Area Deprivation and Regional Disparities in Treatment and Outcome Quality of 29,284 Pediatric Patients With Type 1 Diabetes in Germany: A Cross-sectional Multicenter DPV Analysis
Autor: | Rainer Bachran, Peter Kroschwald, Werner Maier, Stefanie Lanzinger, Johannes Hamann, Joachim Rosenbauer, Paul Martin Holterhus, Kerstin Placzek, Barbara Bohn, Ursula Kuhnle-Krahl, Marie Auzanneau, Dpv Initiative |
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Přispěvatelé: | European Union (EU), Horizon 2020 |
Jazyk: | angličtina |
Předmět: |
Research design
Male Cross-sectional study Endocrinology Diabetes and Metabolism medicine.medical_treatment Kind Overweight Health Services Accessibility Regional disparities 0302 clinical medicine Medizinische Versorgung Diabetes mellitus Type 1 Germany Outcome Assessment Health Care Area deprivation 030212 general & internal medicine Registries Child Geography Diabetes mellitus Typ 1 Severe hypoglycemia 3. Good health Type 1 diabetes Treatment Outcome Female medicine.symptom medicine.medical_specialty Children and adolescents Adolescent Healthcare disparities 030209 endocrinology & metabolism 03 medical and health sciences Internal medicine Diabetes mellitus Internal Medicine medicine Humans ddc:610 Healthcare Disparities Quality of Health Care Advanced and Specialized Nursing business.industry Insulin medicine.disease Cross-Sectional Studies Diabetes Mellitus Type 1 Jugend business Regionale Verteilung |
Zdroj: | Diabetes Care Diabetes Care 41, 2517-2525 (2018) |
ISSN: | 1935-5548 0149-5992 |
DOI: | 10.2337/dc18-0724 |
Popis: | OBJECTIVE This study analyzed whether area deprivation is associated with disparities in health care of pediatric type 1 diabetes in Germany. RESEARCH DESIGN AND METHODS We selected patients RESULTS We analyzed data from 29,284 patients. From the least to the most deprived quintile, use of continuous glucose monitoring systems (CGMS) decreased from 6.3 to 3.4% and use of long-acting insulin analogs from 80.8 to 64.3%, whereas use of rapid-acting insulin analogs increased from 74.7 to 79.0%; average HbA1c increased from 7.84 to 8.07% (62 to 65 mmol/mol), and the prevalence of overweight from 11.8 to 15.5%, but the rate of severe hypoglycemia decreased from 12.1 to 6.9 events/100 patient-years. Associations with other parameters showed a more complex pattern (use of continuous subcutaneous insulin infusion [CSII]) or were not significant. CONCLUSIONS Area deprivation was associated not only with key outcomes in pediatric type 1 diabetes but also with treatment modalities. Our results show, in particular, that the access to CGMS and CSII could be improved in the most deprived regions in Germany. |
Databáze: | OpenAIRE |
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