scholarly journals Characterization of Patients With Type 2 Diabetes and Chronic Kidney Disease in a Large Integrated Health System

2021 ◽  
Author(s):  
Kevin Pantalone ◽  
Xinge Ji ◽  
Sheldon Kong ◽  
Jay Elliott ◽  
Alex Milinovich ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Characteristics ◽  
Hospital Admissions ◽  
Healthcare Resource ◽  
Cleveland Clinic ◽  
Emergency Department Visits ◽  
Cross Sectional

Abstract Background: Chronic kidney disease (CKD) poses substantial clinical, economic, and humanistic burden in patients with type 2 diabetes (T2D). Understanding of how to optimize patient care and slow disease progression is warranted.Objective: To compare the prevalence, clinical characteristics, treatment patterns, and healthcare utilization among patients with CKD, T2D, or CKD associated with T2D.Design: Retrospective cross-sectional analysis. Patients: Adult patients with CKD, T2D, or CKD+T2D in the Cleveland Clinic Health System.Main Measures: Clinical characteristics, laboratory measures, medication utilization, cardiometabolic management and healthcare resource utilization.Key Results: In 2019, 122,276 patients were identified as CKD, 63,643 were identified as T2D, and 35,255 were identified as having CKD associated with T2D. Patients with CKD and CKD+T2D were observed to be older than those with T2D alone, 72.6, 72.2, and 63.0 years, respectively. T2D and T2D+CKD cohorts contained a higher percentage of males vs. those with CKD alone, 49.3%, 50.8%, 43.6%, respectively. ACEi/ARB therapy was observed in 27.7%, 42.4%, and 31.5% patients with CKD, T2D+CKD, and T2D, respectively. SGLT-2i therapy was only prescribed to a minority of patients with T2D (5.8%) and T2D+CKD (4.7%). Emergency department visits and hospital admissions were more prevalent in the group with CKD (26.5%, 52.9%) or CKD+T2D (28.8%, 54.9%) vs. T2D alone (18.6%, 41.8%), respectively. The majority of patients with CKD (90.4%), CKD+T2D (60.0%) or T2D (69.1%) did not have an assessment of urine protein.Conclusions: Patients with CKD+T2D or CKD have higher healthcare resource utilization than those with T2D alone. The majority of patients with CKD, CKD+T2D or T2D do not undergo assessment of urine protein and are under prescribed ACEi/ARB therapy. SGLT-2i therapy was prescribed to only a small minority of patients with T2D or CKD+T2D. An opportunity exists to improve the care of patients with CKD, both with and without T2D.

scholarly journals Sociodemographic factors and health conditions associated with the resilience of people with chronic diseases: a cross sectional study

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Julia Estela Willrich Böell ◽  
Denise Maria Guerreiro Vieira da Silva ◽  
Kathleen Mary Hegadoren
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Study Participants

ABSTRACT Objective: to investigate the association between resilience and sociodemographic variables and the health of people with chronic kidney disease and / or type 2 diabetes mellitus. Method: a cross-sectional observational study performed with 603 people with chronic kidney disease and / or type 2 diabetes mellitus. A tool to collect socio-demographic and health data and the Resilience Scale developed by Connor and Davidson were applied. A descriptive and multivariate analysis was performed. Results: the study participants had on average 61 years old (SD= 13.2), with a stable union (52.24%), religion (96.7%), retired (49.09%), with primary education (65%) and income up to three minimum wages. Participants with kidney disease showed less resilience than people with diabetes. Conclusion: the type of chronic illness, disease duration, body mass index and religious beliefs influenced the resilience of the study participants.

scholarly journals Factors Associated With Chronic Kidney Disease in Patients With Type 2 Diabetes in Bangladesh

2021 ◽  
Author(s):  
Sheikh Mohammed Shariful Islam ◽  
Masudus Salehin ◽  
Sojib Bin Zaman ◽  
Tania Tansi ◽  
Rajat Das Gupta ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Household Income ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Public Health Burden ◽  
Factors Associated

