Paris-Saclay University, Corbeil-Essonnes, France.
Department of Diabetes and Endocrinology, Sud-Francilien Hospital, Corbeil-Essonnes, France.
PLoS One. 2020 Nov 30;15(11):e0242524. doi: 10.1371/journal.pone.0242524. eCollection 2020.
To assess the improvement in the management of diabetes and its complications based on the evolution of hospitalisation rates for diabetic foot ulcer (DFU) and lower extremity amputation (LEA) in individuals with diabetes in France.
Data were provided by the French national health insurance general scheme from 2008 to 2014. Hospitalisations for DFU and LEA were extracted from the SNIIRAM/SNDS French medical and administrative database.
In 2014, 22,347 hospitalisations for DFU and 8,342 hospitalisations for LEA in patients with diabetes were recorded. Between 2008 and 2014, the standardised rate of hospitalisation for DFU raised from 508 to 701/100,000 patients with diabetes. In the same period, the standardised rate of LEA decreased from 301 to 262/100,000 patients with diabetes. The level of amputation tended to become more distal. The proportion of men (69% versus 73%) and the frequency of revascularization procedures (39% versus 46%) increased. In 2013, the one-year mortality rate was 23% after hospitalisation for DFU and 26% after hospitalisation for LEA.
For the first time in France, the incidence of a serious complication of diabetes, i.e. amputations, has decreased in relation with a marked improvement in hospital management.
评估法国糖尿病患者糖尿病足溃疡（DFU）和下肢截肢（LEA）住院率演变情况，评价糖尿病及其并发症管理的改善效果。
数据来源于法国国家健康保险总计划 2008 年至 2014 年的资料。DFU 和 LEA 的住院情况从 SNIIRAM/SNDS 法国医疗和行政数据库中提取。
2014 年，记录了 22347 例糖尿病患者的 DFU 住院和 8342 例 LEA 住院。2008 年至 2014 年期间，DFU 的标准化住院率从 508 增至 701/10 万糖尿病患者，LEA 的标准化住院率从 301 降至 262/10 万糖尿病患者。截肢的水平趋向更远端。男性比例（69%比 73%）和血运重建术的频率（39%比 46%）增加。2013 年，DFU 住院后的一年死亡率为 23%，LEA 住院后的一年死亡率为 26%。
在法国，首次观察到一种严重的糖尿病并发症（即截肢）的发病率下降，同时医院管理得到显著改善。
