The Medical and Economic Impacts of Familial Aggregation of Type 2 Diabetes Mellitus (T2dm) in Taiwan

The etiology of Diabetes Mellitus (DM) is still imperfectly understood. The prognoses of type 2 DM (T2DM) can be attributable to the interactions of genetics, medical care, and environmental factors. Literatures have demonstrated that family disease history plays an important role in the risk of T2DM occurrence. However, the medical seeking behavior and prognosis affected by family history of T2DM is still roomy for further investigations.This study constructed a nationwide kinship relationship spanning 2-5 generations among Taiwanese population during 1997-2008 by using data from the National Health Insurance Research Database. Approximately, 4 million family trees were constructed from 23,000,574 Taiwanese residents recorded during the study period, the base population for calculating kinship relationship in this study. Taiwanese who were diagnosed as ICD9-CM-codes (ICD: 250.x0 or250.x2) and with three consecutive T2DM related prescriptions during 1997-2008 are defined as T2DM cases in this study. A follow-up will be made until the end of 2012 for the prognoses and disease burden. A Cox proportional hazard model was used to calculate the risk ratio of T2DM prognoses of an individual with different degree relatives affected by T2DM. The frequency and length of hospitalization and total medical expenses will be calculated by generalized linear models among different familial aggregation profile.The specific aims of this project are: 1) To estimate the risk of T2DM occurrence of individuals with different profile of family T2DM disease history, including parent, siblings, first degree relatives, and second degree relatives; 2) To investigate the selected T2DM related prognoses, including major vascular and microvascular diseases, of affected individuals with different family T2DM disease profile; 3) To calculate the disease burden, including hospitalization and medical expenses, of affected individuals with different family T2DM disease profile.The study suggests a significant family aggregation of T2DM occurrence of which provides identifications of high risk group and early intervention management strategy. Aggressive treatments and predicting prognoses of T2DM can be pre-planned to reduce disease burdens based on the risk level and classification in the future.

Project ID:PF10708-0824
External Project ID:MOST107-2410-H182-017