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Regional differences in type 2 diabetes treatment and outcomes in Germany—An analysis of the German DPV and DIVE registries
Author(s) -
Hartmann Bettina,
Bramlage Peter,
Lanzinger Stefanie,
Danne Thomas,
Hummel Michael,
Kaltheuner Matthias,
Raddatz Dirk,
Rathmann Wolfgang,
Reuter HansMartin,
Seufert Jochen,
Holl Reinhard W.
Publication year - 2018
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3049
Subject(s) - german , medicine , type 2 diabetes , diabetes treatment , diabetes mellitus , intensive care medicine , geography , endocrinology , archaeology
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 HbA 1c (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.