Fewer people were hospitalized for coronary artery disease, heart attack or diabetic foot syndrome in 2020 than in previous years. However, the number of people with diabetes who were admitted for a lower limb amputation (above the ankle) increased significantly. This is shown by a study by the DZD and DDZ based on data from a German statutory health insurance company. The results of the study have now been published in the European Journal of Epidemiology.
People with diabetes have been seeking medical care less often during the COVID-19 pandemic, which several studies indicate. Reasons for this may be the pandemic-related restrictions of medical services and fear of COVID-19 infection. Researchers from the DDZ and DZD have analyzed the hospitalization and mortality rates of people with and without diabetes in Germany during the COVID-19 pandemic year 2020 compared to 2017-2019. For this purpose, they evaluated the data from a German statutory health insurance company, with which 3.2 million people are insured.
The research team estimated age-sex standardized mortality rates, rates for all-cause hospitalizations, and hospitalization rates due to coronary artery disease, acute myocardial infarction, stroke, diabetic foot syndrome, and above-ankle and below-ankle amputations in people with and without diabetes. Expected rates for 2020 were predicted using Poisson regression based on results from 2017-2019 and compared to observed rates. It was found that the hospitalization rate for lower limb amputations was significantly higher in people with diabetes. However, the hospitalization rate overall and due to coronary heart disease, a heart attack or diabetic foot syndrome was significantly lower. In contrast, mortality and the hospitalization rate for a stroke remained almost unchanged.
The authors of the study emphasize that the increase in hospitalizations due to lower limb amputations in people with diabetes, while the numbers of hospitalizations for diabetic foot syndrome are decreasing, needs special attention.
Narres, M., Claessen, H., Kvitkina, T. … Icks, A. et al.: Hospitalisation rate and mortality among people with and without diabetes during the COVID-19 pandemic year 2020. Eur J Epidemiol 37, 587–590 (2022). doi.org/10.1007/s10654-022-00865-6