scholarly journals Social Deprivation and Incident Diabetes-Related Foot Disease in Patients With Type 2 Diabetes: A Population-Based Cohort Study

Diabetes Care ◽  
2021 ◽  
Vol 44 (3) ◽  
pp. 731-739
Author(s):  
Jenny Riley ◽  
Christina Antza ◽  
Punith Kempegowda ◽  
Anuradhaa Subramanian ◽  
Joht Singh Chandan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Social Deprivation ◽  
Population Based ◽  
Incident Diabetes ◽  
Foot Disease

scholarly journals Social Deprivation and Incident Diabetes-Related Foot Disease in Patients With Type 2 Diabetes: A Population-Based Cohort Study

2021 ◽  
Author(s):  
Jenny Riley ◽  
Christina Antza ◽  
Punith Kempegowda ◽  
Anuradhaa Subramanian ◽  
Joht Singh Chandan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Social Deprivation ◽  
Population Based ◽  
Incident Diabetes ◽  
Lipid Lowering ◽  
Diabetes Diagnosis ◽  
Newly Diagnosed ◽  
Foot Disease

<b>Objective: </b>To investigate the relationship between social deprivation and incident diabetes-related foot disease (DFD), in newly-diagnosed patients with type 2 diabetes. <p><b>Research design and methods:</b> A population-based, open retrospective cohort study, using The Health Improvement Network (01/01/2005-31/12/2019). Patients with type 2 diabetes, free of DFD at baseline, were stratified by Townsend deprivation index and the risk of developing DFD was calculated. DFD was defined as a composite of foot ulcer (FU), Charcot arthropathy, lower limb amputation (LLA), peripheral neuropathy (PN), peripheral vascular disease (PVD) and gangrene.</p> <p><b>Results:</b> 176,359 patients were eligible (56% men; aged 62.9±13.1years). After excluding 26,094 patients with DFD before/within 15 months of type 2 diabetes diagnosis, DFD was incidentally developed in 12.1% of study population during 3.27years (IQR:1.41-5.96). Patients in the most deprived Townsend quintile had increased risk of DFD compared to those in the least deprived (aHR:1.22, 95%CI:1.16-1.29) after adjusting for sex, age at type 2 diabetes diagnosis, ethnicity, smoking, BMI, HbA1c, cardiovascular disease, hypertension, retinopathy, eGFR, insulin, glucose/lipid-lowering medications and baseline foot risk. Patients in the most deprived Townsend quintile had higher risk of PN (aHR:1.18, 95%CI:1.11-1.25), FU (aHR:1.44, 95%CI:1.17-1.77), PVD (aHR:1.40, 95%CI:1.28-1.53) LLA (aHR:1.75, 95%CI:1.08-2.83) and gangrene (aHR:8.49, 95% CI:1.01-71.58) compared to those in the least.</p> <p><b>Conclusion: </b>Social deprivation is an independent risk factor for the development of DFD, PN, FU, PVD, LLA and gangrene in newly-diagnosed patients with type 2 diabetes. Considering the high individual and economic burden of DFD, strategies targeting patients in socially deprived areas are needed to reduce health inequalities.</p> <p><b> </b></p>

scholarly journals Social Deprivation and Incident Diabetes-Related Foot Disease in Patients With Type 2 Diabetes: A Population-Based Cohort Study

2021 ◽  
Author(s):  
Jenny Riley ◽  
Christina Antza ◽  
Punith Kempegowda ◽  
Anuradhaa Subramanian ◽  
Joht Singh Chandan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Social Deprivation ◽  
Population Based ◽  
Incident Diabetes ◽  
Lipid Lowering ◽  
Diabetes Diagnosis ◽  
Newly Diagnosed ◽  
Foot Disease

<b>Objective: </b>To investigate the relationship between social deprivation and incident diabetes-related foot disease (DFD), in newly-diagnosed patients with type 2 diabetes. <p><b>Research design and methods:</b> A population-based, open retrospective cohort study, using The Health Improvement Network (01/01/2005-31/12/2019). Patients with type 2 diabetes, free of DFD at baseline, were stratified by Townsend deprivation index and the risk of developing DFD was calculated. DFD was defined as a composite of foot ulcer (FU), Charcot arthropathy, lower limb amputation (LLA), peripheral neuropathy (PN), peripheral vascular disease (PVD) and gangrene.</p> <p><b>Results:</b> 176,359 patients were eligible (56% men; aged 62.9±13.1years). After excluding 26,094 patients with DFD before/within 15 months of type 2 diabetes diagnosis, DFD was incidentally developed in 12.1% of study population during 3.27years (IQR:1.41-5.96). Patients in the most deprived Townsend quintile had increased risk of DFD compared to those in the least deprived (aHR:1.22, 95%CI:1.16-1.29) after adjusting for sex, age at type 2 diabetes diagnosis, ethnicity, smoking, BMI, HbA1c, cardiovascular disease, hypertension, retinopathy, eGFR, insulin, glucose/lipid-lowering medications and baseline foot risk. Patients in the most deprived Townsend quintile had higher risk of PN (aHR:1.18, 95%CI:1.11-1.25), FU (aHR:1.44, 95%CI:1.17-1.77), PVD (aHR:1.40, 95%CI:1.28-1.53) LLA (aHR:1.75, 95%CI:1.08-2.83) and gangrene (aHR:8.49, 95% CI:1.01-71.58) compared to those in the least.</p> <p><b>Conclusion: </b>Social deprivation is an independent risk factor for the development of DFD, PN, FU, PVD, LLA and gangrene in newly-diagnosed patients with type 2 diabetes. Considering the high individual and economic burden of DFD, strategies targeting patients in socially deprived areas are needed to reduce health inequalities.</p> <p><b> </b></p>

scholarly journals The impact of bariatric surgery on incident microvascular complications in patients with type 2 diabetes: A matched controlled population-based retrospective cohort study

