Tags

Type your tag names separated by a space and hit enter

Influence of macro- and microvascular comorbidity on time to insulin initiation in type 2 diabetes patients: a retrospective database analysis in Germany, France, and UK.
Prim Care Diabetes. 2013 Jul; 7(2):167-71.PC

Abstract

AIM

To investigate if micro- and macrovascular co-morbidity has an influence on the time to insulin initiation in type 2 diabetes patients.

METHODS

Longitudinal data from general practices in Germany, France and UK (Disease Analyzer) from 1995 to 2009 were analyzed, including 44,440 patients in Germany, 10,148 patients in France, and 25,499 patients in UK with newly diagnosed diabetes (index date). Cox regression was used to investigate the association of newly diagnosed micro- and macrovascular complications (ICD-10) on the time to insulin initiation adjusting for age, sex, antidiabetic therapy, and co-morbidity (hypertension, lipid disorders).

RESULTS

Insulin treatment was started in 9747 (22%) patients in Germany within 10 years after index date (France: n=702, 7%; UK: 3936, 14%). In all three countries, occurrence of microvascular complications was significantly associated with a higher likelihood to have insulin initiated (hazard ratio (HR), 95%CI: neuropathy: Germany 1.6; 1.5-1.8; France: 2.1; 1.1-3.9; UK: 1.5; 1.3-1.9; nephropathy: Germany 1.4; 1.3-1.6; France: 2.7; 1.4-3.8; UK: 1.2; 1.1-1.3). Among macrovascular complications, only coronary heart disease was related to insulin initiation in all three countries (Germany 1.2; 1.1-1.3; France: 1.5; 1.2-2.0; UK: 1.5; 1.3-1.7).

CONCLUSIONS

A more rapid progression to insulin therapy was found in patients with microvascular complications.

Authors+Show Affiliations

IMS HEALTH, Frankfurt, Germany. kkostev@de.imshealth.comNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

23478140

Citation

Kostev, Karel, and Wolfgang Rathmann. "Influence of Macro- and Microvascular Comorbidity On Time to Insulin Initiation in Type 2 Diabetes Patients: a Retrospective Database Analysis in Germany, France, and UK." Primary Care Diabetes, vol. 7, no. 2, 2013, pp. 167-71.
Kostev K, Rathmann W. Influence of macro- and microvascular comorbidity on time to insulin initiation in type 2 diabetes patients: a retrospective database analysis in Germany, France, and UK. Prim Care Diabetes. 2013;7(2):167-71.
Kostev, K., & Rathmann, W. (2013). Influence of macro- and microvascular comorbidity on time to insulin initiation in type 2 diabetes patients: a retrospective database analysis in Germany, France, and UK. Primary Care Diabetes, 7(2), 167-71. https://doi.org/10.1016/j.pcd.2013.02.001
Kostev K, Rathmann W. Influence of Macro- and Microvascular Comorbidity On Time to Insulin Initiation in Type 2 Diabetes Patients: a Retrospective Database Analysis in Germany, France, and UK. Prim Care Diabetes. 2013;7(2):167-71. PubMed PMID: 23478140.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of macro- and microvascular comorbidity on time to insulin initiation in type 2 diabetes patients: a retrospective database analysis in Germany, France, and UK. AU - Kostev,Karel, AU - Rathmann,Wolfgang, Y1 - 2013/03/09/ PY - 2012/07/22/received PY - 2013/02/07/revised PY - 2013/02/12/accepted PY - 2013/3/13/entrez PY - 2013/3/13/pubmed PY - 2014/2/20/medline SP - 167 EP - 71 JF - Primary care diabetes JO - Prim Care Diabetes VL - 7 IS - 2 N2 - AIM: To investigate if micro- and macrovascular co-morbidity has an influence on the time to insulin initiation in type 2 diabetes patients. METHODS: Longitudinal data from general practices in Germany, France and UK (Disease Analyzer) from 1995 to 2009 were analyzed, including 44,440 patients in Germany, 10,148 patients in France, and 25,499 patients in UK with newly diagnosed diabetes (index date). Cox regression was used to investigate the association of newly diagnosed micro- and macrovascular complications (ICD-10) on the time to insulin initiation adjusting for age, sex, antidiabetic therapy, and co-morbidity (hypertension, lipid disorders). RESULTS: Insulin treatment was started in 9747 (22%) patients in Germany within 10 years after index date (France: n=702, 7%; UK: 3936, 14%). In all three countries, occurrence of microvascular complications was significantly associated with a higher likelihood to have insulin initiated (hazard ratio (HR), 95%CI: neuropathy: Germany 1.6; 1.5-1.8; France: 2.1; 1.1-3.9; UK: 1.5; 1.3-1.9; nephropathy: Germany 1.4; 1.3-1.6; France: 2.7; 1.4-3.8; UK: 1.2; 1.1-1.3). Among macrovascular complications, only coronary heart disease was related to insulin initiation in all three countries (Germany 1.2; 1.1-1.3; France: 1.5; 1.2-2.0; UK: 1.5; 1.3-1.7). CONCLUSIONS: A more rapid progression to insulin therapy was found in patients with microvascular complications. SN - 1878-0210 UR - https://www.unboundmedicine.com/medline/citation/23478140/Influence_of_macro__and_microvascular_comorbidity_on_time_to_insulin_initiation_in_type_2_diabetes_patients:_a_retrospective_database_analysis_in_Germany_France_and_UK_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1751-9918(13)00027-2 DB - PRIME DP - Unbound Medicine ER -