Primary Care Diabetes最新文献

{"title":"Deprescribing of preventive medications in palliative care patients living with multiple long-term conditions in their final 12 months of life: A retrospective cohort Clinical Practice Research Datalink study","authors":"Elizabeth Hickman ,&nbsp;Clare Gillies ,&nbsp;Kamlesh Khunti ,&nbsp;Samuel Seidu","doi":"10.1016/j.pcd.2025.03.005","DOIUrl":"10.1016/j.pcd.2025.03.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the patterns and trends associated with deprescribing of preventive medications in the final 12 months of life in palliative patients living with multiple long-term conditions using the Clinical Practice Research Datalink.</div></div><div><h3>Participants</h3><div>All patients with a medcode/readcode for palliative care assigned to their profile with a medcode/readcode for a cardiometabolic condition. All patients were on therapeutic interventions for their condition/s.</div></div><div><h3>Primary and secondary outcome measures</h3><div>the trends of medication deprescribing of preventive medications in the final twelve months of life in those known to be end-of-life.</div></div><div><h3>Results</h3><div>Preventive medication deprescribing was only observed in a very small cohort of patients. The findings were consistent across all six medication groups tested. Deprescribing was observed in a range of 2–60 patients with the most deprescribing efforts being associated with antihypertensive medications (n = 177), and antiplatelet medications (n = 70), and antihyperglycaemic medications (n = 10).</div></div><div><h3>Conclusions</h3><div>Deprescribing practices are not commonplace in patients with a known end-of-life designation with low patient numbers (range 2–60) undergoing the intervention, thus potentially reducing the quality of life in these patients final twelve months of life.</div></div><div><h3>CPRD ID</h3><div>#22_002253, linkage request 2914</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 288-295"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of depression and anxiety among pregnant women with gestational diabetes mellitus in South Asia","authors":"Saite Hemavathy ,&nbsp;Mohan Deepa ,&nbsp;Ram Uma ,&nbsp;Ramesh Gowri ,&nbsp;Rajendra Pradeepa ,&nbsp;Wesley Hannah ,&nbsp;Chockalingam Shivashri ,&nbsp;Radhakrishnan Subashini ,&nbsp;Duraivel Mohaneswari ,&nbsp;Yonas Ghebremichael-Weldeselassie ,&nbsp;Ponnusamy Saravanan ,&nbsp;Viswanathan Mohan ,&nbsp;Ranjit Mohan Anjana","doi":"10.1016/j.pcd.2025.03.002","DOIUrl":"10.1016/j.pcd.2025.03.002","url":null,"abstract":"<div><h3>Aim</h3><div>To determine the prevalence of depression and anxiety during pregnancy and its association with GDM.</div></div><div><h3>Methods</h3><div>A total of 2141 pregnant women were recruited before 16 weeks of gestation (mean gestational age: 10.5 ± 2.9 weeks) from the STRiDE study in south India. Early GDM (eGDM) was detected in the first trimester, and late GDM (lGDM) during 24–28 weeks, both diagnosed using IADPSG criteria. Depression and anxiety were assessed using the PHQ-9 (score≥10) and GAD-7 (score≥7) scales, respectively.</div></div><div><h3>Results</h3><div>Overall, 14.9 % had depression and 17.5 % had anxiety in early pregnancy. eGDM was diagnosed in 474 (20.4 %) and lGDM in 321 (19.3 %) women. Women with eGDM had higher prevalence of depression (20.9 %) than those with lGDM (15.6 %, p = 0.06) and those without GDM (13.3 %, p &lt; 0.01). Anxiety was also higher in eGDM (21.1 %) compared to IGDM (15.3 %, p &lt; 0.05) and women without GDM (16.6 %, p &lt; 0.05). eGDM was significantly associated with depression (aOR=1.84, 95 % CI:1.37–2.47, p &lt; 0.001) and anxiety (aOR=1.36, 95 % CI:1.03–1.79, p = 0.03) after adjusting for age, systolic blood pressure, BMI, socioeconomic status, and family history of diabetes.</div></div><div><h3>Conclusion</h3><div>Women with early GDM have a higher prevalence of depression and anxiety compared to those with late GDM and women without GDM. Early and universal screening for GDM should be done and its association with mental health wellbeing should be explored and supported.