scholarly journals Cardiovascular disease prevalence in type 2 diabetes – an analysis of a large German statutory health insurance database

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maximilian Gabler ◽  
Silke Geier ◽  
Lukas Mayerhoff ◽  
Wolfgang Rathmann
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Health System ◽  
Cardiovascular Complications ◽  
Population Based ◽  
Stratified Sample ◽  
Icd 10 ◽  
Definition Of ◽  
Observation Period

Abstract Background The aim of this study was to determine the prevalence of cardiovascular disease in persons with type 2 diabetes mellitus (T2D) in Germany. Methods A claims database with an age- and sex-stratified sample of nearly 4 million individuals insured within the German statutory health system was used. All patients aged ≥18 years with T2D documented between 1 January 2015 and 31 December 2015 and complete retrospective documentation of ≥5 years (continuous enrollment in the German statutory health system) before 2015 were selected based on a validated algorithm. Cardiovascular disease (CVD) events were identified based on ICD-10 and OPS codes according to a previous clinical study (EMPA-REG OUTCOME trial). Results The prevalence of T2D in Germany in 2015 was 9.9% (n = 324,708). Using a narrow definition of CVD, the 6-year observation period prevalence of CVD was estimated as 46.7% [95% CI: 46.52%;46.86%]. Applying a wider CVD definition, the proportion of T2D patients who showed a history of CVD was 57.1% [95% CI: 56.9%;57.24%]. The prevalence of CVD in patients with T2D ranged from 36.3 to 57.1%, depending on the observation period and definition of CVD. Conclusions The results underline the need for a population-based registration of cardiovascular complications in T2D.

scholarly journals Cardiovascular Disease Prevalence in Type 2 Diabetes – An Analysis of A Large German Statutory Health Insurance Database

2020 ◽  
Author(s):  
Maximilian Gabler ◽  
Silke Geier ◽  
Lukas Mayerhoff ◽  
Wolfgang Rathmann
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Health System ◽  
Cardiovascular Complications ◽  
Population Based ◽  
Stratified Sample ◽  
Icd 10 ◽  
Definition Of ◽  
Observation Period

Abstract Background The aim of this study was to determine the prevalence of cardiovascular disease in persons with type 2 diabetes mellitus (T2D) in Germany. Methods A claims database with an age- and sex-stratified sample of nearly 4 million individuals insured within the German statutory health system was used. All patients aged ≥ 18 years with T2D documented between 1 January 2015 and 31 December 2015 and complete retrospective documentation of ≥ 5 years (continuous enrollment in the German statutory health system) before 2015 were selected based on a validated algorithm. Cardiovascular disease (CVD) events were identified based on ICD-10 and OPS codes according to a previous clinical study (EMPA-REG OUTCOME trial).Results The prevalence of T2D in Germany in 2015 was 9.9% (n=324,708). Using a narrow definition of CVD, the 6-year observation period prevalence of CVD was estimated as 46.7% [95% CI: 46.52%;46.86%]. Applying a wider CVD definition, the proportion of T2D patients who showed a history of CVD was 57.1% [95% CI: 56.9%;57.24%]. The prevalence of CVD in patients with T2D ranged from 36.3% to 57.1%, depending on the observation period and definition of CVD.Conclusions The results underline the need for a population-based registration of cardiovascular complications in T2D.

scholarly journals Impact of type 2 diabetes and microvascular complications on mortality and cardiovascular outcomes in a multiethnic Asian population

2021 ◽  
Vol 9 (1) ◽  
pp. e001413
Author(s):  
Jonathan Yap ◽  
Kamalesh Anbalakan ◽  
Wan Ting Tay ◽  
Daniel Ting ◽  
Carol Yim Cheung ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Population Based ◽  
Cardiovascular Outcomes ◽  
Microvascular Complication ◽  
The Impact ◽  
Hba1c Levels

