One third of patients with diabetes in Austria found to discontinue treatment

A research team led by the Complexity Science Hub Vienna and the Medical University of Vienna has analyzed the prevalence of type 2 diabetes in Austria for the first time. In addition to identifying clear regional differences, a previously unknown figure came to light: one in three people suddenly stop treatment and go without medication and/or medical check-ups for at least a year. And, as the study also showed, this group had a higher mortality rate than patients with diabetes who regularly access the care available to them. The results have been published in Scientific Reports.

Until now, data on the prevalence of diabetes in Austria had been based on estimates or surveys. But now, the first ever nationwide scientific study on the incidence of diabetes has pinpointed the exact number of patients who received medication (antihyperglycemic) and/or underwent medical monitoring of blood glucose levels (HbA1c) between 2012 and 2017. The process brought to light a group whose size was previously unknown: of the 746,184 patients analyzed, some 268,680—more women (140,960) than men—discontinued treatment and/or monitoring of the disease for at least one year. For this group, the researchers were also able to demonstrate a significantly higher mortality rate.

"Although neither the cause of mortality among members of this subgroup is known, nor has a causal link between discontinued treatment and mortality been proven, from a clinical perspective we cannot rule out some kind of connection," principal investigator Alexandra Kautzky-Willer from MedUni Vienna's Department of Medicine III. Especially among patients with diabetes, a willingness to undergo treatment has a key role to play if they are to avoid serious complications such as cardiovascular disease, kidney failure, loss of sight or neuropathy to the fullest extent possible.

Analysis of data set covering services provided

The researchers obtained the study results by analyzing the nationwide data on services rendered, which is collected by the Dachverband der Sozialversicherungsträger, the umbrella organization of social insurance institutions in Austria.

"We developed a new epidemiological diabetes progression model to enable us to identify patients with diabetes who have stopped or temporarily interrupted their treatment," noted principal investigator Peter Klimek from the Complexity Science Hub Vienna.

New diabetes clusters identified in Western Austria

In addition to revealing trends relating to the incidence of diabetes, this new procedure also uncovered considerable regional differences in Austria, which were broken down at a district level for the first time. The incidence map confirms the east-west divide identified in previous studies—showing that the highest rates were found in north-eastern Austria and in Bruck/Leitha in particular—but also reveals new diabetes clusters in the west (districts of Imst and Schwaz as well as Innsbruck Stadt).

"As much attention needs to be paid to these new clusters as the large number of patients who break off their diabetes treatment," said Alexandra Kautzky-Willer in conclusion. The reasons why patients stop or temporarily interrupt therapy are to be researched in further studies so that targeted countermeasures can be taken.