对伦敦西北部非糖尿病高血糖和 2 型糖尿病患者的多病症和医疗服务使用情况的真实世界研究。

IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM BMJ Open Diabetes Research & Care Pub Date : 2024-08-08 DOI:10.1136/bmjdrc-2023-003873
Rakesh Dattani, Zia Ul-Haq, Moulesh Shah, Tahereh Kamalati, Benjamin Pierce, Amanda Lucas, Ahmed Baruwa, Livi Bickford-Smith, Jack Chilcott, Thomas Griffiths, Andrew Howard Frankel, Tony Willis, Frederick Wai Keung Tam
{"title":"对伦敦西北部非糖尿病高血糖和 2 型糖尿病患者的多病症和医疗服务使用情况的真实世界研究。","authors":"Rakesh Dattani, Zia Ul-Haq, Moulesh Shah, Tahereh Kamalati, Benjamin Pierce, Amanda Lucas, Ahmed Baruwa, Livi Bickford-Smith, Jack Chilcott, Thomas Griffiths, Andrew Howard Frankel, Tony Willis, Frederick Wai Keung Tam","doi":"10.1136/bmjdrc-2023-003873","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of non-diabetic hyperglycemia (NDH) and type 2 diabetes mellitus (T2DM) is increasing. While T2DM is recognised to be associated with multimorbidity and early mortality, people with NDH are frequently thought to be devoid of such complications, potentially exposing individuals with NDH to suboptimal care. We therefore used the Discover London Secure Data Environment (SDE) dataset to appreciate the relationship of NDH/T2DM with multimorbidity, healthcare usage, and clinical outcomes.</p><p><strong>Research design and methods: </strong>The dataset was retrospectively analysed between January 1, 2015 and December 31, 2020 to understand the relationship between NDH/T2DM and multimorbidity primary/secondary healthcare usage and clinical outcomes. This was compared with a cohort of individuals with thyroid disease but no NDH/T2DM.</p><p><strong>Results: </strong>The dataset identified 152,384 and 124,190 adults with NDH and T2DM compared with 11,626 individuals with thyroid disease (control group). Individuals with NDH and individuals with T2DM had a high burden of disease, with only 13.1% of individuals with either NDH or T2DM not found to be suffering from at least one of the disease states of interest. The three most common comorbidities experienced by individuals with NDH were hypertension (41.4%), hypercholesterolemia (37.5%), and obesity (29.8%) compared with retinopathy (68.7%), hypertension (59.4%), and obesity (45.8%) in individuals with T2DM. Comparatively, the most common comorbidities in the control group were depression (30.8%), hypercholesterolemia (24.4%), and hypertension (17.1%). 28 (control group), 12 (NDH), and 16 (T2DM) primary care contacts per individual per year were identified, with 27,881, 282,371, and 314,880 inpatient admissions for the control, NDH, and T2DM cohorts, respectively. Prescription of drugs used to treat T2DM in individuals with NDH and T2DM was 27,772 (18.2%) and 109,361 (88.1%), respectively, accounting for approximately one in five individuals with NDH developing T2DM.</p><p><strong>Conclusion: </strong>Both NDH and T2DM were associated with significant multimorbidity alongside primary and secondary care utilisation. Given the morbidity highlighted with NDH, we highlight the need for earlier detection of NDH, recognition of multimorbidity associated with both NDH and T2DM, as well as the need for the further implementation of interventions to prevent progression to T2DM/multimorbidity.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409243/pdf/","citationCount":"0","resultStr":"{\"title\":\"Real-world study of the multimorbidity and health service utilisation among individuals with non-diabetic hyperglycemia and type 2 diabetes mellitus in North West London.\",\"authors\":\"Rakesh Dattani, Zia Ul-Haq, Moulesh Shah, Tahereh Kamalati, Benjamin Pierce, Amanda Lucas, Ahmed Baruwa, Livi Bickford-Smith, Jack Chilcott, Thomas Griffiths, Andrew Howard Frankel, Tony Willis, Frederick Wai Keung Tam\",\"doi\":\"10.1136/bmjdrc-2023-003873\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The prevalence of non-diabetic hyperglycemia (NDH) and type 2 diabetes mellitus (T2DM) is increasing. While T2DM is recognised to be associated with multimorbidity and early mortality, people with NDH are frequently thought to be devoid of such complications, potentially exposing individuals with NDH to suboptimal care. We therefore used the Discover London Secure Data Environment (SDE) dataset to appreciate the relationship of NDH/T2DM with multimorbidity, healthcare usage, and clinical outcomes.</p><p><strong>Research design and methods: </strong>The dataset was retrospectively analysed between January 1, 2015 and December 31, 2020 to understand the relationship between NDH/T2DM and multimorbidity primary/secondary healthcare usage and clinical outcomes. This was compared with a cohort of individuals with thyroid disease but no NDH/T2DM.</p><p><strong>Results: </strong>The dataset identified 152,384 and 124,190 adults with NDH and T2DM compared with 11,626 individuals with thyroid disease (control group). Individuals with NDH and individuals with T2DM had a high burden of disease, with only 13.1% of individuals with either NDH or T2DM not found to be suffering from at least one of the disease states of interest. The three most common comorbidities experienced by individuals with NDH were hypertension (41.4%), hypercholesterolemia (37.5%), and obesity (29.8%) compared with retinopathy (68.7%), hypertension (59.4%), and obesity (45.8%) in individuals with T2DM. Comparatively, the most common comorbidities in the control group were depression (30.8%), hypercholesterolemia (24.4%), and hypertension (17.1%). 28 (control group), 12 (NDH), and 16 (T2DM) primary care contacts per individual per year were identified, with 27,881, 282,371, and 314,880 inpatient admissions for the control, NDH, and T2DM cohorts, respectively. Prescription of drugs used to treat T2DM in individuals with NDH and T2DM was 27,772 (18.2%) and 109,361 (88.1%), respectively, accounting for approximately one in five individuals with NDH developing T2DM.</p><p><strong>Conclusion: </strong>Both NDH and T2DM were associated with significant multimorbidity alongside primary and secondary care utilisation. Given the morbidity highlighted with NDH, we highlight the need for earlier detection of NDH, recognition of multimorbidity associated with both NDH and T2DM, as well as the need for the further implementation of interventions to prevent progression to T2DM/multimorbidity.</p>\",\"PeriodicalId\":9151,\"journal\":{\"name\":\"BMJ Open Diabetes Research & Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-08-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409243/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Open Diabetes Research & Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjdrc-2023-003873\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Open Diabetes Research & Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjdrc-2023-003873","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0