IntroductionDiabetes mellitus is a growing public health epidemic in Asia. We examined the impact of type 2 diabetes, glycemic control and microvascular complications on mortality and cardiovascular outcomes in a multiethnic population-based cohort of Asians without prior cardiovascular disease.Research design and methodsThis was a prospective population-based cohort study in Singapore comprising participants from the three major Asian ethnic groups: Chinese, Malays and Indians, with baseline examination in 2004–2011. Participants with type 1 diabetes and those with cardiovascular disease at baseline were excluded. Type 2 diabetes, Hemoglobin A1c (HbA1c) levels and presence of microvascular complications (diabetic retinopathy and nephropathy) were defined at baseline. The primary outcome was all-cause mortality and major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular mortality, myocardial infarction, stroke and revascularization, collected using a national registry.ResultsA total of 8541 subjects were included, of which 1890 had type 2 diabetes at baseline. Subjects were followed for a median of 6.4 (IQR 4.8–8.8) years. Diabetes was a significant predictor of mortality (adjusted HR 1.74, 95% CI 1.45 to 2.08, p<0.001) and MACE (adjusted HR 1.64, 95% CI 1.39 to 1.93, p<0.001). In those with diabetes, higher HbA1c levels were associated with increased MACE rates (adjusted HR (per 1% increase) 1.18, 95% CI 1.11 to 1.26, p<0.001) but not mortality (p=0.115). Subjects with two microvascular complications had significantly higher mortality and MACE compared with those with only either microvascular complication (adjusted p<0.05) and no microvascular complication (adjusted p<0.05).ConclusionDiabetes is a significant predictor of mortality and cardiovascular morbidity in Asian patients without prior cardiovascular disease. Among patients with type 2 diabetes, poorer glycemic control was associated with increased MACE but not mortality rates. Greater burden of microvascular complications identified a subset of patients with poorer outcomes.

scholarly journals Eleven-year multimorbidity burden among 637 255 people with and without type 2 diabetes: a population-based study using primary care and linked hospitalisation data

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e033866
Author(s):  
Salwa S Zghebi ◽  
Douglas T Steinke ◽  
Martin K Rutter ◽  
Darren M Ashcroft
Keyword(s):  
Mental Health ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Population Based ◽  
Mental Illnesses ◽  
Secondary Outcome ◽  
Clinical Practice Research Datalink ◽  
Physical And Mental Health ◽  
Health Comorbidities

ObjectivesTo compare the patterns of 18 physical and mental health comorbidities between people with recently diagnosed type 2 diabetes (T2D) and people without diabetes and how these change by age, gender and deprivation over time between 2004 and 2014. Also, to develop a metric to identify most prevalent comorbidities in people with T2D.DesignPopulation-based cohort study.SettingPrimary and secondary care, England, UK.Participants108 588 people with T2D and 528 667 comparators registered in 391 English general practices. Each patient with T2D aged ≥16 years between January 2004 and December 2014 registered in Clinical Practice Research Datalink GOLD practices was matched to up to five comparators without diabetes on age, gender and general practice.Primary and secondary outcome measuresPrevalence of 18 physical and mental health comorbidities in people with T2D and comparators categorised by age, gender and deprivation. Odds for association between T2D diagnosis and comorbidities versus comparators. A metric for comorbidities with prevalence of ≥5% and/or odds ≥2 in patients with T2D.ResultsOverall, 77% of patients with T2D had ≥1 comorbidity and all comorbidities were more prevalent in patients with T2D than in comparators. Across both groups, prevalence rates were higher in older people, women and those most socially deprived. Conditional logistic regression models fitted to estimate (OR, 95% CI) for association between T2D diagnosis and comorbidities showed that T2D diagnosis was significantly associated with higher odds for all conditions including myocardial infarction (OR 2.13, 95% CI 1.85 to 2.46); heart failure (OR 2.12, 1.84 to 2.43); depression (OR 1.75, 1.62 to 1.89), but non-significant for cancer (OR 1.12, 0.98 to 1.28). In addition to cardiovascular disease, the metric identified osteoarthritis, hypothyroidism, anxiety, schizophrenia and respiratory conditions as highly prevalent comorbidities in people with T2D.ConclusionsT2D diagnosis is associated with higher likelihood of experiencing other physical and mental illnesses. People with T2D are twice as likely to have cardiovascular disease as the general population. The findings highlight highly prevalent and under-reported comorbidities in people with T2D. These findings can inform future research and clinical guidelines and can have important implications on healthcare resource allocation and highlight the need for more holistic clinical care for people with recently diagnosed T2D.

