Abstract
Diabetes mellitus imposes a significant and increasing health burden on the US population. Our objective is to determine if weather is related to daily variations in emergency department (ED) visits for diabetes mellitus in Roanoke, Virginia. A time series of daily ED visits for diabetes mellitus at the Carilion Clinic in southwestern Virginia is associated with daily minimum temperature from 2010–2017. Associations between ED visits (through a 14-day lag period) and temperature are examined using generalized additive models and distributed lag nonlinear models. Heat and cold waves are identified at low and high thresholds, and ED visitation during these events is compared to prior control periods using a time-stratified case crossover approach. ED visits for diabetes exhibit a U-shaped relationship with temperature, with a higher relative risk (RR) during cold events (RR = 1.05) vs. warm events (RR = 1.02). When minimum temperatures are below freezing, ED visitation peaks starting 2 days afterward, with RRs approaching 1.04. The RR on warm days (minimum temperature > 10 °C) approaches 1.02 but peaks on the day of or the day following the elevated temperatures. Cold waves increase the odds of ED visits by up to 11% (p = 0.01), whereas heat waves exhibit no significant effect (p = 0.07). The increasing health burden linked to diabetes requires new research on environmental factors that might exacerbate related illness. When examined in the context of climate change impacts on local weather variations, these kinds of linkages between environment and disease can aid in facility staffing and public health messaging during extreme weather events.
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12 July 2022
A Correction to this paper has been published: https://doi.org/10.1007/s00484-022-02327-w
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Acknowledgements
We would like to acknowledge Bradley A. Katcher, M.S., and Jiaxing Qiu, M.S., for their assistance with aggregating the data for this project and Martha Tenzer from Carilion Clinic for her help in acquiring the ED data. We also thank Hannah Leigh for her GIS support and two anonymous reviewers for their thoughtful comments on an earlier version of this manuscript.
Funding
This research was supported in part by resources from the integrated Translational Health Research Institute of Virginia (iTHRIV), which is funded by the National Center for Advancing Translational Science of the National Institutes of Health Award UL1TR003015/ KL2TR003016. The authors have no financial or non-financial interests to disclose. Access to the data used in this study is governed by the University of Virginia (UVA) Institutional Review Board (IRB) Data Management and Security Plan, which is available from the authors upon request. After the study has ended, anonymized datasets will be made available to other researchers, with the agreement of the authors and the UVA Institutional Review Board, upon request. The research team will decide upon the types of data that may be made available to others, in compliance with the HIPAA laws of the United States of America and UVA IRB policies on data security.
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Robert Davis contributed to conceptualization, methodology, software, validation, formal analysis, investigation, data curation, writing–original draft, writing–review and editing, visualization, and supervision.
Elizabeth Driskill contributed to conceptualization, methodology, software, formal analysis, investigation, data curation, and writing–review and editing.
Wendy Novicoff: conceptualization, methodology, formal analysis, investigation, resources, data curation, writing–review and editing, supervision, and project administration.
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Davis, R.E., Driskill, E.K. & Novicoff, W.M. The Association between Weather and Emergency Department Visitation for Diabetes in Roanoke, Virginia. Int J Biometeorol 66, 1589–1597 (2022). https://doi.org/10.1007/s00484-022-02303-4
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DOI: https://doi.org/10.1007/s00484-022-02303-4