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Routine data sources challenge international diabetes Federation extrapolations of national diabetes prevalence in Switzerland.

ABSTRACT: OBJECTIVE: Information on diabetes prevalence in the general population is scarce and often based on extrapolations. We evaluated whether prevalence could be estimated from routine data sources. RESEARCH DESIGN AND METHODS: The sources were 1) hospital discharges (2008, n = 828,171), 2) death registry (2007/2008, n = 118,659), and 3) Swiss Health Survey (SHS; 2007, n = 18,665). Persons without diabetes as underlying cause of death (death registry) or principal diagnosis (hospital discharges) were regarded as surrogate for a general population random sample. RESULTS: In those aged 20-84 years, 4.5% of men and 3% of women were expected to have diabetes. By source, estimations were 4.4 and 2.8% (hospital discharges), 3.8 and 3.1% (death registry), and 4.9 and 3.7% (SHS) for men and women, respectively. Among sources, age-sex patterns were similar. CONCLUSIONS: In countries with adequate data quality, combination of routine data may provide valid and reliable estimations of diabetes prevalence. Our figures suggest that International Diabetes Federation extrapolations substantially overestimate diabetes prevalence in Switzerland.

SUBMITTER: Bopp M

PROVIDER: S-EPMC3198273 | biostudies-other | 2011 Nov

REPOSITORIES: biostudies-other

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Routine data sources challenge international diabetes Federation extrapolations of national diabetes prevalence in Switzerland.

Bopp Matthias M Zellweger Ueli U Faeh David D

Diabetes care 20110916 11

<h4>Objective</h4>Information on diabetes prevalence in the general population is scarce and often based on extrapolations. We evaluated whether prevalence could be estimated from routine data sources.<h4>Research design and methods</h4>The sources were 1) hospital discharges (2008, n = 828,171), 2) death registry (2007/2008, n = 118,659), and 3) Swiss Health Survey (SHS; 2007, n = 18,665). Persons without diabetes as underlying cause of death (death registry) or principal diagnosis (hospital di ...[more]

PMID: 21926288

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Project description:BackgroundAn increased prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in children was observed in various diabetes centres worldwide during the COVID-19 pandemic. We aimed to evaluate trends in the prevalence of diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes before and during the COVID-19 pandemic, and to identify potential predictors of changes in diabetic ketoacidosis prevalence during the pandemic.MethodsFor this international multicentre study, we used data from 13 national diabetes registries (Australia, Austria, Czechia, Denmark, Germany, Italy, Luxembourg, New Zealand, Norway, Slovenia, Sweden, USA [Colorado], and Wales). The study population comprised 104 290 children and adolescents aged 6 months to younger than 18 years, who were diagnosed with type 1 diabetes between Jan 1, 2006, and Dec 31, 2021. The observed diabetic ketoacidosis prevalence in 2020 and 2021 was compared to predictions based on trends over the pre-pandemic years 2006-19. Associations between changes in diabetic ketoacidosis prevalence and the severity of the COVID-19 pandemic and containment measures were examined with excess all-cause mortality in the whole population and the Stringency Index from the Oxford COVID-19 Government Response Tracker.Findings87 228 children and adolescents were diagnosed with type 1 diabetes between 2006 and 2019, 8209 were diagnosed in 2020, and 8853 were diagnosed in 2021. From 2006 to 2019, diabetic ketoacidosis at diagnosis of type 1 diabetes was present in 23 775 (27·3%) of 87 228 individuals and the mean annual increase in the prevalence of diabetic ketoacidosis in the total cohort from 2006 to 2019 was 1·6% (95% CI 1·3 to 1·9). The adjusted observed prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes was 39·4% (95% CI 34·0 to 45·6) in 2020 and 38·9% (33·6 to 45·0) in 2021, significantly higher than the predicted prevalence of 32·5% (27·8 to 37·9) for 2020 and 33·0% (28·3 to 38·5) for 2021 (p<0·0001 for both years). The prevalence of diabetic ketoacidosis was associated with the pandemic containment measures, with an estimated risk ratio of 1·037 (95% CI 1·024 to 1·051; p<0·0001) per ten-unit increase in the Stringency Index for 2020 and 1·028 (1·009 to 1·047; p=0·0033) for 2021, but was not significantly associated with excess all-cause mortality.InterpretationDuring the COVID-19 pandemic, there was a marked exacerbation of the pre-existing increase in diabetic ketoacidosis prevalence at diagnosis of type 1 diabetes in children. This finding highlights the need for early and timely diagnosis of type 1 diabetes in children and adolescents.FundingGerman Federal Ministry for Education and Research, German Robert Koch Institute, German Diabetes Association, German Diabetes Foundation, Slovenian Research Agency, Welsh Government, Central Denmark Region, and Swedish Association of Local Authorities and Regions.

Project description:Diabetes mellitus (DM) represents an important global burden of disease. In Panama, DM was investigated in 1 study utilizing questionnaires and in another using biomarkers, but at subnational level. Using data from a recent cross-sectional country-wide population-based study that included biomarkers, we estimated the prevalence of DM, its awareness, and control; evaluating possible risk factors. We used data from 4400 participants aged 18 years or older from the National Health Study of Panama (ENSPA) study conducted in 2019 at a national level. Weighted prevalence and 95% confidence intervals for DM, awareness, and control were estimated by sociodemographic factors, family history of DM, tobacco and alcohol use, nutritional status, and hypertension. Odds ratios (ORs) and 95% confidence intervals were calculated using logistic regression models to assess the possible risk factors associated with DM prevalence and awareness. We generated OR estimates by pooling ENSPA data with a previous regional study, prevalence of cardiovascular risk factors. The prevalence of DM was estimated to be 12.4% (10.9%-14.05%). In both men and women, age, family history of diabetes (OR in men: 4.0 ([2.4-6.7]; OR in women 3.5 [2.5-4.8]), and obesity (OR in men: 2.6 [1.4-5.1]; OR in women: 2.0 [0.9-4.5]) were associated with DM. Diagnosed and controlled hypertension was associated with DM only in women (OR: 2.1 [1.2-3.6]). DM awareness was estimated to be 62.6% (56.3%-68.9%). In both men and women, DM awareness was associated with age and a family history of diabetes (OR in men: 6.6 [2.4-18.4]; OR in women 1.9 ([1.1-3.6]). In women, having secondary education (OR: 1.9 [0.9-3.9]) and being diagnosed with uncontrolled hypertension (OR: 3.3 [1.2-9.5]) was also associated to DM awareness. Men in the ENSPA study were less likely to be aware of DM than those in the prevalence of cardiovascular risk factors (OR: 0.2 [0.0-0.7]). Less than half of the individuals diagnosed with DM had their condition controlled (39.6% [31.4%-47.8%]). This study revealed that the prevalence, awareness, and control of DM were similar to recent estimates reported in other Latin American countries. It also provides a baseline regarding DM and associated risk factors in Panama at a country-level knowledge that is essential for health policy development and useful in clinical practice.

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Routine data sources challenge international diabetes Federation extrapolations of national diabetes prevalence in Switzerland.

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Routine data sources challenge international diabetes Federation extrapolations of national diabetes prevalence in Switzerland.

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