Diabetes epidemiology and management最新文献

{"title":"PRODIAB: Perspectives on the use of patient-reported outcome measures among diabetic patients","authors":"Nicolas Naïditch ,&nbsp;Coline Hehn ,&nbsp;Amine Ounajim ,&nbsp;Guy Fagherazzi ,&nbsp;Antonia Gasch-Illescas ,&nbsp;Ben Braithwaite ,&nbsp;Jean-François Thébaut","doi":"10.1016/j.deman.2023.100128","DOIUrl":"10.1016/j.deman.2023.100128","url":null,"abstract":"<div><p>Patient Reported Outcome Measures (PROMs) are recognized by health authorities as fundamental and can be evaluated by several questionnaires. The main complexity of evaluating PROMs in People with Diabetes (PwD), be it type 1 (PwT1D) or type 2 (PwT2D), is choosing the right tool (generic or specific) with the right constructs. This study explores the use of PROMs in PwD. The main objective was to compare generic and specific QoL PROMs in a diabetic population. The secondary objective was to assess potential overlaps of assessed constructs in the different PROMs frequently used in diabetes.</p><p>PRODIAB was an online quantitative survey conducted between January and February 2022. The scientific committee selected the following oft-used questionnaires: EuroQol 5-Dimensions 5-Level (EQ-5D-5L), Audit of Diabetes Dependent Quality of Life (ADDQOL), Treatment Burden Questionnaire (TBQ), Hospital Anxiety and-Depression Scale (HADS-A; HADS-D) and Patient-Health-Questionnaire-9 (PHQ-9). All PROMs used were validated in French.</p><p>Responses from 2,796 French PwD were analyzed. Compared to PwT2D, PwT1D reported a better general Quality of Life (QoL) on the EQ-5D-5L index (0.75 vs 0.66; <em>p</em> &lt; 0.001) and a lower specific QoL on the ADDQOL (-2.8 vs -2.5; <em>p</em> &lt; 0.001). Adjusted analysis showed that age was inversely associated with EQ-5D-5L index score (-0.11; <em>p</em> &lt; 0.001) and a positively associated with ADDQOL score (0.14; <em>p</em> &lt; 0.001). All PROMs were significantly correlated with each other and the HADS-A, HADS-D and PHQ9 (<em>r</em> 0.60 to 0.72) even more so. While principal component analyses suggested that all PROMs measured only one dimension (mental health) (eigenvalue=3.39; first dimension percentage of variance 56.5), adjusted analyses suggested that the EQ-5D-5L is not adequate for assessing the specific impact of diabetes on QoL.</p><p>Our study emphasizes the importance of identifying the constructs assessed by each PROM as well as the target population in order to choose the best-suited questionnaire type with the most appropriate constructs.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"9 ","pages":"Article 100128"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42735825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower risks of new-onset acute pancreatitis and pancreatic cancer in sodium glucose cotransporter 2 (SGLT2) inhibitors compared to dipeptidyl peptidase-4 (DPP4) inhibitors: A propensity score-matched study with competing risk analysis","authors":"Oscar Hou In Chou ,&nbsp;Jiandong Zhou ,&nbsp;Jonathan V Mui MBBChir ,&nbsp;Danish Iltaf Satti ,&nbsp;Cheuk To Chung ,&nbsp;Teddy Tai Loy Lee ,&nbsp;Sharen Lee ,&nbsp;Edward Christopher Dee ,&nbsp;Kenrick Ng MBBChir ,&nbsp;Bernard Man Yung Cheung ,&nbsp;Fengshi Jing ,&nbsp;Gary Tse","doi":"10.1016/j.deman.2022.100115","DOIUrl":"https://doi.org/10.1016/j.deman.2022.100115","url":null,"abstract":"<div><h3>Background</h3><p>Dipeptidyl peptidase-4 inhibitors (DPP4I) may be associated with higher risks of acute pancreatitis and pancreatic cancer. This study compared the risks of acute pancreatitis and pancreatic cancer between sodium glucose cotransporter 2 inhibitors (SGLT2I) and DPP4I users.</p></div><div><h3>Methods</h3><p>This was a retrospective population-based cohort study of patients with type-2 diabetes mellitus on either SGLT2I or DPP4I between January 1^st, 2015, and December 31^st 2020 in Hong Kong. The primary outcome was new-onset acute pancreatitis and pancreatic cancer. Propensity score matching (1:1 ratio) using the nearest neighbour search was performed. Univariable and multivariable Cox regressions were applied to identify significant predictors.</p></div><div><h3>Results</h3><p>This cohort included 31609 Type 2 Diabetes Mellitus patients (median age: 67.4 years old [SD: 12.5]; 53.36% males). 