Control of Glycemia and Cardiovascular Risk Factors in Patients With Type 2 Diabetes in Primary Care in Catalonia (Spain)

Vinagre, Irene; Mata-Cases, Manel; Hermosilla, Eduard; Morros, Rosa; Fina, Francesc; Rosell, Magdalena; Castell, Conxa; Franch-Nadal, Josep; Bolíbar, Bonaventura; Mauricio, Dı́dac

doi:10.2337/dc11-1679

Cited by 205 publications

(150 citation statements)

References 22 publications

(31 reference statements)

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“…This multidisciplinary approach may partially explain the annual 3% decrease in cardiovascular mortality observed in individuals with diabetes in the United States; however, the pattern in individuals without such disease has been much lower (36)(37)(38). In Spain, particularly, despite the improvements observed in the control of cardiovascular risk factors in individuals with diabetes, there is still room for preventive activity (4,39).…”

Section: Public Health Implicationsmentioning

confidence: 99%

Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis

et al. 2016

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OBJECTIVEDiabetes is a common cause of shortened life expectancy. We aimed to assess the association between diabetes and cause-specific death. RESEARCH DESIGN AND METHODSWe used the pooled analysis of individual data from 12 Spanish population cohorts with 10-year follow-up. Participants had no previous history of cardiovascular diseases and were 35-79 years old. Diabetes status was self-reported or defined as glycemia >125 mg/dL at baseline. Vital status and causes of death were ascertained by medical records review and linkage with the official death registry. The hazard ratios and cumulative mortality function were assessed with two approaches, with and without competing risks: proportional subdistribution hazard (PSH) and cause-specific hazard (CSH), respectively. Multivariate analyses were fitted for cardiovascular, cancer, and noncardiovascular noncancer deaths. RESULTSWe included 55,292 individuals (15.6% with diabetes and overall mortality of 9.1%). The adjusted hazard ratios showed that diabetes increased mortality risk: 1) cardiovascular death, CSH = 2.03 (95% CI 1.63-2.52) and PSH = 1.99 (1.60-2.49) in men; and CSH = 2.28 (1.75-2.97) and PSH = 2.23 (1.70-2.91) in women; 2) cancer death, CSH = 1.37 (1.13-1.67) and PSH = 1.35 (1.10-1.65) in men; and CSH = 1.68 (1.29-2.20) and PSH = 1.66 (1.25-2.19) in women; and 3) noncardiovascular noncancer death, CSH = 1.53 (1.23-1.91) and PSH = 1.50 (1.20-1.89) in men; and CSH = 1.89 (1.43-2.48) and PSH = 1.84 (1.39-2.45) in women. In all instances, the cumulative mortality function was significantly higher in individuals with diabetes. CONCLUSIONSDiabetes is associated with premature death from cardiovascular disease, cancer, and noncardiovascular noncancer causes. The use of CSH and PSH provides a comprehensive view of mortality dynamics in a population with diabetes.Diabetes constitutes a worldwide public health problem (1) that affected 382 million people (8.3% of the world's population) in 2013 (2). Recent projections suggest that this prevalence is likely to increase in the next 20 years, affecting 592 million people (10.1%) in 2035. In Spain, diabetes affects 13.8% of individuals older than 18 years and is more prevalent in men than in women (3,4).The average life expectancy of a 50-year-old individual with diabetes is 6 years shorter than it would be without the disease (5). Diabetes not only doubles or

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Section: Public Health Implicationsmentioning

confidence: 99%

Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis

et al. 2016

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“…The psychosocial [9] and psychological [10,11] problems associated with diabetes, as well as the burden of disease and the lifestyle restrictions of diabetic patients are widely addressed in the literature [12]. For these reasons, individuals with DM need ongoing professional support and specific training to minimize complications and improve their well-being [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Health-Related Quality of Life using the EQ-5D-3L in Individuals with Type 2 Diabetes Mellitus