Diabetes and chronic kidney disease (CKD) are a major public health burden in low-and-middle-income countries. This study aimed to explore factors associated with CKD in patients with type 2 diabetes (T2D) in Bangladesh. A cross-sectional study was conducted among 315 adults with T2D presenting at the outpatient department of Bangladesh Institute of Health Sciences (BIHS) hospital between July 2013 to December 2013. CKD was diagnosed based on estimated Glomerular Filtration Rate using the ‘Modification of Diet in Renal Disease’ equations and presence of albuminuria estimated by the albumin-to-creatinine ratio. Multivariate logistic regression analysis was used to determine the factors associated with CKD. The overall prevalence of CKD among patients with T2D was 21.3%. In the unadjusted model Factors associated with CKD were: aged 40-49 years (OR: 5.7, 95% CI: 1.3-25.4), age 50-59 years (7.0, 1.6-39), age ≥60 years (7.6, 1.7-34); being female (2.2, 1.2-3.8), hypertensive (1.9, 1.1-3.5) and household income between 128.2-256.4 US$ (2.9, 1.0-8.2) compared with income ≤128.2$. However, after adjustment of other covariates, only duration of hypertension and household income (128.2-256.4 US$) remained statistically significant. There is a need to implement policies and programs for early detection and management of hypertension and CKD in T2D patients in Bangladesh.

scholarly journals The Effect of Renal Dysfunction on Circulating Sclerostin Level in Patients with Type 2 Diabetes

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Se Hwa Kim ◽  
Soo Young Yoon ◽  
Sung-Kil Lim ◽  
Yumie Rhee
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Renal Dysfunction ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Sclerostin Level

Objective. Sclerostin is a Wnt inhibitor produced specifically by osteocytes. However, it is not currently clear whether renal dysfunction has an effect on circulating sclerostin level in patients with type 2 diabetes. The aim of the study was to evaluate this relationship. Design and Patients. We conducted a cross-sectional observational study of 302 type 2 diabetic patients with or without chronic kidney disease. Serum sclerostin level was analyzed by ELISA, and renal function was assessed by estimated glomerular filtration rate (eGFR) using chronic kidney disease epidemiology collaboration (CKD-EPI) equation. Results. There was a strong correlation between sclerostin level with renal function presented as serum creatinine (r=0.745, P<0.001) and eGFR (r=-0.590, P<0.001). Serum sclerostin level was significantly higher in patients with CKD-G3 stage than those with CKD-G1/2 stages after adjusting for age, sex, and BMI (P=0.011). Patients with CKD-G4/5 stages had dramatically increased level of circulating sclerostin. Multiple regression analyses found that age, sex, and eGFR were independent determining factors for circulating sclerostin level. Conclusion. Our data showed that serum sclerostin levels start to increase in diabetic patients with CKD-G3 stage. Further studies are needed to establish the potential role of elevated sclerostin in diabetic patients with CKD.

scholarly journals Determinants of knowledge, attitude and practice in patients with both type 2 diabetes and chronic kidney disease in Fiji

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 239
Author(s):  
Mohammed Alvis Zibran ◽  
Masoud Mohammadnezhad
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Demographic Variable ◽  
Public Health Intervention ◽  
Attitude Score ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Background:In Fiji, Type 2 diabetes mellitus (T2DM) and Chronic kidney disease (CKD) are amongst the top four causes of premature mortality, disability and death. This study aims to identify the determinants of knowledge, attitude and practice (KAP) in T2DM patients with CKD in Fiji in 2018.Methods:A cross-sectional study was conducted at Sigatoka Sub-divisional Hospital (SSH) in Fiji in July-August, 2018 using a self-structured questionnaire to test KAP of 225 patients. The inclusion criteria were confirmed T2DM patients (Fijian citizens) with CKD, aged 30 years or above and attending Special Out-Patient's Department (SOPD) at SSH. Independent t-test and ANOVA was used to test differences between demographic variable and practice score while non-parametric tests were used for knowledge and attitude. Spearman correlation and multiple linear regressions were also done. All the tests were set at 5% level of significance.Results: From 249 questionnaires distributed, 225 responded thus response rate was 95%. The mean KAP level was high: knowledge, 23.3/30 (SD±3.25); attitude, 23.1/30 (SD±2.73) and practice, 7.1/10 (SD±2.04). A high level of knowledge was seen in those with university-level education (p<0.001), unemployed (p=0.05) and high average monthly income (p=0.03). Those aged 61-70 years had a 0.53-point lower attitude score (p=0.05) than other age categories, while those >70 years had a 1.78-point lower attitude score (p=0.01) than other age categories. Fijians of Indian descent (FID) had lower attitude (p=0.002) and higher practice (p=0.001) scores.Conclusion:Patients with both T2DM and CKD at SSH have high levels of KAP. The determinants of KAP have been shown and thus, this study identified high-risk groups for low KAP, which can become the focus of future public health intervention.

