Assuntos
Diabetes Mellitus/economia , Medicaid/organização & administração , Serviços Preventivos de Saúde/organização & administração , Planos Governamentais de Saúde/organização & administração , Ensaios Clínicos como Assunto , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/prevenção & controle , Humanos , Maryland/epidemiologia , Prevalência , Serviços Preventivos de Saúde/economia , Avaliação de Programas e Projetos de Saúde , Planos Governamentais de Saúde/economia , Resultado do Tratamento , Estados Unidos/epidemiologiaRESUMO
A statewide insulin-dependent diabetes mellitus (IDDM) registry is used to identify and epidemiologically characterize patients admitted to Rhode Island's hospitals. Physician interviews and record reviews are obtained to ascertain reasons for hospitalization. Poor diabetes control (noncompliance with diet/medication) and infection accounted for 44-54% of hospital admissions among 691 known diabetic patients; these patients were readmitted more often (65%) compared with new-onset patients (46%) during a 3-yr follow-up of hospitalization patterns. An outpatient diabetic education program was successful in reducing the number of persons hospitalized (P = 0.04) and the number of hospitalizations for participants (P = 0.01) when comparisons of hospital admissions before and after the program were made. Potential cost savings for persons with IDDM over the 4 yr of the study are estimated at $674,400.00.
Assuntos
Diabetes Mellitus Tipo 1 , Adolescente , Adulto , Pré-Escolar , Custos e Análise de Custo , Feminino , Hospitalização , Humanos , Masculino , Cooperação do Paciente , Educação de Pacientes como Assunto , Rhode IslandRESUMO
A 12-month epidemiologic study in 1979 and 1980 of all diabetic acidosis admissions to all acute care hospitals in Rhode Island detected 152 episodes occurring in 137 persons. Eleven per cent of diabetic acidosis admissions presented in coma and the overall death-to-case ratio was 9%. Newly diagnosed diabetes accounted for 20% of these episodes, while persons having multiple episodes during the year accounted for 15% of the admissions. The annual rate of diabetic acidosis was 46 per 10,000 diabetics. Highest rates of diabetic acidosis were found for the elderly, those admitted from nursing homes and those residing in one geographic area of the state. For known diabetics with an admission for acidosis, 87% were on insulin prior to admission and 81% were nonobese. Patients seldom contacted physicians prior to admission. Insulin dose or frequency was often (40%) changed in the two weeks prior to admission. Most of the known diabetic cases of acidosis had emergency admissions for diabetes in the three-year period prior to admission and few had any structured diabetic outpatient education. Infection and noncompliance were the most frequently identified precipitants of diabetic acidosis occurring in known diabetics.
Assuntos
Cetoacidose Diabética/epidemiologia , Hospitalização , Adolescente , Adulto , Fatores Etários , Idoso , Bicarbonatos/sangue , Glicemia , Coma Diabético/epidemiologia , Coma Diabético/mortalidade , Cetoacidose Diabética/etiologia , Cetoacidose Diabética/mortalidade , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Readmissão do Paciente , Rhode Island , Fatores Sexuais , Fatores SocioeconômicosRESUMO
Data from a statewide insulin-dependent diabetes mellitus (IDDM) registry in Rhode Island show that IDDM affects young adults (20-29 yr) as frequently as adolescents and teenagers (10-19 yr). Overall incidence less than 30 yr was 14/100,000 population. Peak incidence occurred at 10-14 yr (19/100,000 population). Poor diabetic control and infection accounted for 46-62% of hospitalizations among 275 known diabetic persons. Despite a 10-yr mean duration of diabetes, only 31% of hospitalized diabetic persons less than 30 yr of age reported ever having received outpatient diabetes education of two or more hours. Readmissions 1 yr after initial registration were more frequent for known (43%) than new-onset (18%) IDDM cases. Increased risk of readmission for both groups was associated with a poverty socioeconomic status. Total direct hospitalization costs for IDDM in persons under 30 yr of age in Rhode Island was $530,000 per year of $2,245 per patient.
Assuntos
Diabetes Mellitus Tipo 1/epidemiologia , Hospitalização , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Rhode IslandRESUMO
The incidence of insulin dependent diabetes mellitus, as determined from the Pittsburgh Insulin Dependent Diabetes Mellitus Registry, was examined in relationship to social class. The registry consists of all Allegheny County, Pennsylvania, cases of insulin dependent diabetes diagnosed under age 20 years in 1965-1976. Analyses of the registry data revealed little relationship between incidence, age at onset and social class. The lack of a strong relationship to social class indicates that the epidemiology of insulin dependent diabetes is not similar to those of polio or Hodgkin's disease, in which social class is strongly related to incidence and age at onset.
Assuntos
Diabetes Mellitus/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pennsylvania , Sistema de Registros , Classe Social , Fatores SocioeconômicosRESUMO
An insulin-dependent Diabetes Mellitus Registry has been developed in Allegheny County, Pennsylvania, through hospital record review and surveillance of pediatric practices. The yearly incidence ranged from 10/100,000 for nonwhite males to 16/100,000 for white males. There were no temporal trends in incidence for 1965-1976 nor major sex differences. Nonwhites had a slightly lower incidence, primarily in the younger age groups.