Cardoso¹

2016

JDMDC

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The daily experience with type 2 diabetes mellitus (T2DM) has significant adverse effects on health-related quality of life (HRQoL). HRQoL assessment is essential for measuring the impact of the disease on the patient and selecting individualized strategies. Generic measures for assessing HRQoL are very useful because, unlike specific measurement instruments, they allow for the comparison with other instruments. The EQ-5D-3L is a generic measure and it describes HRQoL in five dimensions; mobility, self-care, usual activities, pain/discomfort and anxiety/depression, with three levels each. In Portugal, studies using the EQ-5D-3L as a generic measure to assess HRQoL in diabetic patients are scarce.Objective: To assess HRQoL in individuals with T2DM using the Portuguese version of the EQ-5D-3L.Methodology: An accidental sample of patients with T2DM (n=437) was selected at Family Health Units and healthcare centers in Coimbra, Portugal, between January 2013 and January 2014. The EQ-5D-3L was applied in interviews. The EQ-5D-3L score was calculated based on the answers to the five dimensions and the value system for the Portuguese population.Results: In this sample, 100% of the participants answered the EQ-5D-3L. The HRQoL score was 0.6772 in the EQ-5D-3L and 64.85 in the EQ-VAS. The most frequent answers to the five dimensions were no problems or some problems. The mean score of the EQ-5D-3L was significantly associated with age, male gender, high level of education, having an occupation, practicing physical activity, being single and having been diagnosed with T2DM for less time. The Cronbach alpha's value was 0.674, confirming an acceptable internal consistency. Conclusion:HRQoL levels in individuals with T2DM are lower than the national average and vary depending on sociodemographic and clinical characteristics. The EQ-5D-3L is a reliable instrument that can be used to assess the quality of life of diabetic patients and contribute to assess the patients' overall health status, adding data from the subjective dimension of self-care management.

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“…After a quality control, information from almost 5 million people was available, demographically representative of this population. The quality of the information which SIDIAP contains has been validated 11 ; earlier studies validated the records of incidents of fracture in comparison with classical cohorts 12 and the data related to the records of DM2 13 . From all the patients included in SIDIAP, those who had a diagnosis of DM2 in a period between 01/01/2006 and 31/12/2011 were identified, using the CIE codes 10.…”

Section: Methodsmentioning

confidence: 99%

Riesgo de fractura asociado a los estadios previos al diagnóstico de diabetes mellitus tipo 2: estudio de casos-controles anidados (cohorte DIAFOS)

Martínez-Laguna

Nogues-Solan

Díez-Pérez³

et al. 2013

Rev Osteoporos Metab Miner

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SummaryBackgound: In phases prior to the diagnosis of diabetes mellitus type 2 there is an increased risk of cardiovascular disease, but it is not known if this is the case in relation to the risk of fractures. Objective: To compare the prevalence of fracture in cases of diabetes mellitus and in matched controls. Material and method: Nested case-control study in a population-based cohort. All patients diagnosed with type 2 diabetes in the period 2006-2011 were included, as were, for each of these patients, two control subjects of the same age, gender, and from the same medical centre, without diabetes. Any fractures, cerebro-vascular accidents and ischemic cardiopathy prevalent in these patients were identified using ICD codes 10. The prevalence of osteoporotic, major and hip fractures, and of cardiovascular disease at the time of diagnosis for the diabetic subjects, and on the same date for the matched controls, were calculated. Using conditional logistical regression the odds ratios (OR) were calculated, adjusting for body mass index, smoking, alcoholism, use of statins, cardiovascular disease and diabetic complications. Results: 58,931 diabetic patients and 117,862 controls were identified. At the date of diagnosis the diabetic patients had a higher prevalence of cerebro-vascular accident (4.9% vs 3.5%; p< 0.001) and ischemic cardiopathy (8.1% vs 4.7%; p< 0.001). On the other hand, the prevalence of osteoporotic fracture (2.8% vs 2.7%; p= 0.22), hip fracture (0.4% vs 0.4%; p=0.63) and major fracture (1.5% vs 1.5%; p=0.97) was similar in both groups. The adjusted ORs were: 1.2 (CI 95%: 0.96-1.09), 1.08 (CI 95%: 0.90-1.28), and 0.99 (CI 95%: 0.91-1.09), respectively. Conclusions: The type 2 diabetic patients had a higher prevalence of cardiovascular disease at the time of diagnosis. However, their risk of fracture was similar to the non-diabetic control subjects.

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Control of Glycemia and Cardiovascular Risk Factors in Patients With Type 2 Diabetes in Primary Care in Catalonia (Spain)

Cited by 205 publications

References 22 publications

Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis

Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis

Assessment of Health-Related Quality of Life using the EQ-5D-3L in Individuals with Type 2 Diabetes Mellitus

Riesgo de fractura asociado a los estadios previos al diagnóstico de diabetes mellitus tipo 2: estudio de casos-controles anidados (cohorte DIAFOS)

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