scholarly journals Hospital utilization for hypoglycemia among patients with type 2 diabetes using pooled data from six health systems

2021 ◽  
Vol 9 (Suppl 1) ◽  
pp. e002153
Author(s):  
Scott J Pilla ◽  
Jennifer L Kraschnewski ◽  
Erik B Lehman ◽  
Lan Kong ◽  
Erica Francis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Health Systems ◽  
Emergency Department Visits ◽  
Hospital Utilization ◽  
Electronic Health Record Data ◽  
Icd 10

IntroductionHypoglycemia is the most common serious adverse effect of diabetes treatment and a major cause of medication-related hospitalization. This study aimed to identify trends and predictors of hospital utilization for hypoglycemia among patients with type 2 diabetes using electronic health record data pooled from six academic health systems.Research design and methodsThis retrospective open cohort study included 549 041 adults with type 2 diabetes receiving regular care from the included health systems between 2009 and 2019. The primary outcome was the yearly event rate for hypoglycemia hospital utilization: emergency department visits, observation visits, or inpatient admissions for hypoglycemia identified using a validated International Classification of Diseases Ninth Revision (ICD-9) algorithm from 2009 to 2014. After the transition to ICD-10 in 2015, we used two ICD-10 code sets (limited and expanded) for hypoglycemia hospital utilization from prior studies. We identified independent predictors of hypoglycemia hospital utilization using multivariable logistic regression analysis with data from 2014.ResultsYearly rates of hypoglycemia hospital utilization decreased from 2.7 to 1.6 events per 1000 patients from 2009 to 2014 (p-trend=0.023). From 2016 to 2019, yearly event rates were stable ranging from 5.6 to 6.6, or 6.3 to 7.3, using the limited and expanded ICD-10 code sets, respectively. In 2014, the strongest independent risk factors for hypoglycemia hospital utilization were chronic kidney disease (OR 2.86, 95% CI 2.33 to 3.57), ages 18–39 years (OR 2.43 vs age 40–64 years, 95% CI 1.78 to 3.31), and insulin use (OR 2.13 vs no diabetes medications, 95% CI 1.67 to 2.73).ConclusionsRates of hypoglycemia hospital utilization decreased from 2009 to 2014 and varied considerably by clinical risk factors such that younger adults, insulin users, and those with chronic kidney disease were at especially high risk. There is a need to validate hypoglycemia ascertainment using ICD-10 codes, which detect a substantially higher number of events compared with ICD-9.

scholarly journals Factors Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes in Bangladesh

2021 ◽  
Vol 18 (23) ◽  
pp. 12277
Author(s):  
Sheikh Mohammed Shariful Islam ◽  
Masudus Salehin ◽  
Sojib Bin Zaman ◽  
Tania Tansi ◽  
Rajat Das Gupta ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Household Income ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Public Health Burden ◽  
Factors Associated

Diabetes and chronic kidney disease (CKD) are a major public health burden in low- and middle-income countries. This study aimed to explore factors associated with CKD in patients with type 2 diabetes (T2D) in Bangladesh. A cross-sectional study was conducted among 315 adults with T2D presenting at the outpatient department of Bangladesh Institute of Health Sciences (BIHS) hospital between July 2013 to December 2013. CKD was diagnosed based on the estimated glomerular filtration rate using the ‘Modification of Diet in Renal Disease’ equations and the presence of albuminuria estimated by the albumin-to-creatinine ratio. Multivariate logistic regression analysis was used to determine the factors associated with CKD. The overall prevalence of CKD among patients with T2D was 21.3%. In the unadjusted model, factors associated with CKD included age 40–49 years (OR: 5.7, 95% CI: 1.3–25.4), age 50–59 years (7.0, 1.6–39), age ≥60 years (7.6, 1.7–34), being female (2.2, 1.2–3.8), being hypertensive (1.9, 1.1–3.5), and household income between 10,001 and 20,000 Bangladeshi taka, BDT (2.9, 1.0–8.2) compared with income ≤10,000 BDT. However, after adjustment of other covariates, only the duration of hypertension and household income (10,001–20,000 BDT) remained statistically significant. There is a need to implement policies and programs for early detection and management of hypertension and CKD in T2D patients in Bangladesh.

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