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Associations between cold spells and hospital admission and mortality due to diabetes: A nationwide multi-region time-series study in Korea

医学 置信区间 糖尿病 人口学 相对风险 百分位 泊松回归 环境卫生 人口 内科学 统计 数学 内分泌学 社会学
作者
Kyoung‐Nam Kim,Youn‐Hee Lim,Sanghyuk Bae,Jong‐Hun Kim,Seung‐Sik Hwang,Mi-Ji Kim,Jongmin Oh,Hyungryul Lim,Jonghyuk Choi,Ho‐Jang Kwon
出处
期刊:Science of The Total Environment [Elsevier]
卷期号:838: 156464-156464 被引量:18
标识
DOI:10.1016/j.scitotenv.2022.156464
摘要

Climate change is predicted to increase the frequency, intensity, and duration of extreme cold events in the mid-latitudes. However, although diabetes is one of the most critical metabolic diseases due to its high and increasing prevalence worldwide, few studies have investigated the short-term association between cold exposure and diabetes-related outcomes. The aim of this study was to investigate the associations between cold spells and their characteristics (intensity, duration, and seasonal timing) and hospital admission and mortality due to diabetes. This study used claims data from the National Health Insurance Service and cause-specific mortality data from Statistics Korea (2010–2019). Cold spells were defined as ≥2 consecutive days with a daily mean temperature lower than the region-specific 5th percentile during the cold season (November–March). Quasi-Poisson regressions combined with distributed lag models were used to assess the associations between exposures and outcomes in 16 regions across the Republic of Korea. Meta-analyses were conducted to pool the region-specific estimates. Exposure to cold spells was associated with an increased risk of hospital admission [relative risk (RR) = 1.45, 95% confidence interval (CI): 1.26, 1.66] and mortality (RR = 2.02, 95% CI: 1.37, 2.99) due to diabetes. The association between cold spells and hospital admission due to diabetes was stronger for cold spells that were more intense, longer, and occurred later during the cold season. The association between cold spells and diabetes-related mortality was stronger for more intense and longer cold spells. This study emphasizes the importance of developing effective interventions against cold spells, including education on the dangers of cold spells and early alarm systems. Further studies are needed to create real-world interventions and evaluate their effectiveness in improving diabetes-related outcomes.
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