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 322-328"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporating sedentary behaviour for identifying risk of type 2 diabetes: Implications for primary care","authors":"Francesc Alòs ,&nbsp;Anna Puig-Ribera ,&nbsp;Judit Bort-Roig ,&nbsp;Emilia Chirveches-Pérez ,&nbsp;Anna Berenguera ,&nbsp;Carlos Martin-Cantera ,&nbsp;Ma Àngels Colomer","doi":"10.1016/j.pcd.2025.03.001","DOIUrl":"10.1016/j.pcd.2025.03.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Type 2 diabetes mellitus (DM2) is one of the main public health threats of the 21st century. Half of the people with DM2 worldwide are not diagnosed. The high prevalence, underdiagnosis and complications of diabetes highlight the need for identifying people at risk. Sedentary behaviour (SB) or prolonged sitting is a major predisposing risk factor for the increasing prevalence of DM2. Incorporating SB measures into clinical practice systems for identifying individuals more likely to have DM2 should be considered.</div></div><div><h3>Objective</h3><div>To develop a mathematical model for clinical practice that allows early identification of office employees at risk of DM2 based on objective data on SB.</div></div><div><h3>Methods</h3><div>A cross-sectional study with a cross-validation procedure was conducted. Anthropometric variables (sex, age and body mass index, BMI), sleep time (hours; measured by ActivPAL3M devices), and SB patterns (sedentary breaks and time spent in sedentary bouts of four different lengths; measured by ActivPAL3M devices) of two groups of office employees (adults with and without diabetes) were compared. Eighty-one participants had DM2 and 132 had normal glucose metabolism (NGM). The risk of having DM2 was modelled using generalized linear models (GLM), particularly a logistic regression model.</div></div><div><h3>Results</h3><div>Five non-invasive clinical variables that were significantly correlated to DM2 with no collinearity were included in the mathematical model: sex, age, BMI, sleep time (hours) and sedentary breaks &lt; 20 minutes (number/day). The validated model correctly classified 94.58 % of the participants with DM2 and 97.99 % of participants with NGM. The sensitivity was 94.58 % and the specificity 97.99 %. Additionally, the model allowed the design of a preventive tool to recommend changes in the SB pattern based on the participant’s anthropometric profile, aiming to reduce the risk of developing DM2 in office employees.</div></div><div><h3>Conclusion</h3><div>This study highlights the importance of incorporating SB measures in primary care clinical practice. Our mathematical model suggests that including SB could enhance the early identification of adults at risk of DM2. Further research is needed to validate these findings and assess the practical application of the mathematical model in clinical practice.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 214-220"},"PeriodicalIF":2.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Culturally appropriate care for indigenous people with type 2 diabetes mellitus (T2DM)- a scoping review","authors":"K. Kovanur Sampath ,&nbsp;Yan Ann-Rong ,&nbsp;S. Brownie","doi":"10.1016/j.pcd.2025.02.008","DOIUrl":"10.1016/j.pcd.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Indigenous populations are disproportionately affected by type 2 diabetes mellitus (T2DM) and associated complications. However, the lack of cultural integration with the current management approach does not suit indigenous communities. Therefore, the aim of this scoping review is to map the existing literature related to culturally appropriate care and to establish the key characteristics of a culturally appropriate care provided to indigenous communities with T2D.</div></div><div><h3>Methods</h3><div>Electronic databases such as PubMed, CINAHL, Science Direct and Cochrane Library were searched from inception to September 2024. Identified records from database literature searches were imported into Covidence®. Two independent reviewers screened and extracted the data. Studies included Indigenous people with T2D, culturally appropriate care, measurable outcomes, and any design. The research team collectively created a data charting table/form to standardize data collection that included PICO elements and PROGRESS-Plus factors for equity lens. A narrative synthesis was used to summarize the evidence.