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Epidemiology and Health Impact of Diabetes in France - 29/06/22

[Epidémiologie et Impact sur la Sante du Diabète en France]

Doi : 10.1016/j.ando.2022.05.005 
Yves Reznik, MD PhD 1, , Nicolas Naiditsch, PhD 2, Jean-François Thébault, MD 2, Anaïs Havet 3, Stève Bénard 3, Jean-Pierre Riveline, MD PhD 4
1 Department of Endocrinology and Diabetetology, CHU Côte de Nacre, 14033 Caen cedex, France 
2 Fédération Française des Diabétiques, 88 rue de la Roquette - CS 20013, 75544 PARIS CEDEX11, France 
3 Stève Consulting, 30, rue Narcisse Bertholey, 69600 Oullins, France 
4 Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, 75010 Paris, France; Unité. INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France; Université de Paris, Paris, France 

Corresponding author: Department of Endocrinology and Diabetetology, CHU Côte de Nacre, 14033, Caen cedex, FranceDepartment of Endocrinology and Diabetetology, CHU Côte de NacreCaen cedex14033France
Sous presse. Manuscrit accepté. Disponible en ligne depuis le Wednesday 29 June 2022

Abstract

Objectives: Diabetes is a growing health concern. An update on epidemiology and health outcomes is mandatory to devise strategies to alleviate the burden of diabetes. The objective of this study was to assess the prevalence of diabetes and associated complications in France in 2017.

Methods: Demographics and healthcare data from a representative permanent secondary database were analyzed. Patients with at least 2 national health insurance payments for anti-diabetic drugs in 2017 were selected, with the index date set to the last payment date. Patients were grouped as diabetes treated with insulin only (DTi), diabetes treated with anti-diabetic drugs other than only insulin (DT2) or gestational diabetes. Comorbidities, diabetes-related complications and hospital admissions, healthcare consumption and medical follow-up were extracted for a 5 or 2 year period prior to the index date and summarized using descriptive statistics.

Results: Overall, 29,288 patients were included in the study population: 1,964 (6.7%) were categorized as DTi and 27,243 (93.0%) as DT2. Patients with gestational diabetes (81 [0.3%]) are not further described here.Prevalence was estimated at 4.9%. For DT2, marked geographic disparities were observed, with prevalence being highest in the northeast France. Diabetes-related complications were more frequent in DTi than in DT2 over a 5-year period (52.2% vs 34.7%). Diabetes-related admissions were also more common in DTi than in DT2 over a 2-year period (29.8% vs 16.9%). In the DT2 category, another antidiabetic drug was added during the 3 months prior to the index date in 16.5% of cases overall and in 25% of patients with recent hospital admission or diabetes-related complications.Although more than 80% of patients in the DTi and DT2 categories had at least 1 healthcare consultation during 2 years prior to the index date, only 10% to 20% of patients complied with guidelines for all 5 recommended examinations.

Conclusions: Prevalence of diabetes is high in the French population, while compliance with recommended healthcare consultations falls short of the 80% goal set by regulations. New strategies are mandatory in order to reduce the burden of diabetes-related complications and admissions, focusing on patient and physician information and education in order to increase proactive treatment adjustment and reduce therapeutic inertia.

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© 2022  Publié par Elsevier Masson SAS.
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