2020 ◽  
Author(s):  
Pushpa Singh ◽  
Nicola Adderley ◽  
Anuradhaa Subramanian ◽  
Krishna Gokhale ◽  
Rishi Singhal ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Cohort Study ◽  
Microvascular Complications ◽  
Population Based ◽  
Type2 Diabetes ◽  
Foot Disease ◽  
The Impact ◽  
Surgical Group

Aim: To assess the impact of bariatric surgery (BS) on incident microvascular complications [diabetes-related foot disease (DFD), sight threatening diabetic retinopathy (STDR), chronic kidney disease (CKD)] in patients with type 2 diabetes and obesity. <p>Methods: <a>A retrospective matched, controlled population-based cohort study of adults with type 2 diabetes between 1/1/1990 and 31/1/2018 using </a><a>IQVIA Medical Research Data (IMRD), </a>a database of primary care electronic records. <a>Each patient with type2 diabetes who subsequently had BS (surgical) was matched on index date with up to 2 patients with type 2 diabetes did not have BS (non-surgical) within the same general practice by age, sex, pre-index body mass index and diabetes duration</a>.</p> <p>Results: 1126 surgical and 2219 non-surgical participants were included. In the study population, 2261 (68%) were women; Mean (SD) age was 49.87 (9.3) vs 50.12 (9.3) years and BMI was 46.76 (7.96) kg/m<sup>2</sup> vs 46.14 (7.49) kg/m<sup>2</sup> in surgical vs non-surgical group respectively. In surgical group, 22.1%, 22.7%, 52.2% and 1.1% patients had gastric band, sleeve gastrectomy, gastric bypass & duodenal switch respectively.</p> <p>Over median (IQR) follow-up was 3.9 years (1.8-6.4), BS was associated with reduction in incident combined microvascular complications (adjusted HR 0.63, 95% CI 0.51 to 0.78, p<0.001), DFD (0.61, 0.50 to 0.75, p<0.001), STDR (0.66, 0.44 to 1.00, p<0.001), CKD (0.63, 0.51 to 0.78, p<0.001). Analysis based on the type of surgery showed that all types of surgery were associated with favourable impact on the incident of composite microvascular complications, greatest reduction RYGB.</p> <p>Conclusions: BS was associated with a significant reduction in incident diabetes-related microvascular complications. </p>

scholarly journals The impact of bariatric surgery on incident microvascular complications in patients with type 2 diabetes: A matched controlled population-based retrospective cohort study

2020 ◽  
Author(s):  
Pushpa Singh ◽  
Nicola Adderley ◽  
Anuradhaa Subramanian ◽  
Krishna Gokhale ◽  
Rishi Singhal ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Cohort Study ◽  
Microvascular Complications ◽  
Population Based ◽  
Type2 Diabetes ◽  
Foot Disease ◽  
The Impact ◽  
Surgical Group

Aim: To assess the impact of bariatric surgery (BS) on incident microvascular complications [diabetes-related foot disease (DFD), sight threatening diabetic retinopathy (STDR), chronic kidney disease (CKD)] in patients with type 2 diabetes and obesity. <p>Methods: <a>A retrospective matched, controlled population-based cohort study of adults with type 2 diabetes between 1/1/1990 and 31/1/2018 using </a><a>IQVIA Medical Research Data (IMRD), </a>a database of primary care electronic records. <a>Each patient with type2 diabetes who subsequently had BS (surgical) was matched on index date with up to 2 patients with type 2 diabetes did not have BS (non-surgical) within the same general practice by age, sex, pre-index body mass index and diabetes duration</a>.</p> <p>Results: 1126 surgical and 2219 non-surgical participants were included. In the study population, 2261 (68%) were women; Mean (SD) age was 49.87 (9.3) vs 50.12 (9.3) years and BMI was 46.76 (7.96) kg/m<sup>2</sup> vs 46.14 (7.49) kg/m<sup>2</sup> in surgical vs non-surgical group respectively. In surgical group, 22.1%, 22.7%, 52.2% and 1.1% patients had gastric band, sleeve gastrectomy, gastric bypass & duodenal switch respectively.</p> <p>Over median (IQR) follow-up was 3.9 years (1.8-6.4), BS was associated with reduction in incident combined microvascular complications (adjusted HR 0.63, 95% CI 0.51 to 0.78, p<0.001), DFD (0.61, 0.50 to 0.75, p<0.001), STDR (0.66, 0.44 to 1.00, p<0.001), CKD (0.63, 0.51 to 0.78, p<0.001). Analysis based on the type of surgery showed that all types of surgery were associated with favourable impact on the incident of composite microvascular complications, greatest reduction RYGB.</p> <p>Conclusions: BS was associated with a significant reduction in incident diabetes-related microvascular complications. </p>

115 RISK OF POST-COLONOSCOPY COLORECTAL CANCER IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A DANISH POPULATION-BASED COHORT STUDY

2021 ◽  
Vol 160 (6) ◽  
pp. S-30
Author(s):  
Frederikke Sch⊘nfeldt Troelsen ◽  
Henrik Toft S⊘rensen ◽  
Lars Pedersen ◽  
Rune Erichsen
Keyword(s):  
Diabetes Mellitus ◽  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Population Based ◽  
Danish Population

Risk of type 2 diabetes in patients with insomnia: A population-based historical cohort study

2017 ◽  
Vol 34 (1) ◽  
pp. e2930 ◽  
Author(s):  
Chia-Ling Lin ◽  
Wu-Chien Chien ◽  
Chi-Hsiang Chung ◽  
Fei-Ling Wu
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Population Based ◽  
Historical Cohort ◽  
Historical Cohort Study
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