</div></div><div><h3>Results</h3><div>Seven studies met our eligibility criteria and were included in this scoping review. Overall, there is clear evidence that a culturally appropriate care results in better physiological outcomes and higher rates of adherence and engagement with a treatment plan and disease management processes. However, future studies need to gather and report on other PROGRESS factors that can cause inequity such as Religion, Education, Socioeconomic status of participants.</div></div><div><h3>Conclusion</h3><div>The findings of this review emphasise that a culturally appropriate care is crucial in improving health outcomes and engagement among Indigenous people with T2D. However, systemic barriers still exist, highlighting the need for broader structural changes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 238-245"},"PeriodicalIF":2.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board and Aims & Scopes","authors":"","doi":"10.1016/S1751-9918(25)00053-1","DOIUrl":"10.1016/S1751-9918(25)00053-1","url":null,"abstract":"","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 2","pages":"Pages ii-iii"},"PeriodicalIF":2.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent fasting versus continuous caloric restriction for glycemic control and weight loss in type 2 diabetes: A traditional review","authors":"Hairya Ajaykumar Lakhani ,&nbsp;Deepanwita Biswas ,&nbsp;Mahima Kuruvila ,&nbsp;Manisha Sai Chava ,&nbsp;Kshitij Raj ,&nbsp;Joel Thomas Varghese ,&nbsp;N.L. Swathi","doi":"10.1016/j.pcd.2025.02.006","DOIUrl":"10.1016/j.pcd.2025.02.006","url":null,"abstract":"<div><div>Type 2 Diabetes Mellitus (T2DM) represents a major global health issue, with its incidence anticipated to increase markedly in the forthcoming decades. Efficient non-pharmacological therapies, especially dietary approaches, are essential for regulating glycemic control and facilitating weight reduction. Intermittent Fasting (IF) and Continuous Caloric Restriction (CCR) are two well researched methodologies, but their relative effectiveness and enduring advantages continue to be topics of active discussion. This review systematically assesses and contrasts the impacts of intermittent fasting (IF) and continuous calorie restriction (CCR) on glycemic regulation and weight reduction in persons with type 2 diabetes mellitus (T2DM), highlighting their short-term and long-term effects, safety profiles, and adherence rates. A thorough literature analysis was performed utilizing PubMed and Google Scholar, concentrating on papers published from 2000 to 2024. The review encompassed randomized controlled trials and observational studies that investigated the effects of intermittent fasting (IF) and continuous calorie restriction (CCR) on glycemic indicators (HbA1c, fasting glucose) and body weight. IF shown substantial short-term advantages, encompassing marked decreases in HbA1c levels, fasting glucose, and body weight. Mechanistic discoveries emphasized better insulin sensitivity, augmented fat metabolism, and autophagy as key aspects. In contrast, CCR was linked to enduring metabolic enhancements, including decreased visceral fat and improved insulin sensitivity. Nevertheless, both dietary approaches demonstrated constraints.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 203-213"},"PeriodicalIF":2.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The perspectives of healthcare professionals in providing care to women with GDM in high-income nations: A qualitative systematic review","authors":"Mary-Ellen Hooper ,&nbsp;Ella Kurz ,&nbsp;Cathy Knight-Agarwal ,&nbsp;Mary-Jessimine Bushell ,&nbsp;Elyse Ladbrook ,&nbsp;Deborah Davis","doi":"10.1016/j.pcd.2024.11.005","DOIUrl":"10.1016/j.pcd.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Gestational Diabetes Mellitus (GDM) represents a growing challenge worldwide, with significant risks to both women and their babies that extend beyond the duration of the pregnancy and immediate post-partum period. Healthcare professionals (HCPs) play important roles in the screening, diagnosis, treatment and management of women with GDM.</div></div><div><h3>Methods</h3><div>For this qualitative systematic review, a comprehensive search strategy explored the electronic databases Web of Science, CINAHL, Medline, and Scopus, as well as the reference lists of the included papers, for primary studies investigating the experiences, perspectives and practices of HCPs providing care to women with GDM in high-income healthcare settings. Studies were assessed with the Crowe Critical Appraisal Tool, and findings were synthesised using the approach described by Thomas and Harden.