6479 patients (20.49%) used SGLT2I, and 25130 patients (70.50%) used DPP4I. After matching, the rate of acute pancreatitis was significantly lower in SGLT2I users compared to DPP4I users. Multivariable Cox regression showed that SGLT2I use was associated with lower risks of acute pancreatitis (Hazard ratio, HR: 0.11; 95% Confidence interval, CI: 0.02-0.51; P=0.0017) and pancreatic cancer (HR: 0.22; 95% CI: 0.039-0.378; P=0.0003). The results were consistent using competing risk models and different propensity score approaches.</p></div><div><h3>Conclusions</h3><p>SGLT2I use was associated with lower risks of new-onset acute pancreatitis and pancreatic cancer after propensity score matching and multivariable adjustment, underscoring the need for further evaluation in the randomised controlled trial setting.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"9 ","pages":"Article 100115"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49751615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of traditional versus m-Health educational interventions for diabetic patients: a randomised controlled trial in peripheral district of Bangladesh","authors":"Bilkis Banu ,&nbsp;Kyi Chit Ko ,&nbsp;Md.Mobarak Hossain Khan ,&nbsp;Liaquat Ali ,&nbsp;Till Barnighausen ,&nbsp;Rainer Sauerborn ,&nbsp;Aurélia Souares","doi":"10.1016/j.deman.2022.100106","DOIUrl":"10.1016/j.deman.2022.100106","url":null,"abstract":"<div><h3>Background</h3><p>Mobile Health i.e. m-Health Education (MHE) and Traditional Health Education (THE) interventions are both used for education of diabetic patients. However, it is not yet reported which one is the most effective. This study was designed to compare the effectiveness of these two types of intervention on adherence to the seven dimensions of diabetes' self-management in a peripheral district of Bangladesh.</p></div><div><h3>Methods</h3><p>A randomized controlled trial was conducted in Thakurgaon district, in Bangladesh, with two intervention arms (-MHE and THE- and one control group. All groups received an initial educational session including the control group. During the educational session pictorial materials was used and patients received a logbook to register their different activities related to diabetes. The intervention was conducted over a period of 12 months. MHE group received additionally a monthly reminder and monitoring through mobile phone calls. THE group received a monthly home visit reminder and monitoring through personal visits. 330 adult diabetics patients were included in each group. Data were collected by face-to-face interview using a semi-structured questionnaire at baseline and endline. Adherence to the seven self-management dimensions was measured and compared in the different groups before and after the intervention using analysis of co-variance (ANCOVA) and logistic regression technique.</p></div><div><h3>Findings</h3><p>Study participants took place from January 2016 to June 2017. Among the 990 included patients, 86 were lost to follow-up. Both MHE and THE groups showed significant (<em>p</em>&lt; 0.01) improvement in knowledge, adherence to self-management and health outcomes compared to the control group. Bonferroni post-hoc comparison between groups showed that knowledge (regarding diet, physical exercise, follow-up visit and blood glucose test, stopping tobacco, basic and technical knowledge of diabetes) and waist circumference improved significantly more in the MHE group than in the THE group. Adherence to drug, physical exercise, follow-up visit and blood glucose test and stopping tobacco improved significantly more in the THE group than the MHE group. Furthermore, MHE was found to be more cost-effective.</p></div><div><h3>Interpretation</h3><p>The MHE intervention was more effective than the THE intervention in improving knowledge, adherence to most of the self-management recommendations and health outcomes for peripheral diabetic patients in Bangladesh. MHE intervention has a positive impact also in peripheral areas in LMICs. Thisintervention could be replicated for the self-management of diabetes and other non-communicable diseases in LMICs.</p></div><div><h3>Funding</h3><p>Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany and Bangladesh University of Health Sciences, Dhaka, Bangladesh.