Details

Autor(en) / Beteiligte

• Butalia, Sonia
• Johnson, Jeffrey A.
• Ghali, William A.
• Southern, Danielle A.
• Rabi, Doreen M.

Titel

Temporal variation of diabetic ketoacidosis and hypoglycemia in adults with type 1 diabetes: A nationwide cohort study

Ist Teil von

• Journal of diabetes, 2016-07, Vol.8 (4), p.552-558

Ort / Verlag

Australia: Blackwell Publishing Ltd

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• Background Seasonality in health outcomes has long been recognized for conditions such as colds and flus. The aim of the present study was to determine whether hospitalizations for acute complications of type 1 diabetes (T1D) vary by month and season. Methods An observational study was performed of national administrative health data. Hospitalizations for acute complications in adults (aged ≥18 years) with T1D were identified using ICD‐10 (Canadian revision) codes between 2004 and 2010. Monthly and seasonal counts per year were determined for the study period. For each acute complication, the ratio of the number of observed hospitalizations/expected number of hospitalizations was calculated for each month and season per year, adjusting for varied lengths of month, season, and year. Results In all, there were 21 568 hospitalizations for diabetic ketoacidosis (DKA) and 5349 hospitalizations for hypoglycemia during the study period. December had higher than expected hospitalizations for DKA and March had higher than expected hospitalizations for hypoglycemia. There did not appear to be variation for either DKA or hypoglycemia hospitalizations by season. Conclusions The results of the present study suggest temporal variation in hospitalizations for DKA and hypoglycemia, and therefore signal important times of patient vulnerability. Potential mechanisms underlying this pattern warrant further examination. Prevention strategies and resources for patients with T1D may need to be increased at specific times during the year. 摘要 背景 某些健康问题的预后具有季节性目前早已得到公认,例如感冒和流感。当前这项研究的目的是为了明确1型糖尿病患者因急性并发症而住院治疗的次数是否会随着月份与季节而改变。 方法 这项观察性的研究使用的是全国健康管理数据。使用ICD‐10(加拿大版本)编码来确认2004至2010年之间因急性并发症而住院治疗的成年(年龄≥ 18岁)1型糖尿病患者。研究期间每年按月以及按季节来计算。对于每种急性并发症来说,每年都要计算每月以及每季节观察到的住院治疗次数与预期住院治疗次数的比例,并且按照不同长度的月份、季节以及年份进行了校正。 结果 总的来说,研究期间有21568次因糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)的住院以及5349次因低血糖的住院。12月份因为DKA住院的次数比预期的更多,而3月份因为低血糖住院的次数比预期的更多。按照季节来划分因为DKA或低血糖住院的次数却都没发现有差异。 结论 当前这项研究结果提示因DKA或者低血糖住院的次数随着时间在不断地变化,因此患者的脆弱性具有明确的预警时间。这种变化模式的潜在机制还需要进一步的调查才能够明确。对于1型糖尿病患者来说每年在特殊的时间窗中可能需要增加相应的预防策略以及资源投入。