Regional Disparities in Diabetes Care for Pediatric Patients with Type 1 Diabetes. A Cross-sectional DPV Multicenter Analysis of 24,928 German Children and Adolescents

Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association
B BohnDPV initiative

Abstract

Data on regional differences in the quality of medical care in Germany are scarce. This study aimed to compare outcome quality and medical treatment of pediatric patients with type 1 diabetes between the federal states of Germany. 24,928 patients (< 18 years of age) with type 1 diabetes and German residence were selected from the Diabetes-Patienten-Verlaufsdokumentation database. Indicators of outcome quality were HbA1C, overweight prevalence, and rate of severe hypoglycemia. To reflect medical treatment, use of insulin pumps and use of rapid-acting or long-acting insulin analogues were analyzed. Logistic regression models were created for binary variables with federal state as independent predictor. Linear regression was applied for HbA1C and Poisson regression for rate of severe hypoglycemia. Confounders: Sex, age, diabetes duration, migratory background. Disparity was observed for indicators of outcome quality between the 16 federal states of Germany (all p<0.05). After adjustment, HbA1C varied between 55.8 mmol/mol and 67.3 mmol/mol, overweight prevalence between 10.0 and 15.3%, severe hypoglycemia ranged from 0.06 events/PY to 0.21 events/PY. Overall, the best outcome quality appeared to be present in Saxony. Medical treat...Continue Reading

Citations

Jan 23, 2018·Diabetic Medicine : a Journal of the British Diabetic Association·P PrahaladD M Maahs
Aug 14, 2018·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Christina BächleJoachim Rosenbauer
Mar 22, 2021·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·M-N Campas-LebecqueP Barat
Jul 14, 2021·Journal of Diabetes Science and Technology·Marie AuzanneauReinhard W Holl

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