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Trends in diabetes-related complications in Hong Kong, 2001–2016: a retrospective cohort study

BACKGROUND: Nationwide studies on contemporary trends in incidence of diabetes-related complications in Asia are lacking. We describe trends in incident coronary heart disease (CHD), stroke, heart failure, hyperglycaemic crisis, and lower-extremity amputation (LEA) in people with diabetes in Hong Ko...

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Autores principales: Wu, Hongjiang, Lau, Eric S. H., Yang, Aimin, Ma, Ronald C. W., Kong, Alice P. S., Chow, Elaine, So, Wing-Yee, Chan, Juliana C. N., Luk, Andrea O. Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218631/
https://www.ncbi.nlm.nih.gov/pubmed/32398003
http://dx.doi.org/10.1186/s12933-020-01039-y
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author Wu, Hongjiang
Lau, Eric S. H.
Yang, Aimin
Ma, Ronald C. W.
Kong, Alice P. S.
Chow, Elaine
So, Wing-Yee
Chan, Juliana C. N.
Luk, Andrea O. Y.
author_facet Wu, Hongjiang
Lau, Eric S. H.
Yang, Aimin
Ma, Ronald C. W.
Kong, Alice P. S.
Chow, Elaine
So, Wing-Yee
Chan, Juliana C. N.
Luk, Andrea O. Y.
author_sort Wu, Hongjiang
collection PubMed
description BACKGROUND: Nationwide studies on contemporary trends in incidence of diabetes-related complications in Asia are lacking. We describe trends in incident coronary heart disease (CHD), stroke, heart failure, hyperglycaemic crisis, and lower-extremity amputation (LEA) in people with diabetes in Hong Kong between 2001 and 2016. METHODS: The Hong Kong Diabetes Surveillance Database (HKDSD) is a territory-wide diabetes cohort identified from Hong Kong Hospital Authority electronic medical record system. We identified events of CHD, stroke, heart failure and hyperglycaemic crisis using hospital principal diagnosis codes at discharge and that of LEA using inpatient procedure codes. We used Joinpoint regression analysis to describe incidence trends by age and sex. RESULTS: Between 2001 and 2016, a total of 390,071 men and 380,007 women aged 20 years or older with diabetes were included in the HKDSD. Event rates of CHD, stroke, heart failure, hyperglycaemic crisis and LEA declined by 69.4% (average annual percent change: − 7.6, 95% CI − 10.2, − 5.0), 70.3% (− 8.7, 95% CI − 9.8, − 7.5), 63.6% (− 6.4, 95% CI − 8.0, − 4.7), 59.1% (− 6.6, 95% CI − 12.4, − 0.44), and 67.5% (− 5.8, 95% CI − 7.2, − 4.4), in men and by 77.5% (− 9.9, 95% CI − 11.8, − 7.9), 74.5% (− 9.0, 95% CI − 9.6, − 8.4), 65.8% (− 7.0, 95% CI − 8.0, − 6.0), 81.7% (− 8.5, 95% CI − 10.5, − 6.5), and 72.7% (− 9.1. 95% CI − 12.2, − 5.8) in women, respectively, over a 16-year period in people with diabetes in Hong Kong. Joinpoint analysis identified greater declines in event rates of the five diabetes-related complications in the earlier one-third of study period and slowed down but remained significant until 2016. Event rates decreased for all age groups above 45 years for both sexes. There was no significant change in event rates in the group aged 20–44 years except for decline in hyperglycaemic crisis. CONCLUSIONS: The event rates of diabetes-related complications have declined substantially with no evidence of stabilization or increase in Hong Kong up to 2016. Improvements in outcome were observed for all age subgroups but not in young people with diabetes, calling for urgent action to improve quality of care to prevent complications in young people at risk.
