Abstract
This study evaluates the prevalence of diabetes mellitus (DM) in Pisa (Tuscany, Italy) using four independent data sources. The main source, represented by computerized prescriptions for anti-diabetic agents collected over a 4-month period, was validated using three secondary sources: (a) the list of diabetic patients who receive material of self-care from the National Health Service; (b) the clinical records of diabetic patients obtained from a random sample of family doctors; (c) the clinical records of diabetic patients attending our outpatient clinic. The main source provided 3806 patients, and 697 patients were added from the secondary sources, thus identifying a total number of 4503. The prevalence of known DM in the “Pisa area” exclusively reckoned by the main source, was 2.01%, and the prevalence corrected by the addition of the various sources resulted in 2.4%. The capture-recapture method showed a completeness of ascertainment of the survey of 90.1%, and thus an estimated prevalence of known diabetes of 2.64%. Of these, 141 patients had insulin-dependent diabetes mellitus (IDDM) corresponding to 3.2% of identified diabetic subjects (prevalence 0.07% inhabitants); 4362 patients had non-insulin-dependent diabetes mellitus (NIDDM), 96.8% of identified diabetic subjects (prevalence 2.36%). Of patients with NIDDM 10.5% was treated by diet, 65% with oral hypoglycaemic agents (OHA), 23% with insulin and 1.5% with insulin plus OHA. This study shows that the method used in this survey is suitable for epidemiological studies because it does not demand the cooperation of the diabetic patients, is addressed to the entire diabetic population without age discrimination and singles out the diabetic population in a very reliable way.
Similar content being viewed by others
References
Morsiani M, Beretta P, Pareschi PL, Manservici D, Bottoni L, Long-term results in preventive medicine for type II diabetes. Acta Diabetol Lat 22:191–202, 1985
Savagnone E, Capello F, Caruso V, Galvano L, Mangione G, Nicolosi R, Raimondo FC, Schirò V, Spicolo L, Spinelli M, Sunseri V, Garvano F, Indagine epidemiologica sul diabete mellito sulla popolazione di Pantelleria (Sicilia). G Ital Diabetol 5: 71–80, 1985
Gallus G, Garancini P, Epidemiology of diabetes mellitus in Italy. MGDS Bulletin IV:6–8, 1991
Vaccaro O, Imperatore G, Ferrara A, Palombino R, Riccardi G, Epidemiology of diabetes mellitus in southern Italy: a casefinding method based on drug prescriptions. J Clin Epidemiol 45:835–839, 1992
Erle G, Gennaro R, Lara L, Basso A, Mingardi R, Piva I, Studio epidemiologico del diabete mellito nell'U.S.L. di Vicenza. Proposta di un nuovo metodo di indagine. G Ital Diabetol 8:23–29, 1988
Muggeo M, Girotto S, Bagnani M, Battagia A, Bonara E, Bressan F, Zenere M, Epidemiological survey on diabetes mellitus in Verona, Italy (Abstracts 117). European Diabetes Epidemiology Study Group, 24th scientific annual meeting, Venezia, 1989
Bruno G, Bargero G, Vuolo A, Pisu E, Pagano G, A population-based prevalence survey of known diabetes mellitus in northern Italy based upon multiple independent sources of ascertainment. Diabetologia 35:1–6, 1992
Garancini P, Gallus G, Calori G, Formingaro F, Micossi P, Incidence and prevalence rates of diabetes mellitus in Italy from routine data: a methodological assessment. Eur J Epidemiol VII:55–63, 1991
Pompei A, Mortola V, Brunetti F, Campodonico C, Indagine epidemiologica sul diabete nella popolazione di Camogli. G Ital Diabetol 2:83–91, 1982
Muntoni S, Pintus F, Mascia P, Pintus P, Cabiddu G, Tronci P, Ganga E, Indagine epidemiologica sul diabete note e ignorato in Sardegna. G Ital Diabetol 8:311–316, 1988
Forrest RD, Diabetes mellitus in north Sweden: prevalence: assessed from prescriptions for anti-diabetic agents. J Int Med 228:267–273, 1990
Wittes JT, Colton T, Side VW, Capture-recapture methods for assessing the completeness of case ascertainment when using multiple information sources. J Chronic Dis 27:25–36, 1974
Melton LJ, Palumbo PJ, Chu C, Incidence of diabetes mellitus by clinical type. Diabetes Care 6:75–79, 1983
Papoz L, Recent trends in the epidemiology of diabetes mellitus in European and Mediterranean countries. Acta Diabetol 28: 140–142, 1991
Zimmet P, Finch C, Dowse G, The epidemiology of diabetes mellitus. In: Alberti KGMM, Krall LP (eds) The diabetes annual 15. Elsevier, Amsterdam, 1990
Harris MI, Hadden WC, Knowler WC, Bennet PH, Prevalence of diabetes and impaired glucose levels in U.S. population aged 20–74 yr. Diabetes 36:523–534, 1987
Barrett-Connor EL, The prevalence of diabetes mellitus in an adult community as determined by history or fasting hyperglycemia. Am J Epidemiol 111:705–712, 1980
Croxson SCM, Burden AC, Bodington M, Botha JL, The prevalence of diabetes in elderly people. Diabetic Med 8:28–31, 1991
Wong JSK, Pearson DWM, Murchison L, Williams MJ, The prevalence of diabetes mellitus in north east Scotland. Diabetic Med 8 (Suppl 1):28, 1991
Fabietti PG, Giovannini G, Iorio M, Santeusanio F, Brunetti P, Indagine epidemiologica nella regione Umbria sul diabete mellito. Il Diabete 4 (Suppl 1):17–20, 1992
Pagano G, Bruno G, Epidemiology and pathogenesis of diabetes in elderly. Arch Gerontol Geriatr 13 (Suppl 2):209–218, 1991
Fleegler FM, Rogers KD, Drash A, Rosenbloom AL, Travis LB, Court JM, Age, sex, and season of onset of juvenile diabetes in different geographic areas. Pediatrics 63:374–379, 1979
Christau B, Kromann H, Andersen O, Christy M, Buschard K, Arnung K, Kristensen H, Peitersen B, Steirnud J, Nerup J, Incidence, seasonal and geographical pattern of juvenile onset insulin dependent diabetes mellitus in Denmark. Diabetologia 13:281–284, 1977
Kròlewski A, Warram J, Christlieb A, Onset, course, complications and prognosis of diabetes mellitus. In: Marble A et al. (eds) Joslin's diabetes mellitus. Lea and Febiger, Philadelphia, pp 251–278, 1985
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Di Cianni, G., Benzi, L., Giannarelli, R. et al. A prevalence study of known diabetes mellitus in Tuscany assessed from pharmaceutical prescriptions and other independent sources. Acta Diabetol 31, 87–90 (1994). https://doi.org/10.1007/BF00570541
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00570541