Risk of type 2 diabetes and cardiovascular disease in an incident cohort of people with psoriatic arthritis: a population-based cohort study

Rheumatology ◽  
2018 ◽  
Vol 58 (1) ◽  
pp. 144-148 ◽  
Author(s):  
Rachel Charlton ◽  
Amelia Green ◽  
Gavin Shaddick ◽  
Julia Snowball ◽  
Alison Nightingale ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Psoriatic Arthritis ◽  
Population Based ◽  
Incident Cohort

scholarly journals Estimated incidence of cardiovascular complications related to type 2 diabetes in Mexico using the UKPDS outcome model and a population-based survey

2011 ◽  
Vol 10 (1) ◽  
pp. 1 ◽  
Author(s):  
Nancy Reynoso-Noverón ◽  
Roopa Mehta ◽  
Paloma Almeda-Valdes ◽  
Rosalba Rojas-Martinez ◽  
Salvador Villalpando ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Complications ◽  
Population Based ◽  
Population Based Survey

scholarly journals Metabolic syndrome: аrguments pro's and con's

2012 ◽  
Vol 9 (2) ◽  
pp. 17-27 ◽  
Author(s):  
V A Uchamprina ◽  
T I Romantsova ◽  
M F Kalashnikov
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Clinical Practice ◽  
Glucose Metabolism ◽  
Review Article ◽  
Impaired Glucose Metabolism ◽  
Definition Of

Metabolic syndrome (MS) is a combination of impaired glucose metabolism, abdominal obesity, dyslipidemia, and hypertension and is associated with the development of type 2 diabetes (T2D) and cardiovascular disease (CVD). Despite numerous studies on this subject, the terminology and the definition of MS as well as borderline values for its criteria are not defined. From the standpoint of public health and clinical practice, the early detection of MS is highly important in order to prevent the development of CVD and T2D. This review article reflects the stages of development of the concept of MS, expresses the opinion of the authors with respect to the modern view of the problem and analyzes of contemporary arguments "for" and "against" the use of MS diagnosis in clinical practice.

scholarly journals Vasopressin, from Regulator to Disease Predictor for Diabetes and Cardiometabolic Risk

2016 ◽  
Vol 68 (Suppl. 2) ◽  
pp. 24-28 ◽  
Author(s):  
Olle Melander
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Water Intake ◽  
Plasma Osmolality ◽  
Premature Mortality ◽  
High Water ◽  
Cardiovascular Complications ◽  
Cardiometabolic Disease ◽  
The Metabolic Syndrome

Background: Type 2 diabetes and its cardiovascular disease complications are the major public health threats of our century. Although physical activity and dietary changes are the cornerstones in prevention of diabetes, their broad implementation is not elementary and other complementary lifestyle regimens are needed. Summary: Vasopressin (VP) is the main regulator of body water homeostasis, and at insufficient water intake, normal plasma osmolality can be maintained by increased pituitary VP secretion through VP-2 receptor mediated renal water reabsorption. During the last 6 years several independent studies have shown that high circulating VP, measured by the stable VP marker copeptin, predicts development of type 2 diabetes as well as the metabolic syndrome, cardiovascular disease and premature mortality. Interestingly, VP stimulates adrenocorticotrophic hormone, and as a consequence cortisol secretion, through pituitary VP-1B receptors, which could explain why the 25% of the middle-aged population with high circulating VP have a mild Cushing's syndrome-like phenotype. In rats, high VP results in deterioration of glucose tolerance whereas low VP, obtained by high water intake, ameliorates the VP associated dysmetabolic state, suggesting that the relationship between high VP and risk of diabetes and cardiometabolic disease in humans may be causal and reversible by increasing water intake. Key Messages: With the emerging evidence that high VP, which is present in 25% of the population, is an independent risk factor for diabetes and cardiometabolic disease, VP reduction through water supplementation appears as an attractive candidate intervention to prevent diabetes and its cardiovascular complications.

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