Western Sydney Local Health District, Australia; Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Australia; School of Public Health, Peking Union Medical College, Tsinghua University and the Chinese Academy of Medical Sciences, China.
Bridgeview Medical Practice, Australia; School of Public Health, Peking Union Medical College, Tsinghua University and the Chinese Academy of Medical Sciences, China.
Diabetes Res Clin Pract. 2019 May;151:247-251. doi: 10.1016/j.diabres.2019.04.019. Epub 2019 Apr 18.
Examining pre-diabetes and diabetes rates using glycated haemoglobin (HbA) in emergency department (ED) and in general practice (GP) in western Sydney.
Epidemiological study of HbA1c measurements in individuals ≥18 years receiving a blood test (1) in the hospital setting of the ED at Blacktown/Mt Druitt hospital (1/06/2016 to 31/05/2018) and (2) in primary care involving Bridgeview Medical Practice (BVMP) (1/03/2017 to 01/02/2018) as well as other general practices (June 2018 only).
Totals of 55,568 individuals from ED and 5911 individuals from GP. The prevalence of diabetes in tested individuals was 17.3% (n = 9704) in ED and 17.4% (n = 1027) in GP. The prevalence of pre-diabetes in ED was 30.2% (n = 16,854) and 26.6% (n = 1576) in GP. Regression controlling for age, season, and gender revealed a weekly increase of 1.1% in odds for diabetes and 1.5% for pre-diabetes (p < 0.001), in line with the yearly absolute increase of 1% in rate for both tested and coded hospital patients. In BVMP the rate of diabetes rose by 22% during the testing period from 8.9% to 11%.
There exists a high burden of diabetes both in hospitals and general practice. Testing in ED and general practice revealed similarly high burdens of diabetes across different areas of the healthcare system. In the appropriate hospital and primary care setting, HbA1c can be used to identify individuals with diabetes that may benefit from targeted intervention.
利用糖化血红蛋白（HbA）在西悉尼的急诊部（ED）和全科医生（GP）中检查糖尿病前期和糖尿病的发病率。
对 18 岁以上个体的 HbA1c 测量值进行流行病学研究，这些个体在医院 ED 的 Blacktown/Mt Druitt 医院（1/06/2016 至 31/05/2018）和初级保健中接受血液检查（1）（1/03/2017 至 01/02/2018）以及其他一般实践（仅 2018 年 6 月）。
ED 有 55568 人和 GP 有 5911 人。在接受测试的个体中，糖尿病的患病率为 ED 中的 17.3%（n=9704）和 GP 中的 17.4%（n=1027）。ED 中的糖尿病前期患病率为 30.2%（n=16854）和 GP 中的 26.6%（n=1576）。控制年龄、季节和性别后，糖尿病的患病几率每周增加 1.1%，糖尿病前期的患病几率每周增加 1.5%（p<0.001），这与每年测试和编码住院患者的发病率分别增加 1%的情况一致。在 BVMP，在测试期间，糖尿病的发病率从 8.9%上升到 11%，增加了 22%。
医院和全科医生都存在很高的糖尿病负担。ED 和全科医生的测试显示，不同医疗保健系统区域的糖尿病负担同样很高。在适当的医院和初级保健环境中，HbA1c 可用于识别可能受益于有针对性干预的糖尿病患者。
