Morton Jedidiah I, Lazzarini Peter A, Shaw Jonathan E, Magliano Dianna J
Baker Heart and Diabetes Institute, Melbourne, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Diabetes Care. 2022 Apr 1;45(4):789-797. doi: 10.2337/dc21-2268.
To determine trends in the incidence of major diabetes-related complications in Australia.
This study included 70,885 people with type 1 and 1,089,270 people with type 2 diabetes registered on the Australian diabetes registry followed from July 2010 to June 2019. Outcomes (hospitalization for myocardial infarction [MI], stroke, heart failure [HF], lower-extremity amputation [LEA], hypoglycemia, and hyperglycemia) were obtained via linkage to hospital admissions databases. Trends over time in the age-adjusted incidence of hospitalizations were analyzed using joinpoint regression and summarized as annual percent changes (APCs).
In type 1 diabetes, the incidence of all complications remained stable, except for stroke, which increased from 2010-2011 to 2018-2019 (financial years; APC: +2.5% [95% CI 0.1, 4.8]), and hyperglycemia, which increased from 2010-2011 to 2016-2017 (APC: +2.7% [1.0, 4.5]). In type 2 diabetes, the incidence of stroke remained stable, while the incidence of MI decreased from 2012-2013 to 2018-2019 (APC: -1.7% [95% CI -2.8, -0.5]), as did the incidence of HF and hypoglycemia from 2010-2011 to 2018-2019 (APCs: -0.8% [-1.5, 0.0] and -5.3% [-6.7, -3.9], respectively); the incidence of LEA and hyperglycemia increased (APCs: +3.1% [1.9, 4.4], and +7.4% [5.9, 9.0]). Most trends were consistent by sex, but differed by age; in type 2 diabetes most improvements were confined to individuals aged ≥60 years.
Trends in admissions for diabetes-related complications were largely stable in type 1 diabetes. In type 2 diabetes, hospitalization rates for MI, HF, and hypoglycemia fell over time, while increasing for LEA and hyperglycemia.
确定澳大利亚主要糖尿病相关并发症的发病率趋势。
本研究纳入了2010年7月至2019年6月在澳大利亚糖尿病登记处登记的70885例1型糖尿病患者和1089270例2型糖尿病患者。通过与医院入院数据库的链接获取结局（因心肌梗死[MI]、中风、心力衰竭[HF]、下肢截肢[LEA]、低血糖和高血糖住院）。使用连接点回归分析住院年龄调整发病率随时间的趋势，并总结为年度百分比变化（APC）。
在1型糖尿病中，除中风从2010 - 2011年到2018 - 2019年（财政年度；APC：+2.5%[95%CI 0.1, 4.8]）以及高血糖从2010 - 2011年到2016 - 2017年（APC：+2.7%[1.0, 4.5]）有所增加外，所有并发症的发病率保持稳定。在2型糖尿病中，中风的发病率保持稳定，而MI的发病率从2012 - 2013年到2018 - 2019年下降（APC：-1.7%[95%CI -2.8, -0.5]），HF和低血糖的发病率从2010 - 2011年到2018 - 2019年也下降（APC分别为-0.8%[-1.5, 0.0]和-5.3%[-6.7, -3.9]）；LEA和高血糖的发病率增加（APC：+3.1%[1.9, 4.4]和+7.4%[5.9, 9.0]）。大多数趋势在性别上是一致的，但在年龄上有所不同；在2型糖尿病中，大多数改善仅限于年龄≥60岁的个体。
1型糖尿病中与糖尿病相关并发症的住院趋势基本稳定。在2型糖尿病中，MI、HF和低血糖的住院率随时间下降，而LEA和高血糖的住院率上升。
