Endocrine Abstracts

JOINT2104

Background: The Bulgarian healthcare system requires individual compulsory health insurance administered by the National Health Insurance Fund (NHIF), operating with the health data of 2.75 million Bulgarian women. The Bulgarian Diabetes Register (BDR) collected all pseudonymized NHIF electronic health records of patients with diabetes mellitus type 1 or type 2 (T1DM or T2DM), with the latest dataset being from 2018 (1). BDR includes outpatient NHIF records from all primary care providers and specialists in secondary care nationwide for every visit of a patient suffering from DM.

Methods: The available data about diabetic patients with Turner syndrome (TS) (ICD-10 Q96, ORPHA:881) from the BDR were extracted and analyzed. The collected information included age, type of diabetes, diabetes complications, treatment, concomitant diseases, and a number of medical consultations yearly.

Results: A total of 19 diabetic patients (median 40 [13-69] years) with TS have been found in the BDR database. 84.2% of patients were with DMT2, while 15.8% were with DMT1. Diabetic neuropathy was found in 7 (36.8%) of the patients. The TS patients showed significant co-morbidity and a high number of consultations with general practitioners and/or clinical specialists yearly - an average of 14 (2-29) in 2018.

Conclusions: The lower-than-expected prevalence of diabetic TS patients in the BDR might result from TS or DM underdiagnosis. Diabetic TS patients have a high prevalence of complications and co-morbidities and require high healthcare resources. More efforts should be made by the public health system in the country to ensure the proper diagnosis of TS. Furthermore, regular estimation of carbohydrate metabolism in TS patients is paramount for the early diagnosis of DM in the affected women and the prevention of complications and high medical costs.

References: 1. Krastev E, Markov E, Abanos S, Krasteva R, Tcharaktchiev D. Mapping the Bulgarian Diabetes Register to OMOP CDM: Application Results. Stud Health Technol Inform. 2024;313:28-33.