摘要

简介非糖尿病性高血糖(NDH)和 2 型糖尿病(T2DM)的发病率正在上升。人们认识到 T2DM 与多病症和早期死亡有关,而非糖尿病性高血糖患者通常被认为没有此类并发症,这可能会使非糖尿病性高血糖患者受到次优护理。因此,我们利用 "发现伦敦安全数据环境"(SDE)数据集来了解 NDH/T2DM 与多病症、医疗保健使用和临床结果之间的关系:对 2015 年 1 月 1 日至 2020 年 12 月 31 日期间的数据集进行回顾性分析,以了解 NDH/T2DM 与多病症初级/二级医疗保健使用和临床结果之间的关系。分析结果与患有甲状腺疾病但无NDH/T2DM的人群进行了比较:数据集发现,分别有 152,384 和 124,190 名成年人患有 NDH 和 T2DM,而患有甲状腺疾病的人数为 11,626 人(对照组)。NDH患者和T2DM患者的疾病负担很重,只有13.1%的NDH患者或T2DM患者没有发现至少患有一种相关疾病。NDH 患者最常见的三种合并症是高血压(41.4%)、高胆固醇血症(37.5%)和肥胖(29.8%),而 T2DM 患者最常见的合并症是视网膜病变(68.7%)、高血压(59.4%)和肥胖(45.8%)。相比之下,对照组最常见的合并症是抑郁症(30.8%)、高胆固醇血症(24.4%)和高血压(17.1%)。对照组、NDH 组和 T2DM 组的每人每年初级保健接触次数分别为 28 次(对照组)、12 次(NDH 组)和 16 次(T2DM 组),住院人次分别为 27,881 次、282,371 次和 314,880 次。在 NDH 和 T2DM 患者中,用于治疗 T2DM 的药物处方分别为 27,772 份(18.2%)和 109,361 份(88.1%),大约每五名 NDH 患者中就有一人患上了 T2DM:结论:NDH 和 T2DM 都与严重的多病并发症以及初级和中级医疗服务的使用有关。鉴于 NDH 的发病率较高,我们强调需要更早地发现 NDH,认识到 NDH 和 T2DM 相关的多病症,以及需要进一步实施干预措施,防止发展为 T2DM/多病症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Real-world study of the multimorbidity and health service utilisation among individuals with non-diabetic hyperglycemia and type 2 diabetes mellitus in North West London.