</div></div><div><h3>Results</h3><div>This review included 33 articles - 26 qualitative and seven mixed method studies, representing ten high-income nations. The total number of HCP participants represented across the studies is 989. This figure is constituted by medical professionals (n = 226), nurses and midwives (n = 583), allied health (n = 40) and other or not numerically specified HCPs (n = 140). From 149 findings, four major themes and 10 subthemes were constructed. The four major themes are: multidisciplinary collaboration; healthcare practice; organizational factors; and working with women.</div></div><div><h3>Discussion and conclusion</h3><div>There are barriers to providing optimal care to women with GDM. Including, time and resource constraints, a lack of consensus in practice guidelines, and variable multidisciplinary collaboration. Moving forward, there needs to be a focus on more explicit guidelines, multidisciplinary collaboration, and appropriate resources to support HCPs in providing care to women to manage the short-term and longer-term risks that are associated with a pregnancy affected by GDM.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 246-260"},"PeriodicalIF":2.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Td2Ast project: A pragmatic intervention on diet and physical activity for patients with type 2 diabetes mellitus","authors":"Maria del Mar Fernandez-Alvarez ,&nbsp;Cristina Papín-Cano ,&nbsp;Shelini Surendran ,&nbsp;Ruben Martin-Payo","doi":"10.1016/j.pcd.2025.02.003","DOIUrl":"10.1016/j.pcd.2025.02.003","url":null,"abstract":"<div><h3>Aim</h3><div>The purpose of this study was to assess the efficacy of an educational intervention based on the Behavior Change Wheel (BCW) framework for individuals with type 2 diabetes mellitus (T2DM) on dietary and physical activity recommendations in a Spanish region.</div></div><div><h3>Methods</h3><div>A two-arm pragmatic randomized pilot trial was developed. The intervention consisted of a 6-month period with three components: face-to-face counseling, a phone call, and specially designed written guidelines focusing on dietary and physical activity recommendations The primary outcome was changes in dietary and physical activity recommendations. The secondary outcome, the impact of the intervention on HbA1c levels, body mass index, and the frequency of consultations to primary care.</div></div><div><h3>Results</h3><div>n<!--> <!-->=<!--> <!-->208 patients were recruited. Individuals in the intervention experienced a significative improvement in adherence to dietary recommendations (+0.52; p-value&lt;0.001), physical activity (+0.79; p-value&lt;0.001), and a decrease in HbA1c levels (0.11 %; p-value=0.04).</div></div><div><h3>Conclusion</h3><div>The 6-month intervention, designed for T2DM patients and based on the BCW model, has demonstrated effectiveness in improving adherence to healthy dietary and physical activity recommendations, as well as reducing HbA1c levels.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 270-276"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing quality of diabetes care between immigrants and non-immigrants within dimensions of marginalization: A population-based cohort study","authors":"Shadia Adekunte ,&nbsp;Yu Qing Bai ,&nbsp;Gillian L. Booth ,&nbsp;Ghazal Fazli ,&nbsp;Calvin Ke ,&nbsp;Lorraine L. Lipscombe ,&nbsp;Sarah M. Mah ,&nbsp;Laura C. Rosella ,&nbsp;Walter P. Wodchis ,&nbsp;Baiju R. Shah","doi":"10.1016/j.pcd.2025.02.007","DOIUrl":"10.1016/j.pcd.2025.02.007","url":null,"abstract":"<div><h3>Aims</h3><div>Immigrants in western countries face an increased risk of developing diabetes and have been shown to receive lower quality of diabetes care. However, it is uncertain whether this disparity in care persists when comparing immigrants and non-immigrants with similar levels of marginalization with respect to the social determinants of health.