Impact of a natural disaster on diabetes: exacerbation of disparities and long-term consequences.
Impact of a natural disaster on diabetes: exacerbation of disparities and long-term consequences.
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DOI：
10.2337/dc09-0670
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发表时间：
2009-09
期刊：
影响因子：
16.2
通讯作者：
John-Kalarickal J
中科院分区：
文献类型：
--
作者：
Fonseca VA;Smith H;Kuhadiya N;Leger SM;Yau CL;Reynolds K;Shi L;McDuffie RH;Thethi T;John-Kalarickal J
研究卡特里娜飓风对糖尿病患者健康的影响。这是一项观察性研究，共有1,795名成年人在卡特里娜飓风之前6个月和之后6 - 16个月在三个医疗保健系统中进行了A1 C测量：私人（杜兰大学医院和诊所[TUHC]），州（新奥尔良路易斯安那州医疗中心[MCLNO]）和退伍军人事务部（VA）。将飓风前的血糖控制（A1 C）、血压和血脂与飓风后患者的首次测量结果进行比较。核心糖尿病模型用于预测预期寿命和健康经济影响。MCLNO和VA患者的平均灾前A1 C水平不同（平均7.7 vs. 7.3%，P < 0.001），MCLNO患者显著增加至8.3%（P < 0.001），但VA和TUHC患者之间没有增加。三个系统的平均收缩压均升高（TUHC为130-137.6 mmHg，VA为130.7-143.7 mmHg，P < 0.001; MCLNO为132-136 mmHg，P = 0.008）。VA组（97.1-104.3 mg/dl）和TUHC组（103.4-115.5; P < 0.001）的平均LDL胆固醇升高。卡特里娜飓风增加了直接、间接和总的医疗保健费用，也降低了预期寿命和质量调整后的预期寿命，由于受影响的人口规模很大，经济影响相当大。我们估计受影响的成年人群的终身成本为5.04亿美元，其中MCLNO患者的经济影响最大。一场重大灾害对糖尿病管理产生了重大影响，并加剧了现有的差距。这些影响可能对健康和经济产生持久影响。
To examine the impact of Hurricane Katrina on the health of individuals with diabetes. This was an observational study in 1,795 adults with an A1C measurement 6 months before and 6−16 months after Hurricane Katrina in three health care systems: private (Tulane University Hospital and Clinic [TUHC]), state (Medical Center of Louisiana at New Orleans [MCLNO]), and Veterans Affairs (VA). Glycemic control (A1C), blood pressure, and lipids before the hurricane were compared with the patients' first measurement thereafter. The CORE Diabetes Model was used to project life expectancy and health economic impact. Mean predisaster A1C levels differed between MCLNO and VA patients (mean 7.7 vs. 7.3%, P < 0.001) and increased significantly among MCLNO patients to 8.3% (P < 0.001) but not among VA and TUHC patients. Mean systolic blood pressure increased in all three systems (130–137.6 mmHg for TUHC and 130.7–143.7 for VA, P < 0.001; 132–136 for MCLNO, P = 0.008). Mean LDL cholesterol increased in the VA (97.1–104.3 mg/dl) and TUHC patients (103.4–115.5; P < 0.001). Hurricane Katrina increased modeled direct, indirect, and total health care costs and also reduced life expectancy as well as quality-adjusted life expectancy, with the economic impact being quite substantial because of the large population size affected. We estimate a lifetime cost of USD $504 million for the adult population affected, with the largest economic impact seen among MCLNO patients. A major disaster had a significant effect on diabetes management and exacerbated existing disparities. These effects may have a lasting impact on both health and economic implications.
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影响因子：
16.2
作者：
Eddy, DM;Schlessinger, L
通讯作者：
Schlessinger, L
影响因子：
2.3
作者：
Palmer, AJ;Roze, S;Spinas, GA
通讯作者：
Spinas, GA
影响因子：
8.3
作者：
Kothari, V;Stevens, RJ;Holman, RR
通讯作者：
Holman, RR
影响因子：
1.8
作者：
Takechi, S;Yoneda, R;Nomura, A
通讯作者：
Nomura, A
影响因子：
4.8
作者：
Suzuki, S;Sakamoto, S;Matsuo, T
通讯作者：
Matsuo, T