Bettina Hartmann1, Peter Bramlage2, Stefanie Lanzinger3,4, Thomas Danne5, Michael Hummel6, Matthias Kaltheuner7, Dirk Raddatz8, Wolfgang Rathmann9, Hans-Martin Reuter10, Jochen Seufert11, Reinhard W Holl3,4. 1. Department of Gastroenterology and Diabetology, Klinikum Ludwigshafen, Ludwigshafen, Germany. 2. Institute for Pharmacology and Preventive Medicine, Mahlow, Germany. 3. Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany. 4. German Center for Diabetes Research (DZD), Neuherberg, Germany. 5. Diabeteszentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover, Germany. 6. Diabetes Schwerpunktpraxis Rosenheim & Helmholtz Diabetes Center, Munich, Germany. 7. Gemeinschaftspraxis für Diabetologie, Innere Medizin und Allgemeinmedizin in Leverkusen, Leverkusen, Germany. 8. Department of Gastroenterology and Endocrinology, University Medical Center Goettingen, Goettingen, Germany. 9. Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany. 10. Diabetologische Gemeinschaftspraxis Reuter, Reuter-Ehrlich, Schramm, Jena, Germany. 11. Division of Endocrinology and Diabetology, Department of Internal Medicine II, University Hospital of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Abstract
AIMS: On the basis of the Diabetes Versorgungs-Evaluation (DIVE) and Diabetes-Patienten-Verlaufsdokumentation (DPV) datasets, we aimed to explore the impact of differences in treatment modalities on outcomes in Germany and put these into a global context. METHODS: The 2014 to 2016 DIVE and DPV databases were combined, and a total of 127 838 patients 18 years and older was analysed with respect to demographics, cardiovascular risk factors, comorbidities, treatments, and outcomes, separately for each German state. Estimates were expressed as adjusted least squares means together with 95% confidence intervals. RESULTS: Saarland dataset recorded the lowest mean HbA1c (6.7%; 6.6%-6.8%; 50 mmol/mol, 49-51 mmol/mol), Saxony-Anhalt showed the highest (8.3%; 8.2%-8.3%; 67 mmol/mol, 66-67 mmol/mol). The highest percentage of hypoglycaemic events was reported in Mecklenburg-West Pomerania (MWP) (4.7%; 3.9%-5.7%), the lowest in Thuringia (0.9%; 0.2%-3.4%). Metformin and sulfonylurea accounted for 36.4% to 53.3% of anti-diabetic treatments across states; other antihyperglycaemic drugs such as DPP-4 inhibitors, SGLT2 inhibitors, and GLP-1 analogues were used most often in MWP (40.0%; 37.8%-42.1%) and least in Rhineland-Palatinate (13.6%; 13.0%-14.2%). Treatment with insulin (alone or in combination) was reported most often in MWP (78.2%; 76.4%-80.0%) and least in Thuringia (26.0%; 20.1%-32.9%). CONCLUSIONS: Federal states in Germany are heterogeneous concerning diabetes treatment and associated outcomes. These data should stimulate further discussion about how optimal diabetes care can be implemented in all areas of Germany, to achieve good treatment outcomes in all federal states.
AIMS: On the basis of the Diabetes Versorgungs-Evaluation (DIVE) and Diabetes-Patienten-Verlaufsdokumentation (DPV) datasets, we aimed to explore the impact of differences in treatment modalities on outcomes in Germany and put these into a global context. METHODS: The 2014 to 2016 DIVE and DPV databases were combined, and a total of 127 838 patients 18 years and older was analysed with respect to demographics, cardiovascular risk factors, comorbidities, treatments, and outcomes, separately for each German state. Estimates were expressed as adjusted least squares means together with 95% confidence intervals. RESULTS: Saarland dataset recorded the lowest mean HbA1c (6.7%; 6.6%-6.8%; 50 mmol/mol, 49-51 mmol/mol), Saxony-Anhalt showed the highest (8.3%; 8.2%-8.3%; 67 mmol/mol, 66-67 mmol/mol). The highest percentage of hypoglycaemic events was reported in Mecklenburg-West Pomerania (MWP) (4.7%; 3.9%-5.7%), the lowest in Thuringia (0.9%; 0.2%-3.4%). Metformin and sulfonylurea accounted for 36.4% to 53.3% of anti-diabetic treatments across states; other antihyperglycaemic drugs such as DPP-4 inhibitors, SGLT2 inhibitors, and GLP-1 analogues were used most often in MWP (40.0%; 37.8%-42.1%) and least in Rhineland-Palatinate (13.6%; 13.0%-14.2%). Treatment with insulin (alone or in combination) was reported most often in MWP (78.2%; 76.4%-80.0%) and least in Thuringia (26.0%; 20.1%-32.9%). CONCLUSIONS: Federal states in Germany are heterogeneous concerning diabetes treatment and associated outcomes. These data should stimulate further discussion about how optimal diabetes care can be implemented in all areas of Germany, to achieve good treatment outcomes in all federal states.
Authors: Andrew Blauvelt; Melinda Gooderham; Neal Bhatia; Richard G Langley; Shannon Schneider; John Zoidis; Azra Kurbasic; April Armstrong; Jonathan I Silverberg Journal: Dermatol Ther (Heidelb) Date: 2022-09-24
Authors: Clemens Engler; Marco Leo; Bernhard Pfeifer; Martin Juchum; Di Chen-Koenig; Karin Poelzl; Hans Schoenherr; David Vill; Juliana Oberdanner; Egon Eisendle; Klaus Middeldorf; Bernhard Heindl; Hannes Gaenzer; Gerald Bode; Karl Kirchmeyr; Guenther Ladner; Lisa Rieger; Ursula Koellensperger; Andrea Schwaiger; Florian Stoeckl; Guenther Zangerl; Monika Lechleitner; Irmgard Delmarko; Wilhelm Oberaigner; Clemens Rissbacher; Herbert Tilg; Christoph Ebenbichler Journal: BMJ Open Diabetes Res Care Date: 2020-09
Authors: D Stoyanova; B Stratmann; A Schwandt; N Heise; S Mühldorfer; H-J Ziegelasch; A Zimmermann; D Tschoepe; R W Holl Journal: Diabet Med Date: 2019-02-27 Impact factor: 4.359