scholarly journals Effect of socioeconomic deprivation on outcomes of diabetes complications in patients with type 2 diabetes mellitus: a nationwide population-based cohort study of South Korea

2020 ◽  
Vol 8 (1) ◽  
pp. e000729
Author(s):  
Dong-Woo Choi ◽  
Sang Ah Lee ◽  
Doo Woong Lee ◽  
Jae Hong Joo ◽  
Kyu-Tae Han ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Diabetes Complications ◽  
Socioeconomic Deprivation ◽  
Cox Proportional Hazards Model ◽  
Hazards Model ◽  
All Cause Mortality

IntroductionThis study aimed to examine the effect of socioeconomic deprivation on the outcomes of diabetes complications in patients with type 2 diabetes mellitus (T2DM).Research design and methodsWe conducted a cohort study using claims data and 2005 national census data. We included of 7510 patients newly diagnosed with T2DM from 2004 to 2012 and aged 40 years or above. We excluded participants who had onset of diabetes complications and hospitalization within 1 year after initial onset T2DM, aged less than 40 years and with missing covariates. We used the regional socioeconomic deprivation index and classified study participants into five categories according to the quintile distribution. We calculated the adjusted HR and 95% CI for hospitalization related to diabetes complications and all-cause mortality by applying Cox proportional hazards model and the adjusted subdistribution hazards model.ResultsThe percentages of participants in the first quintile (least deprived) to fifth quintile (most deprived) were 27.0%, 27.9%, 19.5%, 14.8%, and 10.8% for socioeconomic deprivation; 25.4%, 28.8%, 32.4%, 34.6%, and 37.6% for hospitalization due to diabetes complications; 1.3%, 2.1%, 2.5%, 2.9%, and 3.6% for deaths from diabetes complications; and 5.7%, 7.2%, 9.7%, 9.7%, and 13.1% for deaths from all causes, respectively. Participants with higher socioeconomic deprivation had a higher HR for hospitalization and mortality from all-cause and diabetes complications. These associations were the strongest among men and participants in their 40s in hospitalization related to diabetes complications, 50s in diabetes complications-specific mortality and 50s and 60s in all-cause mortality.ConclusionsPatients with T2DM with high socioeconomic deprivation had higher hospital admission and mortality rates for diabetes complications than those with low deprivation. We cannot fully explain the effect of socioeconomic deprivation on diabetes outcomes. Therefore, further studies are needed in order to find underlying mechanisms for these associations.

scholarly journals Cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus in the MADIABETES Cohort Study: Association with chronic kidney disease

2016 ◽  
Vol 30 (2) ◽  
pp. 227-236 ◽  
Author(s):  
Miguel Ángel Salinero-Fort ◽  
Francisco Javier San Andrés-Rebollo ◽  
Carmen de Burgos-Lunar ◽  
Juan Carlos Abánades-Herranz ◽  
Enrique Carrillo-de-Santa-Pau ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Kidney Disease ◽  
All Cause Mortality ◽  
Study Association

scholarly journals On the survival of individuals diagnosed with type 2 diabetes mellitus in the United Kingdom: a retrospective matched cohort study

2021 ◽  
Author(s):  
Njabulo Ncube ◽  
Elena Kulinskaya ◽  
Nicholas Steel ◽  
Dmitry Pchejetski
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Birth Cohort ◽  
Matched Cohort ◽  
Birth Cohorts ◽  
All Cause Mortality

Objective To estimate long-term hazards of all-cause mortality following a diagnosis of type 2 diabetes mellitus (T2DM) using electronic primary care data. Methodology Retrospective matched cohort study using electronic health records from THIN primary care database. The study included individuals born between 1930 and 1960, diagnosed with T2DM between 2000 and 2016 and aged 50-74 years and excluded those with pre-existing stroke, cancer, cognitive impairment, lower limb amputation or chronic kidney disease (CKD) stages 3 to 5. T2DM individuals were matched at diagnosis to at most 3 controls by age, gender and general practice (GP) and followed up to 1 January 2017. Time-varying hazards of all-cause mortality were then estimated using Gompertz-double-Cox model with frailty on GP, adjusting for medical history, socio-demographic and lifestyle factors. Results A total of 221 182 (57.6% Males, 30.8% T2DM) individuals were selected for the study of whom 29 618 (13.4%) died during follow-up. The adjusted mortality hazard of type 2 diabetes mellitus (T2DM) was estimated to be 1.21[1.12-1.3] and 1.52[1.44-1.6] among individuals diagnosed at 50-59 years and 60-74 years, respectively, compared to controls. Deprivation, obesity, smoking and comorbidities affected survival of cases and controls equally. Compared to the 1930-39 birth cohort, all-cause mortality hazards were reduced in the 1940-49 cohort, but increased at older ages in the 1950-60 birth cohort for both cases and controls. Conclusion T2DM is associated with raised all-cause mortality hazards which increase with age of diagnosis. These hazards associated with age at diagnosis are constant across all birth cohorts demonstrating a lack of progress over time in reducing the relative risks of all-cause mortality associated with T2DM. A further study that includes people born after 1960 is needed to fully understand the emerging higher mortality hazards among the younger birth cohorts.

