) with diabetes.
We used Behavioral Risk Factor Surveillance System data to describe demographic characteristics and health behaviors of people with diabetes, clinical quality data to assess HbA levels, and hospital discharge data to assess reasons for hospitalization.
Compared with older adults with diabetes, adults aged 18 to 44 were more likely to use tobacco and to have had depression; these younger adults were less likely to report having HbA levels checked in the last year. According to age-specific cutoffs, 40.5% of 18- to 44-year-olds met HbA goals versus 74.7% of people aged 45 to 64 and 84.4% of people aged 65 to 74. Hospitalization rates for diabetes as a primary cause were highest among 18- to 44-year-olds at 47 per 1,000 adults with diabetes, much higher than older ages. Hospitalization rates for mental health problems were higher among younger adults.
Our analysis confirmed that 18- to 44-year-olds with diabetes have poorer HbA control than older adults with diabetes. These results underscore the importance of age-based public health surveillance of diabetes. Age-stratified surveillance can inform efforts to monitor clinical care quality and to design clinical/public health interventions.
在明尼苏达州 30 多万名被诊断患有糖尿病的成年人中，有 16%的人年龄在 45 岁以下；然而，州糖尿病监测数据主要描述的是老年人。国家报告表明，年龄在 45 岁以下的糖尿病成年人比年龄较大的成年人更不可能达到血糖（血红蛋白 A[HbA]）目标。对于这项针对特定年龄差异的研究，我们检查了明尼苏达州的数据集，以确定年龄在 18-44 岁的年轻人是否更不可能达到 HbA 目标，以及他们的住院模式是否与年龄较大（45-74 岁）的糖尿病患者不同。
我们使用行为风险因素监测系统数据来描述患有糖尿病的人的人口统计学特征和健康行为，使用临床质量数据来评估 HbA 水平，使用医院出院数据来评估住院原因。
与年龄较大的糖尿病成年人相比，年龄在 18 至 44 岁之间的成年人更有可能使用烟草，并且更有可能患有抑郁症；这些年轻人更不可能报告在过去一年中检查过 HbA 水平。根据特定年龄的切点，40.5%的 18-44 岁人群达到了 HbA 目标，而 45-64 岁人群为 74.7%，65-74 岁人群为 84.4%。作为主要原因的糖尿病住院率在 18-44 岁人群中最高，每 1000 名糖尿病成年人中有 47 人住院，远高于其他年龄段。心理健康问题导致的住院率在年轻人中更高。
我们的分析证实，18-44 岁的糖尿病患者的 HbA 控制情况比年龄较大的糖尿病患者更差。这些结果强调了基于年龄的糖尿病公共卫生监测的重要性。年龄分层监测可以为监测临床护理质量和设计临床/公共卫生干预措施提供信息。