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"9 ","pages":"Article 100106"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45982745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in antidiabetic drug prescription patterns during follow-up of the GERODIAB cohort. Comparison with professional recommendations","authors":"Jean Doucet ,&nbsp;Olivia Guérin ,&nbsp;Caroline Hilbert ,&nbsp;Lyse Bordier ,&nbsp;Christiane Verny ,&nbsp;Charlotte Marchand ,&nbsp;Hugo Mouton-Sclaunich ,&nbsp;Carina Bezerra ,&nbsp;Jacques Bénichou ,&nbsp;Bernard Bauduceau","doi":"10.1016/j.deman.2022.100084","DOIUrl":"10.1016/j.deman.2022.100084","url":null,"abstract":"<div><h3>Introduction</h3><p>The aim of the present study was to analyse the changes in antidiabetic drug prescription patterns during the follow-up of the GERODIAB cohort between 2009 and 2015 and to compare them with the available professional recommendations.</p></div><div><h3>Patients and methods</h3><p>The present study included 637 type 2 diabetic patients aged 70 years and over who have survived after 5 years. We compared the three main types of therapeutic modalities: (1) insulin only; (2) combination of insulin and one or more oral antidiabetic drugs (OADs) and/or glucagon-like peptide-1 receptor agonists (GLP-1RAs); and (3) treatment with one or more OADs and/or GLP-1RAs without insulin. We analysed changes in the antidiabetic drug classes, notably the antidiabetic drugs exposing patients to hypoglycaemia. Finally, we analysed changes in the prescriptions of patients initially treated with antidiabetic monotherapy.</p></div><div><h3>Results</h3><p>At inclusion, 25.6% patients were receiving only insulin, 30.9% patients were receiving insulin and OADs and/or GLP-1RAs, and 42.5% patients were receiving OADs and/or GLP-1RAs without insulin. At the final visit, 69.5% of patients continued to receive the same treatment modality. Only the number of patients treated with insulin alone increased (+9.9%). Prescriptions of insulin increased and prescriptions of OADs or GLP-1RAs decreased. The total drugs exposing patients to hypoglycaemia remained constant. Prescriptions of metformin remained high, prescriptions of sulfonylureas and glinides decreased and those of DPP-4 inhibitors increased.</p></div><div><h3>Discussion - Conclusion</h3><p>The increased prescription of insulin was predictable. Prescriptions of sulfonylureas and glinides remained relatively high, although recommendations for these drugs continue to decline.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"9 ","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43058522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits and limitations of hypo/hyperglycemic alarms associated with continuous glucose monitoring in individuals with diabetes","authors":"Philippe Oriot ,&nbsp;Noemie Klipper dit kurz ,&nbsp;Michel Ponchon ,&nbsp;Eric Weber ,&nbsp;Ides. M. Colin ,&nbsp;Jean Christophe Philips","doi":"10.1016/j.deman.2022.100125","DOIUrl":"10.1016/j.deman.2022.100125","url":null,"abstract":"<div><p>Continuous Glucose Monitoring (CGM) has improved the diabetes follow up. The use of CGM can be expected to reduce the long-term complications of diabetes. To achieve this, education of physicians and diabetic individuals is essential. The latest CGMs have alarms to improve glycemic control by avoiding hypoglycemia and hyperglycemia, hence the importance of proper setting of these alarms. Although useful to signal these events, we have noted that these alarms do not necessarily meet with unanimity in consultations… Are alarms considered a comfort or a possible disturbance ?</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"9 ","pages":"Article 100125"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44442660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of treatment intensification on glycemic control in patients with subcontrolled type 2 diabetes who failed on two oral antidiabetic agents","authors":"Malinda S. Tan ,&nbsp;Kibum Kim ,&nbsp;Cody J. Olsen ,&nbsp;Diana I. Brixner","doi":"10.1016/j.deman.2022.100127","DOIUrl":"10.1016/j.deman.2022.100127","url":null,"abstract":"<div><h3>Aims</h3><p>Treatment intensification (TI) may help patients with type 2 diabetes mellitus (T2DM) achieve target hemoglobin A1c (A1c) &lt; 7.0%. This study aimed to measure the influence of TI on A1c outcome in patients who insufficiently responded to two classes of oral antidiabetic drugs (2OADs).