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Armocida B, Monasta L, Sawyer SM, Bustreo F, Onder G, Castelpietra G, Pricci F, Minardi V, Giacomozzi C, Abbafati C, Stafford LK, Pasovic M, Hay SI, Ong KL, Perel P, Beran D. The Burden of Type 1 and Type 2 Diabetes Among Adolescents and Young Adults in 24 Western European Countries, 1990-2019: Results From the Global Burden of Disease Study 2019. Int J Public Health 2024; 68:1606491. [PMID: 38420040 PMCID: PMC10899430 DOI: 10.3389/ijph.2023.1606491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/18/2023] [Indexed: 03/02/2024] Open
Abstract
Objectives: As little is known about the burden of type 1 (T1DM) and type 2 diabetes (T2DM) in adolescents in Western Europe (WE), we aimed to explore their epidemiology among 10-24 year-olds. Methods: Estimates were retrieved from the Global Burden of Diseases Study (GBD) 2019. We reported counts, rates per 100,000 population, and percentage changes from 1990 to 2019 for prevalence, incidence and years lived with disability (YLDs) of T1DM and T2DM, and the burden of T2DM in YLDs attributable to high body mass index (HBMI), for 24 WE countries. Results: In 2019, prevalence and disability estimates were higher for T1DM than T2DM among 10-24 years old adolescents in WE. However, T2DM showed a greater increase in prevalence and disability than T1DM in the 30 years observation period in all WE countries. Prevalence increased with age, while only minor differences were observed between sexes. Conclusion: Our findings highlight the substantial burden posed by DM in WE among adolescents. Health system responses are needed for transition services, data collection systems, education, and obesity prevention.
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Affiliation(s)
- Benedetta Armocida
- Division of Tropical and Humanitarian Medicine, University of Geneva, Geneva, Switzerland
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | - Lorenzo Monasta
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Susan M Sawyer
- Department of Paediatrics, Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia
| | | | - Graziano Onder
- Fondazione Policlinico Gemelli IRCCS, Rome, Italy
- Department of Geriatric and Orthopedic Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulio Castelpietra
- Outpatient and Inpatient Care Service, Central Health Directorate, Trieste, Italy
| | - Flavia Pricci
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | - Valentina Minardi
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità, Rome, Italy
| | - Claudia Giacomozzi
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | - Cristiana Abbafati
- Department of Juridical and Economic Studies, Sapienza University of Rome, Rome, Italy
| | - Lauryn K Stafford
- Institute for Health Metrics and Evaluation, Seattle, WA, United States
| | - Maja Pasovic
- Institute for Health Metrics and Evaluation, Seattle, WA, United States
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, Seattle, WA, United States
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
| | - Kanyin Lian Ong
- Institute for Health Metrics and Evaluation, Seattle, WA, United States
| | - Pablo Perel
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
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2
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Biester T, Schwandt A, Heidtmann B, Rami-Merhar B, Haak T, Festa A, Kostow S, Müller A, Mönkemöller K, Danne T. Declining Frequency of Acute Complications Associated with Tubeless Insulin Pump Use: Data from 2,911 Patients in the German/Austrian Diabetes Patienten Verlaufsdokumentation Registry. Diabetes Technol Ther 2021; 23:527-536. [PMID: 33684335 PMCID: PMC8377506 DOI: 10.1089/dia.2020.0675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: To characterize patients with diabetes treated with a tubeless insulin pump (Omnipod® Insulin Management System; Insulet Corp., Acton, MA), and to evaluate the frequency of acute complications with long-term use of the system. Methods: This retrospective analysis of the German/Austrian Diabetes Patienten Verlaufsdokumentation (DPV) registry included data from 3657 patients with diabetes (n = 3582 type 1, n = 25 type 2, n = 50 latent autoimmune diabetes in adults/other) treated with a tubeless insulin pump. Hemoglobin A1c (HbA1c) levels and frequency of diabetic ketoacidosis (DKA) and severe hypoglycemia (SH) were compared between 1 year pre- and 1 year (n = 2911) or up to 3 years (n = 1311) post-tubeless insulin pump initiation and compared with a contemporary cohort on multiple daily injections (MDI) with 3-year data (n = 1874). Results: Patients using tubeless insulin pump therapy had a median age of 13.7 years [interquartile range 10.8, 17.3], diabetes duration 3.7 years [1.7, 8.0], and HbA1c 7.5% [6.9, 8.2]. In patients with 3 years of follow-up data (n = 1311), the percentage with ≥1 episode of DKA, SH (Level 3, requiring assistance), and SH (coma) event with prior treatment was 6.3%, 5.5%, and 1.7%, respectively. After 3 years of tubeless insulin pump therapy, the frequency of DKA, SH (Level 3), and SH (coma) decreased to 2.2%, 4.1%, and 0.5%, respectively. Both DKA and SH remained significantly lower compared with MDI after adjustment in multiple regression analysis. High treatment retention rates (>90%) were observed. Conclusion: Real-world registry data document that tubeless insulin pump therapy is associated with good glycemic control and a low frequency of DKA and SH in an age group prone to acute complications.
