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Alcohol Consumption and Complications of Diabetes

饮酒和糖尿病并发症

基本信息

批准号：
7414384
负责人：
Ameena T Ahmed
金额：
$ 13.53万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-05-15 至 2010-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7414384
关键词：
Accident and Emergency department Acute Address Adherence Adult Affect Age Alcohol consumption Alcohols Amputation Behavior California Caring Clinical Cohort Studies Complications of Diabetes Mellitus Confounding Factors (Epidemiology)Congestive Heart Failure Consumption Coronary Coronary heart disease Cost Analysis Daily Databases Diabetes Mellitus Dyslipidemias Economic Burden Ethnic Origin Etiology Event Financial cost Frequencies Funding Gender Glycosylated hemoglobin A Health Health Care Costs Health behavior Healthcare Systems Heart Hospitalization Hypertension Incidence Individual Intake Intervention Kidney Diseases Knowledge Link Lower Extremity Managed Care Measures Medical Metabolic Modification Morbidity - disease rate Myocardial Infarction Ophthalmic examination and evaluation Outcome Outpatients Patients Pattern Persons Pharmaceutical Preparations Pharmacy facility Physiological Population Prospective Studies Public Health Rate Research Research Design Research Personnel Retinal Diseases Risk Role Self Management Severity of illness Smoking Staging Stroke Study Subject Surveys Testing Time base cohort cost diabetic diet and exercise follow-up health care service utilization health economics medical appointment mortality programs

项目摘要

DESCRIPTION (provided by applicant): This proposal will evaluate differences in the incidence of diabetes complications and health care costs attributable to alcohol consumption in a large, multiethnic, well-characterized cohort of 65,996 patients with diabetes who receive medical care in an integrated, managed care setting, Kaiser Permanente Northern California. We propose to determine incidence of diabetic complications and all-cause mortality, occurring in groups stratified by alcohol consumption, during up to 11 years follow-up. We will further determine health care costs in each group. Despite the fact that half of U.S. adults consume alcohol, little is known about how this potentially modifiable health behavior affects incidence of complications other than coronary heart disease among people with diabetes. Our study aims are: 1) to evaluate the associations between baseline alcohol consumption (average daily intake, frequency of consumption) and incidence of diabetes complications (myocardial infarction, stroke, congestive heart failure, end-stage renal disease, lower extremity amputation, proliferative retinopathy, acute metabolic events) and all-cause mortality during up to 11 years of follow-up; 2) to determine if ethnicity, gender, or age modify any observed associations between alcohol intake and diabetes complications; 3) to investigate explanatory factors that may link alcohol consumption and diabetes complication incidence rate; 4) to determine the costs of health care (total costs; outpatient, emergency department, and pharmacy costs; hospitalization costs) and 5) to evaluate endogeneity bias, among patients with different levels of alcohol consumption. Using a cohort study design, we will assess these outcomes in 65,996 patients with diabetes who were surveyed in 1994-1997 and have been followed prospectively since then. Our large, ethnically diverse cohort; complete capture of outcomes through automated databases; and extensive characterization of clinical status and other putative confounding variables provides a unique opportunity to study the role of alcohol consumption in the incidence of diabetes complications. Given the incomplete understanding of these epidemiologic relationships, the common use of alcohol, and the increasing public health and economic burden associated with diabetes, these study findings will have important public health significance.

描述（由申请人提供）：本提案将评估在北加州Kaiser Permanente综合管理医疗机构接受医疗护理的65,996名大型、多种族、特征明确的糖尿病患者中，由饮酒引起的糖尿病并发症发生率和医疗费用的差异。我们建议在长达11年的随访期间，确定按饮酒分层的糖尿病并发症发生率和全因死亡率。我们将进一步确定每个群体的医疗保健费用。尽管事实上有一半的美国成年人饮酒，但人们对这种潜在的可改变的健康行为如何影响糖尿病患者冠心病以外的并发症的发生率知之甚少。我们的研究目的是：1)在长达11年的随访期间，评估基线饮酒（平均每日摄入量、饮酒频率）与糖尿病并发症（心肌梗死、中风、充血性心力衰竭、终末期肾病、下肢截肢、增生性视网膜病变、急性代谢事件）发生率和全因死亡率之间的关系；2)确定种族、性别或年龄是否改变了观察到的酒精摄入与糖尿病并发症之间的关联；3)探讨饮酒与糖尿病并发症发生率相关的解释因素；4)确定医疗保健费用（总费用；门诊、急诊和药房费用；住院费用）；5)进行评估