Eckert Alexander J, Zhou Fang L, Grimsmann Julia M, Pettus Jeremy H, Kerner Wolfgang, Miller Kellee M, Stechemesser Lars, Edelman Steven V, Spies Carsten, Holl Reinhard W, Ibald-Mulli Angela M
Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany; German Centre for Diabetes Research (DZD), Neuherberg, Germany.
Sanofi, Bridgewater, NJ, USA.
J Diabetes Complications. 2021 Mar;35(3):107812. doi: 10.1016/j.jdiacomp.2020.107812. Epub 2020 Nov 26.
Studies on acute complications in adult T1D were previously reported from the United States (U.S.) and from Germany. The aim was to compare demographic characteristics and patterns of severe hypoglycaemia (SH) and diabetic ketoacidosis (DKA) between Germany and the U.S.
Descriptive comparison on individuals aged ≥18 years, with T1D duration ≥2 years were made between the German diabetes-patient registry (DPV) and the U.S. electronic-health-record database (T1PCO). Individuals in both databases were divided into patients with haemoglobin A1c (HbA1c) <7% and HbA1c ≥7%.
5190 (DPV) and 31,430 individuals (T1PCO) fulfilled the inclusion criteria. DPV patients were younger, more often male and had lower body-mass index. In both databases, more males than females had HbA1c <7%. Individuals had higher HbA1c in T1PCO compared to DPV. The relationship between HbA1c and DKA was similar in both databases. SH revealed a U-shaped curve in T1PCO, but no clear pattern was present in DPV. SH events increased with higher age in DPV, but not in T1PCO.
Patterns of SH differ between Germany and U.S. Differences in capture of SH among the databases cannot be excluded, but differences in health care including patient education and level of care by specialists are likely.
此前已有来自美国和德国的关于成人1型糖尿病急性并发症的研究报告。目的是比较德国和美国之间严重低血糖（SH）和糖尿病酮症酸中毒（DKA）的人口统计学特征及模式。
对德国糖尿病患者登记处（DPV）和美国电子健康记录数据库（T1PCO）中年龄≥18岁、1型糖尿病病程≥2年的个体进行描述性比较。两个数据库中的个体被分为糖化血红蛋白（HbA1c）<7%和HbA1c≥7%的患者。
5190名（DPV）和31430名个体（T1PCO）符合纳入标准。DPV患者更年轻，男性比例更高，体重指数更低。在两个数据库中，HbA1c<7%的男性多于女性。与DPV相比，T1PCO中的个体HbA1c更高。两个数据库中HbA1c与DKA之间的关系相似。SH在T1PCO中呈U形曲线，但在DPV中无明显模式。DPV中SH事件随年龄增长而增加，但在T1PCO中并非如此。
德国和美国之间SH模式存在差异。不能排除数据库之间SH记录的差异，但可能存在包括患者教育和专科护理水平在内的医疗保健差异。