</div></div><div><h3>Methods</h3><div>Using population-based healthcare administrative data linked to immigration and neighbourhood census data, we conducted a retrospective cohort study of all people aged ≥ 40 years with diabetes in Ontario, Canada on 1 April 2019. Process measures (testing for HbA1c, LDL-cholesterol and urine albumin-creatinine ratio; eye examinations; and appropriate prescriptions) and outcome measures (achieving guideline-recommended targets for laboratory tests) over the following year were ascertained. They were compared between immigrants and non-immigrants overall and within the highest and lowest quintiles of three measures of marginalization: material deprivation, residential instability and dependency.</div></div><div><h3>Results</h3><div>There were 1,449,589 people with diabetes included in the study (22.6 % immigrants). Immigrants were less likely than non-immigrants to achieve many of the process quality indicators and were less likely to achieve both HbA1c and LDL-cholesterol targets. These findings were similar when stratified within the highest and lowest quintiles of material deprivation, residential instability and dependency.</div></div><div><h3>Conclusions</h3><div>Even within similar levels of marginalization, immigrants were less likely to achieve many quality indicators for diabetes care than non-immigrants. This finding suggests that the gap in quality of care between immigrants and non-immigrants is not simply due to differences in these social determinants of health, and highlights the intersecting impact of immigration and marginalization. However, the disparities were relatively small, so the greater issue is the overall low achievement of these quality indicators among all people with diabetes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 296-301"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of onset of chronic kidney disease in type 2 diabetes mellitus (ROCK-DM): Development and validation of a 4-variable prediction model","authors":"Jie Ming Nigel Fong ,&nbsp;Serena Low ,&nbsp;Yang Xu ,&nbsp;Pek Siang Edmund Teo ,&nbsp;Gek Hsiang Lim ,&nbsp;Huili Zheng ,&nbsp;Keven Ang ,&nbsp;Ngiap Chuan Tan ,&nbsp;Cheng Boon Poh ,&nbsp;Hui Boon Tay ,&nbsp;Allen Yan Lun Liu ,&nbsp;Choong Meng Chan ,&nbsp;Chieh Suai Tan ,&nbsp;Su Chi Lim ,&nbsp;Yong Mong Bee ,&nbsp;Jia Liang Kwek","doi":"10.1016/j.pcd.2025.02.005","DOIUrl":"10.1016/j.pcd.2025.02.005","url":null,"abstract":"<div><h3>Aims</h3><div>The aim of this study was to develop and validate a prediction model for incident chronic kidney disease (CKD) in type 2 diabetes mellitus (T2DM), defined as eGFR &lt; 60 ml/min/1.73m2 and/or urine albumin:creatinine ratio (UACR) &gt; 3 mg/mmol in ≥ 2 consecutive readings ≥ 3 months apart.</div></div><div><h3>Methods</h3><div>Model derivation was performed in the SingHealth Diabetes Registry, including patients aged ≥ 21 years diagnosed with T2DM without pre-existing CKD. External validation was performed in a single-center prospective observational cohort. Cox Proportional Hazard model was created to evaluate predictors associated with time-to-onset of incident CKD. Increasingly parsimonious models were assessed for discrimination and calibration. Models underwent external validation, benchmarking against existing models, and decision curve analysis.</div></div><div><h3>Results</h3><div>25,142 (59 %) of 42,552 patients in the derivation cohort developed CKD over a median 4.0 years (IQR 2.1–7.7) follow up. An 18-variable model, 12-variable model, and 4-variable model (including age, duration of T2DM, eGFR, and previous non-persistent albuminuria) was developed. The 4-variable model had a C-statistic of 0.78 and good calibration on plots of observed-versus-predicted risk. The 12-variable and 18-variable models performed similarly. In the external validation cohort of 2249 patients, of whom 1035 (46 %) developed incident CKD, the 4-variable model had a C-statistic of 0.87. All models had better discrimination than existing benchmarks. Decision curve analysis of the 4-variable model showed positive net benefit for any threshold probability above 16 % for 2-year and 28 % for 5-year CKD risk.</div></div><div><h3>Conclusion</h3><div>The 4-variable model for prediction of incident CKD in T2DM demonstrates good performance, predicts both eGFR and albuminuria endpoints, and is simple-to-use. This may guide personalized care, resource allocation and population health.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 312-321"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}