TY - JOUR
T1 - Associations between cold spells and hospital admission and mortality due to diabetes
T2 - A nationwide multi-region time-series study in Korea
AU - Kim, Kyoung Nam
AU - Lim, Youn Hee
AU - Bae, Sanghyuk
AU - Kim, Jong Hun
AU - Hwang, Seung Sik
AU - Kim, Mi Ji
AU - Oh, Jongmin
AU - Lim, Hyungryul
AU - Choi, Jonghyuk
AU - Kwon, Ho Jang
N1 - Funding Information:
This work was supported by the Research Program funded by the Korea Disease Control and Prevention Agency (fund code 2021-12-304 ).
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/9/10
Y1 - 2022/9/10
N2 - Background: 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. Objective: 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. Methods: 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. Results: 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. Conclusion: 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.
AB - Background: 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. Objective: 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. Methods: 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. Results: 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. Conclusion: 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.
KW - Cold duration
KW - Cold intensity
KW - Cold spell characteristics
KW - Diabetes-related morbidity
KW - Diabetes-related mortality
KW - Seasonal timing
UR - http://www.scopus.com/inward/record.url?scp=85131433937&partnerID=8YFLogxK
U2 - 10.1016/j.scitotenv.2022.156464
DO - 10.1016/j.scitotenv.2022.156464
M3 - Article
C2 - 35660607
AN - SCOPUS:85131433937
SN - 0048-9697
VL - 838
JO - Science of the Total Environment
JF - Science of the Total Environment
M1 - 156464
ER -
