scholarly journals Antihyperglycaemic treatment patterns, observed glycaemic control and determinants of treatment change among patients with type 2 diabetes in the United Kingdom primary care: a retrospective cohort study

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Andrew Maguire ◽  
Beth D Mitchell ◽  
Javier Cid Ruzafa
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Cohort Study ◽  
Glycaemic Control ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Treatment Patterns ◽  
Treatment Change ◽  
The United Kingdom

Treatment Patterns Among Older Patients with Type 2 Diabetes in the United States: A Retrospective Cohort Study

2014 ◽  
Vol 16 (12) ◽  
pp. 833-839 ◽  
Author(s):  
Haoda Fu ◽  
Bradley H. Curtis ◽  
Dara P. Schuster ◽  
Andreas Festa ◽  
David M. Kendall
Keyword(s):  
United States ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Older Patients ◽  
Retrospective Cohort ◽  
The United States ◽  
Treatment Patterns

scholarly journals Adherence to guideline-recommended HbA1c testing frequency and better outcomes in patients with type 2 diabetes: a 5-year retrospective cohort study in Australian general practice

2021 ◽  
pp. bmjqs-2020-012026 ◽  
Author(s):  
Chisato Imai ◽  
Ling Li ◽  
Rae-Anne Hardie ◽  
Andrew Georgiou
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Glycaemic Control ◽  
Patient Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Adherence Rate ◽  
Testing Frequency ◽  
High Adherence

BackgroundClinical practice guidelines emphasise the role of regular monitoring of glycated haemoglobin A1c (HbA1c) for patients with type 2 diabetes, with most recommending 6-monthly testing. Nonetheless, there are few in-depth studies evaluating the clinical impact of the recommended testing frequency for patients to underpin the significance of guideline adherence.ObjectiveThis study aimed to examine associations between patient outcomes and adherence to HbA1c testing frequencies recommended by Australian guidelines (6-monthly for patients with adequate glycaemic control and 3-monthly for patients with inadequate glycaemic control). The primary and secondary outcomes of interest were longitudinal changes in HbA1c values and development of ischaemic heart disease (IHD) and chronic kidney disease (CKD).MethodsThis 5-year retrospective cohort study (July 2013–June 2018) evaluated HbA1c testing frequency in a subset of patients with type 2 diabetes identified within data collected from approximately 250 Australian general practices. The study included patients who were aged ≥18 in 2013 and had a record of HbA1c testing in study practices during the study period. Each patient’s adherence rate was defined by the proportion of HbA1c tests performed within the testing intervals recommended by Australian guidelines. Based on the adherence rate, adherence level was categorised into low (≤33%), moderate (34%–66%) and high (>66%). Generalised additive mixed models were used to examine associations between adherence to the recommended HbA1c testing frequency and patient outcomes.ResultsIn the 6424 patients with diabetes, the overall median HbA1c testing frequency was 1.6 tests per year with an adherence rate of 50%. The estimated HbA1c levels among patients with low adherence gradually increased or remained inadequately controlled, while HbA1c values in patients with high adherence remained controlled or improved over time. The risk of developing CKD for patients with high adherence was significantly lower than for patients with low adherence (OR: 0.42, 95% CI 0.18 to 0.99). No association between IHD and adherence to the recommended HbA1c frequency was observed.ConclusionBetter adherence to guideline-recommended HbA1c testing frequency was associated with better glycaemic control and lower risk of CKD. These findings may provide valuable evidence to support the use of clinical guidelines for better patient outcomes in patients with type 2 diabetes.

scholarly journals Association between weight change and remission of type 2 diabetes: a retrospective cohort study in primary care

2021 ◽  
Vol 38 (5) ◽  
pp. 8
Author(s):  
Hajira Dambha‐Miller ◽  
Hilda Hounkpatin ◽  
Beth Stuart ◽  
Andrew Farmer
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Cohort Study ◽  
Weight Change ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort

scholarly journals Type 2 diabetes mellitus, glycaemic control, associated therapies and risk of rheumatoid arthritis: a retrospective cohort study

