Department of Environmental Sciences, University of Virginia, P.O. Box 400123, Charlottesville, VA, 22904-4123, USA.
School of Medicine, University of Virginia, P.O. Box 800159HSC, Charlottesville, VA, 22908, USA.
Int J Biometeorol. 2022 Aug;66(8):1589-1597. doi: 10.1007/s00484-022-02303-4. Epub 2022 May 18.
Diabetes mellitus imposes a significant and increasing health burden on the US population. Our objective is to determine if weather is related to daily variations in emergency department (ED) visits for diabetes mellitus in Roanoke, Virginia. A time series of daily ED visits for diabetes mellitus at the Carilion Clinic in southwestern Virginia is associated with daily minimum temperature from 2010-2017. Associations between ED visits (through a 14-day lag period) and temperature are examined using generalized additive models and distributed lag nonlinear models. Heat and cold waves are identified at low and high thresholds, and ED visitation during these events is compared to prior control periods using a time-stratified case crossover approach. ED visits for diabetes exhibit a U-shaped relationship with temperature, with a higher relative risk (RR) during cold events (RR = 1.05) vs. warm events (RR = 1.02). When minimum temperatures are below freezing, ED visitation peaks starting 2 days afterward, with RRs approaching 1.04. The RR on warm days (minimum temperature > 10 °C) approaches 1.02 but peaks on the day of or the day following the elevated temperatures. Cold waves increase the odds of ED visits by up to 11% (p = 0.01), whereas heat waves exhibit no significant effect (p = 0.07). The increasing health burden linked to diabetes requires new research on environmental factors that might exacerbate related illness. When examined in the context of climate change impacts on local weather variations, these kinds of linkages between environment and disease can aid in facility staffing and public health messaging during extreme weather events.
糖尿病给美国人口带来了巨大且日益增加的健康负担。我们的目的是确定天气是否与弗吉尼亚州罗阿诺克的糖尿病患者每日急诊就诊量的变化有关。弗吉尼亚州西南部的卡里隆诊所的每日糖尿病急诊就诊时间序列与 2010-2017 年的每日最低温度相关。使用广义加性模型和分布滞后非线性模型，研究了急诊就诊量（通过 14 天滞后期）与温度之间的关联。通过时间分层病例交叉法，确定了低温和高温热浪事件，并将这些事件期间的急诊就诊量与之前的对照期进行比较。糖尿病患者的急诊就诊量与温度呈 U 型关系，寒冷天气（RR=1.05）的相对风险（RR）高于温暖天气（RR=1.02）。当最低温度低于冰点时，急诊就诊量从 2 天后开始达到峰值，RR 接近 1.04。温暖天气（最低温度>10°C）的 RR 接近 1.02，但在高温日或之后一天达到峰值。冷浪事件使急诊就诊的可能性增加了 11%（p=0.01），而热浪事件则无显著影响（p=0.07）。与糖尿病相关的健康负担不断增加，需要对可能加重相关疾病的环境因素进行新的研究。在气候变化对当地天气变化的影响背景下，环境与疾病之间的这种联系可以帮助在极端天气事件中为医疗机构配备人员和发布公共卫生信息。
