Incidence, prevalence and mortality of type 2 diabetes requiring glucose-lowering treatment, and associated risks of cardiovascular complications: a nationwide study in Sweden, 2006-2013
Incidence, prevalence and mortality of type 2 diabetes requiring glucose-lowering treatment, and associated risks of cardiovascular complications: a nationwide study in Sweden, 2006-2013
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DOI：
10.1007/s00125-016-3971-y
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发表时间：
2016-08-01
期刊：
影响因子：
8.2
通讯作者：
Nathanson, David
中科院分区：
文献类型：
--
作者：
Norhammar, Anna;Bodegard, Johan;Nathanson, David
目的/假设全球糖尿病流行对各国的影响不同。我们的目的是描述需要降糖治疗的2型糖尿病的发病率和患病率的趋势，以及相关的预期寿命和重大临床并发症的风险。方法2006 - 2013年期间使用任何降糖药物（GLD）处方的2型糖尿病患者的数据摘自瑞典处方药物登记处，结果：2013年，接受GLD治疗的2型糖尿病患病率为4.4%（n = 352，436），发病率为399/100，000（n = 30，620）。在2006 - 2013年期间，患病率增加了61%，而发病率保持相对稳定;心血管疾病（CVD，2013年为34%）和微血管疾病（2013年为16%）的患病率也保持稳定。胰岛素使用增加了29%，而磺脲类药物使用下降了55%。与普通人群相比，2型糖尿病患者心肌梗死、卒中和全因死亡的风险增加，年龄标准化风险分别为1.7倍、1.5倍和1.3倍。这些风险随着时间的推移而下降。2006年至2013年，由于糖尿病导致的生命年损失在年轻人中最为明显，随着时间的推移，女性的生命年损失有所改善。结论/解释近年来，瑞典需要GLD治疗的2型糖尿病的患病率大幅增加，而发病率保持稳定。磺脲类药物的使用减少，而胰岛素的使用增加。糖尿病相关合并症的高患病率，并发症和生命年损失的风险增加，突出了2型糖尿病患者需要优化和新的预防策略。
Aims/hypothesis The global diabetes epidemic affects countries differently. We aimed to describe trends in the incidence and prevalence of type 2 diabetes mellitus requiring glucose-lowering treatment, together with associated life expectancy and risks of significant clinical complications.Methods Data on patients with type 2 diabetes who filled a prescription for any glucose-lowering drug (GLD) during the period 2006-2013 were extracted from the Swedish Prescribed Drug Register, Cause of Death Register and Swedish National Patient Register.Results In 2013, the prevalence of GLD-treated type 2 diabetes was 4.4% (n = 352,436) and the incidence was 399 per 100,000 population (n = 30,620). During 2006-2013, the prevalence increased by 61% while the incidence remained relatively stable; the prevalence of cardiovascular disease (CVD, 34% in 2013) and microvascular disease (16% in 2013) was also stable. Insulin use increased by 29% while sulfonylurea use declined by 55%. Compared with the general population, patients with type 2 diabetes had increased risk of myocardial infarction, stroke and all-cause mortality, with age-standardised risks of similar to 1.7-, 1.5- and 1.3-fold, respectively. These risks declined over time. Life-years lost due to diabetes was most pronounced at younger ages and improved in women over time from 2006 to 2013.Conclusions/interpretation The prevalence of type 2 diabetes requiring GLD treatment in Sweden increased substantially in recent years, while the incidence remained stable. Use of sulfonylurea declined while insulin use increased. The high prevalence of diabetes-related comorbidities, increased risk of complications and life-years lost highlights the need for optimised and new preventive strategies in patients with type 2 diabetes.