Exp Clin Endocrinol Diabetes 2020; 128(05): 325-331
DOI: 10.1055/a-0741-6801
Article
© Georg Thieme Verlag KG Stuttgart · New York

Inpatient Rehabilitation for Children and Adolescents With Diabetes in Germany Between 2006 and 2013

Descriptive study based on data from the German Statutory Pension Insurance Scheme
Marie Auzanneau
1   Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
2   German Center for Diabetes Research (DZD), Neuherberg, Germany
,
Barbara Bohn
1   Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
2   German Center for Diabetes Research (DZD), Neuherberg, Germany
,
Ralf Schiel
3   MEDIGREIF Inselklinik Heringsdorf GmbH, Clinic for Diabetes and Metabolic Diseases, Ostseebad Heringsdorf, Germany
,
Rainer Stachow
4   Rehabilitation Hospital for Children and Adolescents Sylt, Sylt, Germany
,
Sibylle Koch
5   Rehabilitation Centre for Chronic Diseases for Children, Adolescents and Parents, Clinic Gaißach, Gaißach, Germany
,
Thomas Hermann
6   Rehabilitation Clinic Prinzregent Luitpold, Scheidegg, Germany
,
Reinhard W. Holl
1   Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
2   German Center for Diabetes Research (DZD), Neuherberg, Germany
› Author Affiliations
Funding This analysis was supported by the German Center for Diabetes Research (DZD), by the German Diabetes Association (DDG), and by the Association of Diabetic Children and Adolescents (BdKJ).
Further Information

Publication History

received  20 May 2018
revised  +31 August 2018

accepted  13 September 2018

Publication Date:
02 October 2018 (online)

Abstract

Introduction In Germany, inpatient rehabilitation is a well-established additive option in the therapeutic concept for children and adolescents with diabetes. However, its contribution in pediatric diabetes care is not known exactly. Our objective was to analyze inpatient rehabilitation in pediatric diabetes over eight years in Germany.

Methods We requested secondary data from the German Statutory Pension Insurance Scheme to evaluate all completed inpatient rehabilitations for children and adolescents with diabetes (ICD-code E10-14) reimbursed by this institution between 2006 and 2013. For each type of diabetes, we analyzed the distribution of admissions by year, age-group, sex, nationality, and other documented diagnoses. All analyses were conducted via remote computing with IBM SPSS Version 24.

Results Between 2006 and 2013, 5,403 admissions to inpatient rehabilitation for 4,746 children and adolescents with diabetes were documented. For type 1 diabetes (T1D; 88.5% of admissions), the number of yearly admissions increased from 458 in 2006 to 688 in 2013 (p=0.013), especially for age-group>5-10. The increase for type 2 diabetes (T2D) was not significant. Admissions were more frequent for girls (53.6%, p≤0.001), age>10-15 years (42.8%, p=0.001), and German nationality (98.5%). Obesity (T1D: 11.1%; T2D: 87.9%) and mental disorders (T1D: 11.6%; T2D: 27.4%) were the most frequent documented diagnoses in addition to diabetes.

Conclusion This study provides a comprehensive overview of inpatient rehabilitation for children and adolescents with diabetes over many years in Germany. Until 2013, inpatient rehabilitation remained important in pediatric diabetes care, especially for children with mental disorders or obesity.