Introduction: The prevalence of non-diabetic hyperglycemia (NDH) and type 2 diabetes mellitus (T2DM) is increasing. While T2DM is recognised to be associated with multimorbidity and early mortality, people with NDH are frequently thought to be devoid of such complications, potentially exposing individuals with NDH to suboptimal care. We therefore used the Discover London Secure Data Environment (SDE) dataset to appreciate the relationship of NDH/T2DM with multimorbidity, healthcare usage, and clinical outcomes.

Research design and methods: The dataset was retrospectively analysed between January 1, 2015 and December 31, 2020 to understand the relationship between NDH/T2DM and multimorbidity primary/secondary healthcare usage and clinical outcomes. This was compared with a cohort of individuals with thyroid disease but no NDH/T2DM.

Results: The dataset identified 152,384 and 124,190 adults with NDH and T2DM compared with 11,626 individuals with thyroid disease (control group). Individuals with NDH and individuals with T2DM had a high burden of disease, with only 13.1% of individuals with either NDH or T2DM not found to be suffering from at least one of the disease states of interest. The three most common comorbidities experienced by individuals with NDH were hypertension (41.4%), hypercholesterolemia (37.5%), and obesity (29.8%) compared with retinopathy (68.7%), hypertension (59.4%), and obesity (45.8%) in individuals with T2DM. Comparatively, the most common comorbidities in the control group were depression (30.8%), hypercholesterolemia (24.4%), and hypertension (17.1%). 28 (control group), 12 (NDH), and 16 (T2DM) primary care contacts per individual per year were identified, with 27,881, 282,371, and 314,880 inpatient admissions for the control, NDH, and T2DM cohorts, respectively. Prescription of drugs used to treat T2DM in individuals with NDH and T2DM was 27,772 (18.2%) and 109,361 (88.1%), respectively, accounting for approximately one in five individuals with NDH developing T2DM.

Conclusion: Both NDH and T2DM were associated with significant multimorbidity alongside primary and secondary care utilisation. Given the morbidity highlighted with NDH, we highlight the need for earlier detection of NDH, recognition of multimorbidity associated with both NDH and T2DM, as well as the need for the further implementation of interventions to prevent progression to T2DM/multimorbidity.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
BMJ Open Diabetes Research & Care
BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
9.30
自引率
2.40%
发文量
123
审稿时长
18 weeks
期刊介绍: BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.
期刊最新文献
Effect of weight-maintaining ketogenic diet on glycemic control and insulin sensitivity in obese T2D subjects. National health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in Germany: a simulation study. Ethnic-specific oral glucose tolerance (OGTT) phenotypes in women with hyperglycemia in pregnancy. Recent trends in GLP-1 RA and SGLT2i use among people with type 2 diabetes and atherosclerotic cardiovascular disease in the USA. Applying machine learning approaches for predicting obesity risk using US health administrative claims database.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1