Prevalence and incidence of microvascular and macrovascular complications over 15 years among patients with incident type 2 diabetes
Introduction Type 2 diabetes (T2D) is a common condition that, if left untreated or poorly managed, can lead to adverse microvascular and macrovascular complications. We estimated the prevalence and incidence of microvascular and macrovascular complications among patients newly diagnosed with T2D wi...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-03-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/9/1/e001847.full |
| _version_ | 1826936630735273984 |
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| author | Gregory A Nichols JaeJin An Lei Qian Mercedes A Munis Teresa N Harrison Zhuoxin Li Rong Wei Tracey Weiss Swapnil Rajpathak Kristi Reynolds |
| author_facet | Gregory A Nichols JaeJin An Lei Qian Mercedes A Munis Teresa N Harrison Zhuoxin Li Rong Wei Tracey Weiss Swapnil Rajpathak Kristi Reynolds |
| author_sort | Gregory A Nichols |
| collection | DOAJ |
| description | Introduction Type 2 diabetes (T2D) is a common condition that, if left untreated or poorly managed, can lead to adverse microvascular and macrovascular complications. We estimated the prevalence and incidence of microvascular and macrovascular complications among patients newly diagnosed with T2D within a US integrated healthcare system.Research design and methods We conducted a retrospective cohort study among patients newly diagnosed with T2D between 2003 and 2014. We evaluated 13 complications, including chronic kidney disease (CKD), cardiovascular disease (CVD), and all-cause mortality through 2018. Multivariable Cox proportional hazards models were used to study factors associated with complications.Results We identified 135 199 patients with incident T2D. The mean age was 58 years, and 48% were women. The prevalence of CKD was the highest of the complications at the time of T2D diagnosis (prevalence=12.3%, 95% CI 12.2% to 12.5%), while the prevalence of CVD was among the lowest at 3.3% (95% CI 3.2% to 3.3%). The median time to incidence of a T2D complication ranged from 3.0 to 5.2 years. High incidence rates (95% CI) of T2D complications included peripheral neuropathy (26.9, 95% CI 26.5 to 27.3 per 1000 person-years (PY)), CKD (21.2, 95% CI 20.9 to 21.6 per 1000 PY), and CVD (11.9, 95% CI 11.7 to 12.2 per 1000 PY). The trend of 5-year incidence rates of T2D complications by diagnosis year decreased over time (p value<0.001). Older age, non-Hispanic white race/ethnicity, sex, higher A1C, smoking, and hypertension were associated with increased CKD and CVD incidence.Conclusion Though incidence rates of T2D complications were lower in more recent years (2010–2014), a significant proportion of patients had complications at T2D diagnosis. Earlier preventive therapies as well as managing modifiable factors may help delay the development and progression of T2D complications. |
| first_indexed | 2024-12-17T03:04:26Z |
| format | Article |
| id | doaj.art-f7a6efc04d02452ab4ec983d8328d6fc |
| institution | Directory Open Access Journal |
| issn | 2052-4897 |
| language | English |
| last_indexed | 2025-02-17T18:25:49Z |
| publishDate | 2021-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Diabetes Research & Care |
| spelling | doaj.art-f7a6efc04d02452ab4ec983d8328d6fc2024-12-12T19:25:10ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972021-03-019110.1136/bmjdrc-2020-001847Prevalence and incidence of microvascular and macrovascular complications over 15 years among patients with incident type 2 diabetesGregory A Nichols0JaeJin An1Lei Qian2Mercedes A Munis3Teresa N Harrison4Zhuoxin Li5Rong Wei6Tracey Weiss7Swapnil Rajpathak8Kristi Reynolds9Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USAResearch and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USADepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USAResearch and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USAResearch and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USAResearch and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USADepartment of Anesthesiology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai, ChinaMerck & Co., Inc, Kenilworth, New Jersey, USAMerck & Co., Inc, Kenilworth, New Jersey, USADepartmnt of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USAIntroduction Type 2 diabetes (T2D) is a common condition that, if left untreated or poorly managed, can lead to adverse microvascular and macrovascular complications. We estimated the prevalence and incidence of microvascular and macrovascular complications among patients newly diagnosed with T2D within a US integrated healthcare system.Research design and methods We conducted a retrospective cohort study among patients newly diagnosed with T2D between 2003 and 2014. We evaluated 13 complications, including chronic kidney disease (CKD), cardiovascular disease (CVD), and all-cause mortality through 2018. Multivariable Cox proportional hazards models were used to study factors associated with complications.Results We identified 135 199 patients with incident T2D. The mean age was 58 years, and 48% were women. The prevalence of CKD was the highest of the complications at the time of T2D diagnosis (prevalence=12.3%, 95% CI 12.2% to 12.5%), while the prevalence of CVD was among the lowest at 3.3% (95% CI 3.2% to 3.3%). The median time to incidence of a T2D complication ranged from 3.0 to 5.2 years. High incidence rates (95% CI) of T2D complications included peripheral neuropathy (26.9, 95% CI 26.5 to 27.3 per 1000 person-years (PY)), CKD (21.2, 95% CI 20.9 to 21.6 per 1000 PY), and CVD (11.9, 95% CI 11.7 to 12.2 per 1000 PY). The trend of 5-year incidence rates of T2D complications by diagnosis year decreased over time (p value<0.001). Older age, non-Hispanic white race/ethnicity, sex, higher A1C, smoking, and hypertension were associated with increased CKD and CVD incidence.Conclusion Though incidence rates of T2D complications were lower in more recent years (2010–2014), a significant proportion of patients had complications at T2D diagnosis. Earlier preventive therapies as well as managing modifiable factors may help delay the development and progression of T2D complications.https://drc.bmj.com/content/9/1/e001847.full |
| spellingShingle | Gregory A Nichols JaeJin An Lei Qian Mercedes A Munis Teresa N Harrison Zhuoxin Li Rong Wei Tracey Weiss Swapnil Rajpathak Kristi Reynolds Prevalence and incidence of microvascular and macrovascular complications over 15 years among patients with incident type 2 diabetes BMJ Open Diabetes Research & Care |
| title | Prevalence and incidence of microvascular and macrovascular complications over 15 years among patients with incident type 2 diabetes |
| title_full | Prevalence and incidence of microvascular and macrovascular complications over 15 years among patients with incident type 2 diabetes |
| title_fullStr | Prevalence and incidence of microvascular and macrovascular complications over 15 years among patients with incident type 2 diabetes |
| title_full_unstemmed | Prevalence and incidence of microvascular and macrovascular complications over 15 years among patients with incident type 2 diabetes |
| title_short | Prevalence and incidence of microvascular and macrovascular complications over 15 years among patients with incident type 2 diabetes |
| title_sort | prevalence and incidence of microvascular and macrovascular complications over 15 years among patients with incident type 2 diabetes |
| url | https://drc.bmj.com/content/9/1/e001847.full |
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