Metabolic Control, Diabetic Complications and Drug Therapy in a Cohort of Patients with Type 1 and Type 2 Diabetes in Secondary and Tertiary Care between 2004 and 2019

Matthias Roth (), Thomas Lehmann, Christof Kloos, Sebastian Schmidt, Christiane Kellner, Gunter Wolf and Nicolle Müller
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Matthias Roth: Department of Internal Medicine III, Jena University Hospital, 07747 Jena, Germany
Thomas Lehmann: Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, 07743 Jena, Germany
Christof Kloos: Department of Internal Medicine III, Jena University Hospital, 07747 Jena, Germany
Sebastian Schmidt: Department of Internal Medicine III, Jena University Hospital, 07747 Jena, Germany
Christiane Kellner: Department of Internal Medicine III, Jena University Hospital, 07747 Jena, Germany
Gunter Wolf: Department of Internal Medicine III, Jena University Hospital, 07747 Jena, Germany
Nicolle Müller: Department of Internal Medicine III, Jena University Hospital, 07747 Jena, Germany

IJERPH, 2023, vol. 20, issue 3, 1-16

Abstract: This paper studies the features of metabolic parameters, diabetic complications and drug therapy of a single-centre cohort of patients with type 1 diabetes (T1DM) or type 2 diabetes (T2DM) in secondary care and tertiary care over a 15-year period. Methods: Retrospective cross-sectional analysis of four single-centre cohorts between 2004 and 2019. All patients with T1DM or T2DM in secondary care ( n = 5571) or tertiary care ( n = 2001) were included. Statistical analyses were performed using linear mixed models. Results: Diabetes duration increased in both patients with T1DM and T2DM in secondary care and tertiary care ( p < 0.001). Patients in secondary care consistently showed good glycaemic control, while patients in tertiary care showed inadequate glycaemic control. All four cross-sectional cohorts showed a significant increase in the prevalence of nephropathy over time and three out of four cohorts (T1DM and T2DM in secondary care and T2DM in tertiary care) showed an increase in the prevalence of neuropathy (all p < 0.001). The incidence of severe hypoglycaemia was consistently low. The use of insulin pumps and insulin analogues in the therapy of T1DM increased significantly. Conclusions: The increased prevalence of complications is likely due to older age and longer diabetes duration. Low rates of hypoglycaemia, lower limb amputations and good glycaemic control in secondary care patients indicate a good structure of patient care.

Keywords: diabetes mellitus; metabolic control; complications; therapy; quality of care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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