</p></div><div><h3>Materials and methods</h3><p>A retrospective observational study of patients with T2DM was performed using health plan claims and A1c records accrued between January 2010 and March 2017. The study population had an A1c ≥ 7.0% (baseline A1c) after treatment with 2OADs for one year. Patients who had TI with a third-class antidiabetic agent, including basal/biphasic insulin, glucagon-like peptide-1 receptor agonists (GLP-1RA), or OAD, within 365 days after baseline A1c were included. Patients who did not receive TI (NTI) within one year from the suboptimal A1c control were matched with TI patients using a propensity score approach. The odds ratio of achieving an A1c &lt; 9.0% and &lt; 7.0% for TI vs. NTI were calculated by logistic regressions.</p></div><div><h3>Results</h3><p>A1c values of 401 TI − NTI matched pairs were analyzed. TI patients achieved a significantly lower follow-up A1c than NTI patients (7.79% ± 1.45 vs. 8.02% ± 1.67, <em>p</em> = 0.03). The odds ratio [95% confidence interval] of achieving A1c &lt; 9.0% and &lt; 7.0% for TI was 1.50 [1.04−2.17] and 1.19 [0.87−1.63], respectively.</p></div><div><h3>Conclusion</h3><p>TI with a third-class agent further reduced A1c levels in patients whose A1c insufficiently responded with 2OADs; however, most patients failed to achieve an A1c &lt; 7.0% on the intensified treatment.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"9 ","pages":"Article 100127"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44406580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between asymptomatic malaria and blood glucose among outpatients in a rural low-income setting","authors":"Francis Xavier Kasujja, F. Nuwaha, E. E. Kiracho, Ronald Kusolo, R. Mayega","doi":"10.1016/j.deman.2022.100112","DOIUrl":"https://doi.org/10.1016/j.deman.2022.100112","url":null,"abstract":"","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54176920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissecting the reduction in cardiovascular death with SGLT2 inhibitors: Potential contribution of effects on ventricular arrhythmias and sudden cardiac death?","authors":"André J Scheen","doi":"10.1016/j.deman.2022.100107","DOIUrl":"10.1016/j.deman.2022.100107","url":null,"abstract":"<div><p>Type 2 diabetes is associated with a higher risk of cardiac arrhythmias, especially in presence of cardiovascular disease and/or heart failure. Ventricular arrhythmias (VA: tachycardia/fibrillation) may lead to sudden cardiac arrest/death (SCA/SCD). Sodium-glucose cotransporter type 2 inhibitors (SGLT2is) exert a remarkable protection against cardiovascular disease, especially hospitalisation for heart failure, yet their effects on malignant cardiac arrhythmias are poorly known. Nevertheless, findings derived from experimental animal and clinical studies suggested that SGLT2is could reduce the risk of not only supraventricular but also ventricular cardiac arrhythmias. A trend for less VA and SCA/SCD events was reported in post hoc analyses of randomised controlled trials/cardiovascular outcome trials versus placebo, yet statistical significance was not reached presumably because of too few events in both treatment groups. Retrospective observational cohort studies that reported malignant cardiac arrhythmias in patients treated with SGLT2is versus other glucose-lowering agents are scare, compared to the numerous ones that focused on atrial fibrillation/flutter. Further studies specifically devoted to the effects of SGLT2is on malignant cardiac arrhythmias are needed to confirm positive effects in patients with diabetes and/or heart failure and if possible to carefully dissect the underlying anti-arrhythmic protective mechanisms.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"8 ","pages":"Article 100107"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000579/pdfft?md5=4fd74e30e02034d0fbe8f0c2f7caadfa&pid=1-s2.0-S2666970622000579-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42638899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydroxychloroquine lowers the risk for Diabetes Mellitus in patients with Systemic Lupus Erythematosus","authors":"Dennis Levinson ,&nbsp;Ashraf Abugroun ,&nbsp;Kristen Osinski","doi":"10.1016/j.deman.2022.100089","DOIUrl":"10.1016/j.deman.2022.100089","url":null,"abstract":"<div><h3>Background</h3><p>Previous literature suggests a lower prevalence of diabetes mellitus (DM) in patients with systemic lupus erythematosus (SLE).</p></div><div><h3>Study question</h3><p>We aimed to investigate the impact of hydroxychloroquine (HCQ) on the risk of DM in patients with SLE.</p></div><div><h3>Study design</h3><p>We queried The TriNetX database for all patients aged &gt;18 years diagnosed with SLE from January 1, 2000, until January 1, 2021. We identified patients with SLE using disease–specific International Classification of Diseases, Tenth Revision (ICD-10) diagnosis code (M32). At the time of enrollment, we excluded all patients who were diagnosed with diabetes mellitus (ICD-10 code: E08-E13) either prior to or at the initial visit.