Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
J Formos Med Assoc. 2019 Nov;118 Suppl 2:S103-S110. doi: 10.1016/j.jfma.2019.07.027. Epub 2019 Aug 30.
BACKGROUND/PURPOSE: Patients with diabetes have a higher risk of developing chronic complications and cause a huge burden to the public health care system as well as on patients and their families. We studied these diabetic complications about kidney, eye and peripheral vascular diseases to understand their prevalence and distributions in a national survey.
We analyzed diabetic complications using National-Health-Insurance claims filed from 2005 to 2014. We used this database to evaluate their developments of kidney, eye, and peripheral vascular diseases according to the International-Classification-of-Diseases, Ninth Revision using clinical modification diagnosis codes.
The prevalence of diabetic kidney disease (DKD) significantly increased from 10.49% to 17.92% from 2005 to 2014. The prevalence rate of diabetic foot significantly decreased from 1.34% to 1.05% from 2005 to 2014, and the rate of severe infection also significantly decreased from 50.69% to 45.85%. The amputation rate significantly decreased from 24.91% to 17.47% among all patients with diabetic foot.
In this study, the trends in DKD and dialysis prevalence were similar to those of the 2012 report. The rate of increase in dialysis prevalence is lower in this study than in the 2012 report. The prevalence of diabetic foot, severe infection, and amputation in this report exhibited significantly decreasing trends. This improvement may be attributable to care from multidisciplinary teams. We should dedicate more resources to our prevention program of DKD and retinopathy to further improve outcomes in the future.
背景/目的：糖尿病患者患慢性并发症的风险较高，给公共医疗保健系统以及患者及其家庭带来了巨大负担。我们研究了这些肾脏、眼部和外周血管疾病的糖尿病并发症，以了解全国调查中它们的流行情况和分布情况。
我们使用 2005 年至 2014 年的国家健康保险索赔数据来分析糖尿病并发症。我们使用这个数据库，根据国际疾病分类，第九版临床修改诊断代码，评估肾脏、眼部和外周血管疾病的发展情况。
糖尿病肾病（DKD）的患病率从 2005 年的 10.49%显著增加到 2014 年的 17.92%。2005 年至 2014 年，糖尿病足的患病率从 1.34%显著下降至 1.05%，严重感染的比率也从 50.69%显著下降至 45.85%。所有糖尿病足患者的截肢率从 24.91%显著下降至 17.47%。
在这项研究中，DKD 和透析患病率的趋势与 2012 年报告相似。与 2012 年报告相比，本研究中透析患病率的增长率较低。本报告中糖尿病足、严重感染和截肢的患病率呈显著下降趋势。这种改善可能归因于多学科团队的护理。我们应该投入更多的资源到我们的 DKD 和视网膜病变预防计划，以进一步改善未来的结果。
