gms | German Medical Science

Background: Diabetes mellitus (DM) has developed to a substantial, and still growing, health epidemic with severe consequences for both the patients and the health systems [1]. According to the tenth edition of the International Diabetes Federation (IDF) Atlas, worldwide approximately 537 million people aged 20 to 79 years suffered from diabetes in 2021 (2). Due to the increasing number of patients with diabetes and patients with long-term complications, considerable public health and economic burden are expected worldwide and for Austria [2].

The Austrian Diabetes Strategy Paper addresses the lack of high-quality data on DM in Austria and the need to develop a national data network on diabetes epidemiology and the quality of diabetes care [3]. The aims of our study are to describe the demographic and clinical characteristics of a cohort including all diabetes patients in a district in Western Austria and to provide a prevalence estimation.

Methods: We established a population-based cohort including adult patients with a diagnosis of DM from 2018 until the end of June 2021 accompanied by a network connecting all caregivers (general practitioners, diabetes specialists in private practice, hospital). Data collection was based on a case report form, including patient characteristics, clinical parameters, and long-term complications. Documentation was mainly performed by a qualified study nurse who visited the care units. Additionally, it was possible for the physicians to document themselves. All cohort data were stored in a pseudonymized web-based database [4]. All results for patient characteristics, clinical parameters and long-term complications are reported as summary measures and stratified for gender. We estimated period prevalence (study period from January 2018 until the end of June 2021) with 95% confidence intervals (95%CI) based on all patients with DM detected in our study in the region of Landeck.

Results: In total, 1,845 patients with DM were analyzed. We observed an overall prevalence of 5.3% [95% CI: 5.0-5.5] with substantial heterogeneity across subregions. For the further main analysis, we included 1755 patients with DM. 90 patients with gestational diabetes mellitus, who did not develop type 2 DM, were excluded. In our study population, 5.7% of patients were diagnosed with type 1 DM, 92.4% with type 2 DM, and 1.9% with other types of DM. We observed differences between genders in the distribution of specific clinical parameters (e.g., BMI, HbA1c, LDL), patient characteristics (e.g., duration of diabetes, smoking status,) and the long-term complications diabetic foot, amputation, and cardiovascular diseases.

Conclusion: We successfully established a population-based cohort following the guidelines of the Austrian Diabetes Strategy [3], despite the difficult conditions during the pandemic. Some results, such as prevalence or the proportion of specific long-term complications, are in the lower range when compared within the international variation [5], [6], [7], [8]. We assume that the Diabetes-Landeck-Cohort has reached high degree of completeness, however, we were not able to identify independent sources for a sound check of completeness. Nevertheless, our population-based DM cohort provides the first comprehensive Austrian data basis to support future health care decision-making and to improve patient-relevant outcomes in patients with DM.

Our institution received funding for the project "Diabetes Landeck" from Tiroler Gesundheitsfonds.

The authors declare that a positive ethics committee vote has been obtained.