THE KID-STUDY-I - STRUCTURAL BASE-LINE CHARACTERISTICS OF THE DERAL-INSURANCE-FOR-SALARIED-EMPLOYEES-INSTITUTION (BFA) DIABETIC-PATIENTS ININPATIENT REHABILITATION

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 .