Rheumatology ◽  
2021 ◽  
Author(s):  
Dawit T Zemedikun ◽  
Krishna Gokhale ◽  
Joht Singh Chandan ◽  
Jennifer Copper ◽  
Janet M Lord ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Glycaemic Control ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Research Database

Abstract Objective To compare the incident risk of rheumatoid arthritis (RA) in patients with type 2 diabetes mellitus (T2DM), and to explore the role of glycaemic control and associated therapeutic use on the onset of RA. Methods This study was a retrospective cohort study using patients derived from the IQVIA medical research database (IMRD-UK) between 1995 and 2019. 224 551 newly diagnosed patients with T2DM were matched to 449 101 patients without T2DM and followed up to assess their risk of RA. Further analyses investigated the effect of glycaemic control, statin use, and anti-diabetic drugs on the relationship between T2DM and RA using time-dependent Cox regression model. Results During the study period, the incidence rate for RA was 8.1 and 10.6 per 10 000 person-years in the exposed and unexposed groups respectively. Following adjustment, the hazard ratio (aHR) was 0.73 (95% CI 0.67–0.79). In patients who had not used statins in their lifetime, the aHR was 0.89 (95% CI 0.69–1.14). When quantifying the effects of glycaemic control, anti-diabetic drugs and statins using time-varying analyses, there was no association with glycaemic control (aHR 1.00 (95% CI 0.99–1.00)), use of metformin (aHR 1.00 (95% CI 0.82–1.22)), dipeptidyl peptidase-4 inhibitors (DPP4i) (aHR 0.94 (95% CI 0.71–1.24)), and the development of RA. However, statins demonstrated a protective effect for progression of RA in those with T2DM (aHR 0.76 (95% CI 0.66–0.88), with evidence of duration-response relationship. Conclusion There is a reduced risk of RA in patients with T2DM, that may be attributable to the use of statins.

scholarly journals Time trends in the incidence of clinically diagnosed type 2 diabetes and pre-diabetes in the UK 2009–2018: a retrospective cohort study

2021 ◽  
Vol 9 (1) ◽  
pp. e001989
Author(s):  
Kingshuk Pal ◽  
Laura Horsfall ◽  
Manuj Sharma ◽  
Irwin Nazareth ◽  
Irene Petersen
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Cohort Study ◽  
Incidence Rate ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Complication Rates ◽  
Clinical Diagnoses ◽  
The Uk

IntroductionTo describe recent trends in the incidence of clinically diagnosed type 2 diabetes and pre-diabetes in people seen in UK general practice.Research design and methodsA retrospective cohort study using IQVIA Medical Research Data looking at people newly diagnosed with type 2 diabetes and pre-diabetes through primary care registers in the UK between 1 January 2009 and 31 December 2018.ResultsA cohort of 426 717 people were clinically diagnosed with type 2 diabetes and 418 656 people met the criteria for a diagnosis of pre-diabetes in that time period. The incidence of clinically diagnosed type 2 diabetes per 1000 person years at risk (PYAR) in men decreased from a peak of 5.06 per 1000 PYAR (95% CI 4.97 to 5.15) in 2013 to 3.56 per 1000 PYAR (95% CI 3.46 to 3.66) by 2018. For women, the incidence of clinically diagnosed type 2 diabetes per 1000 PYAR decreased from 4.45 (95% CI 4.37 to 4.54) in 2013 to 2.85 (2.76 to 2.93) in 2018. The incidence rate of pre-diabetes tripled by the end of the same study period in men and women.ConclusionsBetween 2009 and 2018, the incidence rate of new clinical diagnoses of type 2 diabetes recorded in a UK primary care database decreased by a third from its peak in 2013–2014, while the incidence of pre-diabetes has tripled. The implications of this on timely treatment, complication rates and mortality need further longer term exploration.

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