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Affiliation(s)
- Torben Biester
- AUF DER BULT Diabetes Center for Children and Adolescents, Hannover, Germany
| | - Anke Schwandt
- Institute for Epidemiology and Medical Biometry,ZIBMT,Ulm University, Ulm, Germany
- German Center for Diabetes Research (DZD),Neuherberg, Germany
| | | | - Birgit Rami-Merhar
- Department of Pediatric and Adolescent Medicine,Medical University of Vienna, Vienna, Austria
| | - Thomas Haak
- Diabetes Clinic Bad Mergentheim,Bad Mergentheim,Germany
| | - Andreas Festa
- Landesklinikum Korneuburg Stockerau,Korneuburg Stockerau,Austria
| | - Susanne Kostow
- Sana Klinikum Lichtenberg—Oskar-Ziethen-Krankenhaus,Berlin,Germany
| | | | | | - Thomas Danne
- AUF DER BULT Diabetes Center for Children and Adolescents, Hannover, Germany
- Address correspondence to: Thomas Danne, MD, Diabetes Center for Children and Adolescents, Kinder-und Jugendkrankenhaus AUF DER BULT, Janusz-Korczak-Allee 12, Hannover 30173, Germany
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3
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Lawrence L, Ali KF, Buehler L, Bailey R, Bena J, Gambino RR, Hamaty M. Prediction of Hypoglycemia By Quality of Life Measures: A Retrospective Analysis of Electronically Patient-Reported Data. Endocr Pract 2021; 26:1153-1165. [PMID: 33471717 DOI: 10.4158/ep-2020-0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/13/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We aimed to examine the utility of electronically patient-reported data (e-PRD) in exploring the risk of diabetes-related hypoglycemia and to evaluate hypoglycemia prediction by the quality of life (QoL) measures. METHODS A retrospective analysis of e-PRD for patients with diabetes mellitus who completed the American Diabetes Association's Low Blood Sugar Questionnaire (Hypo-Q) and the Patient-Reported Outcomes Measurement Information System (PROMIS) for QoL assessment. Associations between Hypo-Q answers and PROMIS scores were described using Spearman correlations and 95% confidence intervals, or medians and quartiles. RESULTS Records of 538 subjects were reviewed; 55% were female, 95% were non-Hispanic, with a mean age (± SD) of 53 ± 15 years. Patients with type 1 diabetes had a longer disease duration and more hypoglycemic episodes (P<.001) with higher PROMIS Physical and Mental T-scores (P<.001, both), when compared to patients with type 2 diabetes. The latter had a higher number of co-existing conditions. Having >5 episodes of either moderate or severe hypoglycemia in a year were reported by 18% and 5% of all patients, respectively. Mean PROMIS Physical and Mental health T-scores were 46 ± 10 and 47 ± 10, respectively. Patients with fewer moderate and severe hypoglycemic episodes had better Physical (P = .047 and P<.001) and Mental (P = .015 and P<.001) PROMIS T-scores with incremental decreases in the odds of hypoglycemia with each point increase in PROMIS T-scores. CONCLUSION e-PRD of QoL measures and Hypo-Q were effective in exposing the risks for hypoglycemia and reproducing published findings with significant associations between QoL measures and hypoglycemia risks while providing new insights.
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Affiliation(s)
- Lima Lawrence
- From the Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio
| | - Khawla F Ali
- From the Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio
| | - Lauren Buehler
- From the Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio
| | - Richard Bailey
- the School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - James Bena
- the Section of Biostatistics, Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Ronald R Gambino
- From the Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio
| | - Marwan Hamaty
- From the Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio.
