Department of endocrinology, diabetes, metabolic disorders, University Hospital Caen, 14033 Caen, France.
Fédération Française des Diabétiques, 88 rue de la Roquette, CS 20013, 75544 Paris cedex 11, France.
Ann Endocrinol (Paris). 2023 Feb;84(1):21-31. doi: 10.1016/j.ando.2022.05.005. Epub 2022 Jun 30.
Diabetes is a growing health concern. An update on epidemiology and health outcomes is mandatory to devise strategies to alleviate the burden of diabetes. The objective of this study was to assess the prevalence of diabetes and associated complications in France in 2017.
Demographics and healthcare data from a representative permanent secondary database were analyzed. Patients with at least 2 national health insurance payments for anti-diabetic drugs in 2017 were selected, with the index date set to the last payment date. Patients were grouped as diabetes treated with insulin only (DTi), diabetes treated with anti-diabetic drugs other than only insulin (DT2) or gestational diabetes. Comorbidities, diabetes-related complications and hospital admissions, healthcare consumption and medical follow-up were extracted for a 5- or 2-year period prior to the index date and summarized using descriptive statistics.
Overal, 29,288 patients were included in the study population: 1964 (6.7%) were categorized as DTi and 27,243 (93.0%) as DT2. Patients with gestational diabetes (81 [0.3%]) are not further described here. Prevalence was estimated at 4.9%. For DT2, marked geographic disparities were observed, with prevalence being highest in the northeast France. Diabetes-related complications were more frequent in DTi than in DT2 over a 5-year period (52.2% vs 34.7%). Diabetes-related admissions were also more common in DTi than in DT2 over a 2-year period (29.8% vs 16.9%). In the DT2 category, another antidiabetic drug was added during the 3 months prior to the index date in 16.5% of cases overall and in 25% of patients with recent hospital admission or diabetes-related complications. Although more than 80% of patients in the DTi and DT2 categories had at least 1 healthcare consultation during 2 years prior to the index date, only 10% to 20% of patients complied with guidelines for all 5 recommended examinations.
Prevalence of diabetes is high in the French population, while compliance with recommended healthcare consultations falls short of the 80% goal set by regulations. New strategies are mandatory in order to reduce the burden of diabetes-related complications and admissions, focusing on patient and physician information and education in order to increase proactive treatment adjustment and reduce therapeutic inertia.
糖尿病是一个日益严重的健康问题。为了制定减轻糖尿病负担的策略，必须了解其流行病学和健康结果的最新情况。本研究的目的是评估 2017 年法国糖尿病的患病率及其相关并发症。
分析了一个具有代表性的永久性二级数据库的人口统计学和医疗保健数据。选择了 2017 年至少有 2 次国家医疗保险支付抗糖尿病药物的患者，并将索引日期设置为最后一次付款日期。患者分为仅用胰岛素治疗的糖尿病（DTi）、除胰岛素外用其他抗糖尿病药物治疗的糖尿病（DT2）或妊娠期糖尿病。在索引日期前 5 年或 2 年内提取合并症、糖尿病相关并发症和住院、医疗保健消费和医疗随访数据，并使用描述性统计进行总结。
总体而言，共有 29288 名患者纳入研究人群：1964 名（6.7%）患者被归类为 DTi，27243 名（93.0%）患者被归类为 DT2。这里不进一步描述患有妊娠糖尿病的 81 名患者（0.3%）。估计患病率为 4.9%。对于 DT2，观察到明显的地域差异，东北部法国的患病率最高。在 5 年内，DTi 患者的糖尿病相关并发症比 DT2 患者更常见（52.2%比 34.7%）。在 2 年内，DTi 患者的糖尿病相关住院也比 DT2 患者更常见（29.8%比 16.9%）。在 DT2 类别中，在索引日期前 3 个月内，总体上有 16.5%的患者和最近有住院或糖尿病相关并发症的患者中有 25%的患者添加了另一种抗糖尿病药物。尽管 DTi 和 DT2 类别的 80%以上的患者在索引日期前 2 年内至少有 1 次医疗咨询，但只有 10%至 20%的患者符合所有 5 项推荐检查的指南。
法国人群中糖尿病的患病率很高，而推荐的医疗保健咨询的依从性低于法规规定的 80%目标。为了降低糖尿病相关并发症和住院的负担，必须制定新的策略，重点关注患者和医生的信息和教育，以增加主动治疗调整和减少治疗惰性。