</p></div><div><h3>Measures and outcomes</h3><p>Patients were classified into two groups according to treatment with HCQ. The primary objective was to compare the impact of HCQ over a consecutive 10-year period on the risk of DM in an SLE population.</p></div><div><h3>Results</h3><p>Following propensity matching an equal cohort, 19025 SLE patients on HCQ and 19025 SLE controls, were included with a mean period of follow-up of 10 years. Patients who were adherent to HCQ had lower rates of DM (event rate: 13.3% vs 18.5%) with relative risk (RR) 72.0% (68.7% to 75.4%). In Kaplan-Meier survival analysis the cumulative probability of survival was significantly higher in the HCQ subjects compared to control (78.1% vs 68.3%; log-rank, <em>p</em>&lt;0.001).</p></div><div><h3>Conclusion</h3><p>We provide further evidence for the antidiabetic effect of hydroxychloroquine in a lupus cohort. We suggest a unifying hypothesis linking the pharmacologic effect of hydroxychloroquine with its favorable effects on glucose metabolism.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"8 ","pages":"Article 100089"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000397/pdfft?md5=cfe6e0d4e661745abf915a64227e7c6d&pid=1-s2.0-S2666970622000397-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43986484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular outcome according to renal status in Finnish patients with type 2 diabetes","authors":"Tapio A. Hellman ,&nbsp;Ole-Christian Skare ,&nbsp;Christopher Lee ,&nbsp;Uta Wagner ,&nbsp;Johanna Vikkula ,&nbsp;Jenni Hällfors ,&nbsp;Outi Laatikainen ,&nbsp;Mariann I. Lassenius ,&nbsp;Kaj Metsärinne","doi":"10.1016/j.deman.2022.100103","DOIUrl":"10.1016/j.deman.2022.100103","url":null,"abstract":"<div><h3>Background</h3><p><strong>:</strong> Type 2 diabetes (T2DM) increases the risk for chronic kidney disease (CKD). The objective of this study was to describe the characteristics of patients with T2DM and assess their cardiovascular (CV) and renal outcomes as well as survival in a real-life setting in Finland. The study aimed to map the use of diagnostic and monitoring measures in the management of T2DM patients in clinical practice and to assess the proportion of patients that could benefit from SGLT2 inhibitor treatment.</p></div><div><h3>Methods</h3><p><strong>:</strong> This retrospective registry study included 29,628 adult T2DM patients gathered from national registries in Finland between 2012 and 2018. Patients were included from primary and specialized care. From all patients, all available health care data, including laboratory results, degree of albuminuria, and eGFR data, was gathered. The occurrence of CV events and end-stage kidney disease (ESKD) was assessed using a multivariable Cox proportional hazards model. All-cause and CV deaths were visualized using Kaplan-Meier plots.</p></div><div><h3>Results</h3><p><strong>:</strong> Overall, patients were more frequently male (54%), and their mean age was 66 (SD = ±12.4) years. eGFR status was available for 21,889 patients, and among these patients CKD stage 3–5 was observed in 3,945 (13.3%) patients. Data on albuminuria was available in less than half (45.5%) of the cohort. In patients with available urinary albumin measurement, increased albumin excretion was present in 12% of patients with CKD class 1–2, of whom 1.6% had severe albuminuria. Of all comorbidities, atrial fibrillation was independently associated with the risk of CV events and ESKD.</p></div><div><h3>Conclusions</h3><p><strong>:</strong> This large real-world study confirms that CV morbidity and mortality are substantial within T2DM patients, and that age, prior kidney function, albuminuria and prior diagnosis of AF were associated with the risk of CV events, including death, and progression to ESKD. Despite guideline recommendations, monitoring and treatment of T2DM was suboptimal leaving patients at risk of inadequate treatment.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"8 ","pages":"Article 100103"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000531/pdfft?md5=37b32b4f344a3c1dc469e934d1c0565f&pid=1-s2.0-S2666970622000531-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44929784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}