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Nationwide Trends in Type 1 and Type 2 Diabetes in France (2010-2019): A Population-Based Study Using a Machine

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Summary

France saw a rise in type 2 diabetes prevalence from 2010-2019, while type 1 remained stable. The study highlights underused specialist care and the need for improved surveillance strategies for diabetes management.

Keywords:
EpidemiologyFranceHealth outcomesMachine learning algorithmType 1 diabetesType 2 diabetes

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Services Research

Background:

  • Diabetes is a growing public health concern in France, with limited national data differentiating type 1 and type 2 diabetes and insulin usage.
  • This study addresses the need for comprehensive epidemiological data on diabetes in France.

Purpose of the Study:

  • To describe trends in the epidemiology, care pathways, and health outcomes of adults with type 1 or type 2 diabetes in France from 2010 to 2019.
  • To analyze trends in individuals treated with or without insulin, utilizing a predictive classification algorithm for accurate type distinction.

Main Methods:

  • A 10-year retrospective population-based cohort study using a one-tenth sample of the French national healthcare database (Système National des données de Santé).
  • Inclusion of adults (≥18 years) affiliated with the general insurance scheme.
  • Application of a machine learning algorithm to classify diabetes type and assessment of annual trends in prevalence, incidence, comorbidities, treatments, care, complications, and mortality.

Main Results:

  • In 2019, 3.5% had type 1 and 96.5% had type 2 diabetes, with type 2 prevalence increasing from 6.2% to 8.0% (2010-2019).
  • High and increasing comorbidity rates were observed in insulin-treated type 2 diabetes patients.
  • 15.3% of insulin-treated type 2 diabetes patients experienced complication-related hospitalizations in 2019; specialist consultations were underused, particularly for type 2 diabetes.
  • Mortality in type 1 diabetes declined (2.6% to 1.5%), with an increased mean age at death.

Conclusions:

  • The study provides updated national insights into diabetes epidemiology and outcomes in France.
  • There is a critical need to enhance access to specialized diabetes care and strengthen long-term surveillance strategies.