scholarly journals The Association Between Age at Initiation of Alcohol Consumption and Type 2 Diabetes Mellitus: A Cohort Study of 0.5 Million Persons in China

2020 ◽  
Vol 189 (12) ◽  
pp. 1478-1491
Author(s):  
Haoxin Li ◽  
Jun Lv ◽  
Canqing Yu ◽  
Yu Guo ◽  
Zheng Bian ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Alcohol Consumption ◽  
Lower Risk ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Chinese Adults

Abstract It is well known that alcohol consumption is associated with type 2 diabetes mellitus. However, the association of age at initiation of alcohol consumption and duration of alcohol drinking with type 2 diabetes mellitus among Chinese adults is not fully understood. This study was based on data from the China Kadoorie Biobank, which included 512,712 participants aged 30–79 years who were living in China in 2004–2008. A Cox proportional hazards model was used to estimate the association of AAI and drinking duration with type 2 diabetes. After adjustment for potential covariates, ages at alcohol initiation (AAIs) of 18.1–29.0 years, 29.1–39.0 years, and >39.0 years were associated with 22% (95% confidence interval (CI): 14, 30), 25% (95% CI: 17, 33), and 32% (95% CI: 24, 39) lower hazards of type 2 diabetes compared with abstaining, respectively. Drinking durations of <10.1 years, 10.1–20.0 years, and 20.1–30.0 years were associated with a lower risk of type 2 diabetes, compared with abstaining. Among current (weekly) drinkers, AAI <18.1 years and drinking duration >30.0 years were associated with 18% (95% CI: 4, 33) and 20% (95% CI: 3, 40) higher hazards of type 2 diabetes, compared with AAI 18.1–29.0 years and drinking duration <10.1 years, respectively. In conclusion, late AAI and a short drinking duration were associated with a lower risk of type 2 diabetes in this large prospective cohort study of Chinese adults, but early AAI and long drinking duration were not.

Pioglitazone Exposure Reduced the Risk of All-Cause Mortality in Insulin-Treated Patients with Type 2 Diabetes Mellitus

2019 ◽  
Vol 105 (3) ◽  
pp. e401-e409 ◽  
Author(s):  
Fu-Shun Yen ◽  
Hsiang-Chi Wang ◽  
Chun-Wei Pan ◽  
James Cheng-Chung Wei ◽  
Chih-Cheng Hsu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Insulin Therapy ◽  
Severity Index ◽  
Incidence Rates ◽  
Research Database ◽  
All Cause Mortality

Abstract Context The long-term safety and benefit of pioglitazone use in combination with insulin are still uncertain. Objective This study compared the risks of all-cause mortality and major cardiovascular (CV) events between pioglitazone users and nonusers receiving insulin therapy. Design, Setting and Patients We conducted a 13-year retrospective cohort study by using data from the population-based National Health Insurance Research Database in Taiwan. A total of 20 376 patients with type 2 diabetes mellitus (T2DM) receiving insulin therapy were enrolled during 2000 to 2012. Overall, the incidence rates of all-cause mortality and CV events were compared between 2579 pioglitazone users and 2579 matched nonusers. Results After adjustment for age, sex, comorbidities, Diabetes Complications Severity Index scores, and drugs used, mortality rates were 30.26 and 15.02 per 1000 person-years for pioglitazone nonusers and users, respectively. The adjusted hazard ratio (aHR) of mortality was 0.47 (95% confidence interval [CI]: 0.38–0.58, P < 0.001) for pioglitazone users compared with nonusers. The aHRs of CV and non-CV deaths were 0.78 (95% CI: 0.51–1.19) and 0.50 (95% CI: 0.38–0.66), respectively. The aHRs of hospitalized coronary artery disease, hospitalized stroke, and incident heart failure were not significantly different between pioglitazone users and nonusers. Conclusions This nationwide cohort study demonstrated that pioglitazone use reduced the risks of all-cause mortality and non-CV death for patients with T2DM undergoing insulin therapy.

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