THE KID-STUDY-I - STRUCTURAL BASE-LINE CHARACTERISTICS OF THE DERAL-INSURANCE-FOR-SALARIED-EMPLOYEES-INSTITUTION (BFA) DIABETIC-PATIENTS ININPATIENT REHABILITATION
E. Haupt et al., THE KID-STUDY-I - STRUCTURAL BASE-LINE CHARACTERISTICS OF THE DERAL-INSURANCE-FOR-SALARIED-EMPLOYEES-INSTITUTION (BFA) DIABETIC-PATIENTS ININPATIENT REHABILITATION, EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY & DIABETES, 104(5), 1996, pp. 370-377
The Kissingen Diabetes Intervention Study (KIDS) evaluated 1050 diabet
ic patients of the German Federal Insurance for Salaried Employees' In
sititution (BfA) who had been admitted for inpatient rehabilitation. A
single-center, prospective, longitudinal study collected data from 19
92-1995 in respect of the baseline characteristics of the patient coho
rt, socioeconomic factors and mode of intervention at the time of admi
ssion, discharge and outcome 6 and 12 months after discharge by means
of consecutive random tests. This cohort of patients is especially int
eresting for aspects of health policy because it comprises rather youn
g diabetics In higher professional activities. 68.2% of the patients a
re type II diabetics, 28.0% are type I diabetics, 2.7% suffer from sec
ondary diabetes, and 1.1% are difficult to classify. 63.3% of the type
I diabetics and 46.6% of type II diabetics suffer from diabetic compl
ications, Comparing subgroups with a similarly long history of diabete
s, type II diabetics are involved as often as type I diabetics, but su
ffer more frequently from concomittant diseases promoting macroangiopa
thy (51.2% hypertension, 47.0% hyperlipidemia) and therefore show a hi
gher incidence of coronary heart disease and peripheral vascular disea
se. According to the HbA1, both groups are not sufficiently adjusted m
etabolically with emphasis on type HI diabetics, who furthermore revea
l a poorer constellation of blood lipids, a higher EMI but still a hig
h secretion of C peptide in spite of a mean duration of known diabetes
of 9.3 years. Of the type I diabetics tested for C peptide, surprisin
gly 69.3% revealed a minimal pancreatic insulin secretion. This fact i
s especially remarkable as their average diabetic history was 18.8 yea
rs. 47.5% of type I diabetics are not administering insulin according
to the intensified conventional therapy schedules,only 16.8% of all ty
pe II diabetics are treated with diet only Type II diabetics are much
too often treated with pre-mixed insulins of too high dosage (26.2%) o
r with oral hypoglycemics (46.2%) of which 90% were sulphonylureas and
nearly exclusively glibenclamide. Oral hypoglycemics with extrapancre
atic activity or combined therapies were not common among the patients
.