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4
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Bronner MB, Peeters MAC, Sattoe JNT, van Staa A. The impact of type 1 diabetes on young adults' health-related quality of life. Health Qual Life Outcomes 2020; 18:137. [PMID: 32398086 PMCID: PMC7218580 DOI: 10.1186/s12955-020-01370-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 04/17/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Young adulthood is a challenging period for people with diabetes mellitus type 1 (T1DM) as they are facing multiple life transitions while managing a demanding disease. This poses a risk for impaired health-related quality of life (HRQOL). We assessed HRQOL in a cohort of young adults with T1DM in the Netherlands, and compared outcomes with those of Dutch norm groups of healthy young adults and young adults with a chronic disease. METHODS We analyzed data collected in a larger evaluation study on transitional care for young adults with T1DM in a nationwide sample in the Netherlands, including twelve participating hospitals. These data had been obtained from online questionnaires completed by young adults with T1DM after they had transferred to adult care. HRQOL was self-reported with the Pediatric Quality of Life Inventory for young adults (PedsQL-YA). RESULTS One hundred and sixty-five young adults with T1DM participated (44.2% response); and they scored significantly worse than did healthy peers on all domains of HRQOL, except social functioning. Particularly, functioning at school or work was worse than that of the norm group. The study group's HRQOL-scores were comparable to norm scores of young adults with chronic diseases, although the physical and social functioning of young people with T1DM was better. One quarter (26.1%) of all young adults with T1DM reported fatigue. CONCLUSIONS During transition to adulthood, young adults with T1DM struggle to maintain a balance between the demands of managing a disease and their life. Many of them encounter problems at work or school, and suffer from fatigue. These findings underscore the need to regularly assess HRQOL, and to discuss work- and education-related issues in clinical practice.
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Affiliation(s)
- Madelon B Bronner
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Mariëlle A C Peeters
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jane N T Sattoe
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - AnneLoes van Staa
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands. .,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
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5
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Varni JW, Delamater AM, Hood KK, Driscoll KA, Wong JC, Adi S, Yi-Frazier JP, Grishman EK, Faith MA, Corathers SD, Kichler JC, Miller JL, Raymond JK, Doskey EM, Aguirre V, Heffer RW, Wilson DP. Diabetes management mediating effects between diabetes symptoms and health-related quality of life in adolescents and young adults with type 1 diabetes. Pediatr Diabetes 2018; 19:1322-1330. [PMID: 29927039 PMCID: PMC6641859 DOI: 10.1111/pedi.12713] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/09/2018] [Accepted: 06/14/2018] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES The primary objective was to investigate the mediating effects of diabetes management in the relationship between diabetes symptoms and generic health-related quality of life (HRQOL) in adolescents and young adults (AYAs) with type 1 diabetes. The secondary objective explored patient health communication and perceived treatment adherence barriers as mediators in a serial multiple mediator model. METHODS The PedsQL 3.2 Diabetes Module 15-item diabetes symptoms summary score, 18-item diabetes management summary score, and PedsQL 4.0 generic core scales were completed in a 10-site national field test study by 418 AYA aged 13 to 25 years with type 1 diabetes. Diabetes symptoms and diabetes management were tested for bivariate and multivariate linear associations with overall generic HRQOL. Mediational analyses were conducted to test the hypothesized mediating effects of diabetes management as an intervening variable between diabetes symptoms and generic HRQOL. RESULTS The predictive effects of diabetes symptoms on HRQOL were mediated in part by diabetes management. In predictive analytics models utilizing multiple regression analyses, demographic and clinical covariates, diabetes symptoms, and diabetes management significantly accounted for 53% of the variance in generic HRQOL (P < 0.001), demonstrating a large effect size. Patient health communication and perceived treatment adherence barriers were significant mediators in an exploratory serial multiple mediator model. CONCLUSIONS Diabetes management explains in part the effects of diabetes symptoms on HRQOL in AYA with type 1 diabetes. Patient health communication to healthcare providers and perceived treatment adherence barriers further explain the mechanism in the relationship between diabetes symptoms and overall HRQOL.
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Affiliation(s)
- James W Varni
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, Texas
| | - Alan M Delamater
- Department of Pediatrics, Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, Florida
| | - Korey K Hood
- Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, California
| | - Kimberly A Driscoll
- Department of Pediatrics, Barbara Davis Center for Diabetes, University of Colorado Denver, Denver, Colorado
| | - Jenise C Wong
- The Madison Clinic for Pediatric Diabetes and Department of Pediatrics, Division of Endocrinology, University of California San Francisco, San Francisco, California
| | - Saleh Adi
- The Madison Clinic for Pediatric Diabetes and Department of Pediatrics, Division of Endocrinology, University of California San Francisco, San Francisco, California
| | | | - Ellen K Grishman
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Melissa A Faith
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sarah D Corathers
- Department of Pediatrics, Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jessica C Kichler
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jennifer L Miller
- Division of Pediatric Endocrinology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jennifer K Raymond
- Center for Endocrinology, Diabetes, & Metabolism, Children’s Hospital Los Angeles, Los Angeles, California
| | - Elena M Doskey
- Department of Educational Psychology, Texas A&M University, College Station, Texas
| | - Vincent Aguirre
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas
| | - Robert W Heffer
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas
| | - Don P Wilson
- Cook Children’s Medical Center, Fort Worth, Texas
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