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spelling pubmed-72186312020-05-20 Trends in diabetes-related complications in Hong Kong, 2001–2016: a retrospective cohort study Wu, Hongjiang Lau, Eric S. H. Yang, Aimin Ma, Ronald C. W. Kong, Alice P. S. Chow, Elaine So, Wing-Yee Chan, Juliana C. N. Luk, Andrea O. Y. Cardiovasc Diabetol Original Investigation BACKGROUND: Nationwide studies on contemporary trends in incidence of diabetes-related complications in Asia are lacking. We describe trends in incident coronary heart disease (CHD), stroke, heart failure, hyperglycaemic crisis, and lower-extremity amputation (LEA) in people with diabetes in Hong Kong between 2001 and 2016. METHODS: The Hong Kong Diabetes Surveillance Database (HKDSD) is a territory-wide diabetes cohort identified from Hong Kong Hospital Authority electronic medical record system. We identified events of CHD, stroke, heart failure and hyperglycaemic crisis using hospital principal diagnosis codes at discharge and that of LEA using inpatient procedure codes. We used Joinpoint regression analysis to describe incidence trends by age and sex. RESULTS: Between 2001 and 2016, a total of 390,071 men and 380,007 women aged 20 years or older with diabetes were included in the HKDSD. Event rates of CHD, stroke, heart failure, hyperglycaemic crisis and LEA declined by 69.4% (average annual percent change: − 7.6, 95% CI − 10.2, − 5.0), 70.3% (− 8.7, 95% CI − 9.8, − 7.5), 63.6% (− 6.4, 95% CI − 8.0, − 4.7), 59.1% (− 6.6, 95% CI − 12.4, − 0.44), and 67.5% (− 5.8, 95% CI − 7.2, − 4.4), in men and by 77.5% (− 9.9, 95% CI − 11.8, − 7.9), 74.5% (− 9.0, 95% CI − 9.6, − 8.4), 65.8% (− 7.0, 95% CI − 8.0, − 6.0), 81.7% (− 8.5, 95% CI − 10.5, − 6.5), and 72.7% (− 9.1. 95% CI − 12.2, − 5.8) in women, respectively, over a 16-year period in people with diabetes in Hong Kong. Joinpoint analysis identified greater declines in event rates of the five diabetes-related complications in the earlier one-third of study period and slowed down but remained significant until 2016. Event rates decreased for all age groups above 45 years for both sexes. There was no significant change in event rates in the group aged 20–44 years except for decline in hyperglycaemic crisis. CONCLUSIONS: The event rates of diabetes-related complications have declined substantially with no evidence of stabilization or increase in Hong Kong up to 2016. Improvements in outcome were observed for all age subgroups but not in young people with diabetes, calling for urgent action to improve quality of care to prevent complications in young people at risk. BioMed Central 2020-05-12 /pmc/articles/PMC7218631/ /pubmed/32398003 http://dx.doi.org/10.1186/s12933-020-01039-y Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Original Investigation
Wu, Hongjiang
Lau, Eric S. H.
Yang, Aimin
Ma, Ronald C. W.
Kong, Alice P. S.
Chow, Elaine
So, Wing-Yee
Chan, Juliana C. N.
Luk, Andrea O. Y.
Trends in diabetes-related complications in Hong Kong, 2001–2016: a retrospective cohort study
title Trends in diabetes-related complications in Hong Kong, 2001–2016: a retrospective cohort study
title_full Trends in diabetes-related complications in Hong Kong, 2001–2016: a retrospective cohort study
title_fullStr Trends in diabetes-related complications in Hong Kong, 2001–2016: a retrospective cohort study
title_full_unstemmed Trends in diabetes-related complications in Hong Kong, 2001–2016: a retrospective cohort study
title_short Trends in diabetes-related complications in Hong Kong, 2001–2016: a retrospective cohort study
title_sort trends in diabetes-related complications in hong kong, 2001–2016: a retrospective cohort study
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218631/
https://www.ncbi.nlm.nih.gov/pubmed/32398003
http://dx.doi.org/10.1186/s12933-020-01039-y
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