Supplementary Material

 
  • References

  • 1 Lange K, Swift P, Pankowska E. et al. ISPAD Clinical Practice Consensus Guidelines 2014. Diabetes education in children and adolescents. Pediatr Diabetes 2014; 15: 77-85
  • 2 Martin D, Lange K, Sima A. et al. Recommendations for age-appropriate education of children and adolescents with diabetes and their parents in the European Union. Pediatr Diabetes 2012; 13 (Suppl. 16) 20-28
  • 3 Stachow R, Schiel R, Koch S. et al. Effects of inpatient rehabilitation on children and adolescents with type 1 diabetes. Multicentre DPV-Wiss analysis. Monatsschr Kinderheilkd 2013; 8: 727-734
  • 4 Fröhlich C, Hermann T, Koch S. et al. Indikationen für eine stationäre Rehabilitation von Kindern und Jugendlichen mit Typ-1-Diabetes – eine bundesweite „DPV-Wiss“-Analyse. Diabetol Stoffwechs 2008; 53: 256-263
  • 5 Bundesarbeitsgemeinschaft für Rehabilitation (BAR). Gemeinsames Rahmenkonzept [online publication], 2008. Available from https://www.bar-frankfurt.de/fileadmin/dateiliste/publikationen/arbeitsmaterialien/downloads/Gemeinsames_Rahmenkonzept.pdf. Accessed 26 march 2018
  • 6 Barone MT, Vivolo MA, Madden PB. Are diabetes camps effective?. Diabetes Res Clin Pract 2016; 114: 15-22
  • 7 Neu A, Bürger-Büsing J, Danne T. et al. Diagnosis, therapy and follow-up of diabetes mellitus in children and adolescents [German]. Diabetol Stoffwechs 2016; 35-116
  • 8 Förderverein Kinder- und Jugendlichenrehabilitation in Österreich. Available from https://www.foerderverein-kinderreha.at/geschichte/Accessed 29 August 2018
  • 9 Sperl W. Rehabilitation von Kindern und Jugendlichen in Österreich. Ein Blick zurück und nach vorne. Paediatr Paedoleog 2017; 52: 256-263
  • 10 Schiel R, Stachow R, Fröhlich C. et al Psychosocial Characteristics of Children and Adolescents with Type 1 Diabetes Mellitus Admitted to an In-Patient Rehabilitation Procedure – A German-Wide “DPV-Wiss”-Analysis [German]. Diabetol Stoffwechs 2010; 5: 104-109
  • 11 Schiel R, Perenthaler T, Müller S. et al. Rehabilitation bei Kindern und Jugendlichen mit Diabetes mellitus: "Was hat sich in den letzten 12 Jahren verändert?". Präv Gesundheitsf 2017; 12: 232-232
  • 12 Statistisches Bundesamt (Destatis). Ergebnisse auf Grundlage des Zensus 2011 (09.05.2011). 2011; Available at https://www.statistik-bw.de/Statistik-Portal/de_jb01_z2.asp. Accessed 16 August 2017
  • 13 Rosenbauer J, Bächle C, Stahl A. et al. Prevalence of type 1 diabetes mellitus in children and adolescents in Germany [German]. Diabetologia 2012; 55 S1 S369 (Abstract)
  • 14 Pulgaron ER. Childhood obesity: a review of increased risk for physical and psychological comorbidities. Clin Ther 2013; 35: A18-A32
  • 15 Holl RW, Grabert M. “Versorgung von Kindern und Jugendlichen mit Diabetes” in Deutsche Gesundheitsbericht. Diabetes 2015. Deutsche Diabetes Gesellschaft (DDG) und diabetesDE p.128–138
  • 16 Patterson CC, Dahlquist GG, Gyurus E. et al. Incidence trends for childhood type 1 diabetes in Europe during 1989-2003 and predicted new cases 2005-20: A multicentre prospective registration study. Lancet 2009; 373: 2027-2033
  • 17 Patterson CC, Gyurus E, Rosenbauer J. et al. Trends in childhood type 1 diabetes incidence in Europe during 1989-2008: Evidence of non-uniformity over time in rates of increase. Diabetologia 2012; 55: 2142-2147
  • 18 Deutsche Rentenversicherung Bund. Reha-Bericht 2018. Die medizinische und berufliche Rehabilitation der Rentenversicherung im Licht der Statistik p. 22
  • 19 Bohn B, Schwandt A, Ihle P. et al. Hospital admission in children and adolescents with or without type 1 diabetes from Germany: An analysis of statutory health insurance data on 12 million subjects. Pediatr Diabetes 2018; 19: 721-726
  • 20 Jürgensen M, Großmann N, Thyen U. “I would not even think of applying!” – Barriers to Claiming Benefits for Rehabilitation Services for Children and Adolescents from Families’ Perspectives [German]. RehabilitatioN 2017; 56: 109–118
  • 21 Statistische Ämter des Bundes und der Länder. Bevölkerung nach Migrationsstatus regional 2011 Available from https://www.destatis.de/DE/Publikationen/Thematisch/Bevoelkerung/MigrationIntegration/BevoelkerungMigrationsstatus.html. Accessed 22 February 2018
  • 22 Maahs DM, West NA, Lawrence JM. et al. Epidemiology of type 1 diabetes. Endocrinol Metab Clin North Am 2010; 39: 481-497
  • 23 Mayer-Davis EJ, Lawrence JM, Dabelea D. et al. Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012. N Engl J Med 2017; 376: 1419-1429
  • 24 Bruns W. 50 Jahre DDG! Die Geschichte der Diabetologie in der DDR. Deutsche Diabetes Gesellschaft 2014; p.68-79
  • 25 Korzilius H. Kinder- und Jugendrehabilitation. Sinkende Antragszahlen. Dtsch Arztebl 2017; Jg 114: 1713
  • 26 Holl RW, Prinz N. "Versorgung von Kindern und Jugendlichen mit Diabetes", in Deutscher Gesundheitsbericht, Diabetes 2016. Deutsche Diabetes Gesellschaft (DDG) und diabetesDE : p. 124–135
  • 27 DuBose SN, Hermann JM, Tamborlane WV. et al. Obesity in youth with type 1 diabetes in Germany, Austria, and the United States. J Pediatr 2015; 167: 627-632
  • 28 Schienkiewitz A, Brettschneider AK, Damerow S. et al . Overweight and obesity among children and adolescents in Germany. Results of the cross-sectional KiGGS Wave 2 study and trends. . Journal of Health Monitoring 2018; 3: 15-22
  • 29 Holling H, Schlack R, Petermann F. et al. Psychopathological problems and psychosocial impairment in children and adolescents aged 3-17 years in the German population: Prevalence and time trends at two measurement points (2003-2006 and 2009-2012): Results of the KiGGS study: first follow-up (KiGGS Wave 1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014; 57: 807-819
  • 30 Ueberschär I. Begutachtung von Kindern und Jugendlichen. Kinder- und Jugendlichenrehabilitation. Med Sachverstand 2016; 5: 208
  • 31 Schiel R, Stachow R, Hermann T. et al Rehabilitation in Germany 2004-2016 A Multicenter Analysis Over a Period of 13 Years in Children and Adolescents with Diabetes Mellitus. . Exp Clin Endocrinol Diabetes 2018 2018; DOI: 10.1055/a-0594-9311. [Epub ahead of print]