Prevalence and Risk Factors of Type 2 Diabetes and Prediabetes Among 53,288 Middle-Aged and Elderly Adults in China: A Cross-Sectional Study

Xia, Mengdi; Liu, Kaixiang; Feng, Jiafu; Zheng, Z Q; Xie, Xi-Sheng

doi:10.2147/dmso.s305919

Cited by 11 publications

(5 citation statements)

References 50 publications

(59 reference statements)

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“…Previous studies have shown that advanced age is an important risk factor for the occurrence and development of patients with diabetes mellitus and AKI ( 43 , 44 ). Our study also showed that advanced age was an independent risk factor for all-cause mortality in diabetic patients with AKI.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Prediction Model for Survival in Diabetic Patients With Acute Kidney Injury

Pan

Huang

et al. 2021

Front. Endocrinol.

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ObjectiveWe aimed to analyze the risk factors affecting all-cause mortality in diabetic patients with acute kidney injury (AKI) and to develop and validate a nomogram for predicting the 90-day survival rate of patients.MethodsClinical data of diabetic patients with AKI who were diagnosed at The First Affiliated Hospital of Guangxi Medical University from April 30, 2011, to April 30, 2021, were collected. A total of 1,042 patients were randomly divided into a development cohort and a validation cohort at a ratio of 7:3. The primary study endpoint was all-cause death within 90 days of AKI diagnosis. Clinical parameters and demographic characteristics were analyzed using Cox regression to develop a prediction model for survival in diabetic patients with AKI, and a nomogram was then constructed. The concordance index (C-index), receiver operating characteristic curve, and calibration plot were used to evaluate the prediction model.ResultsThe development cohort enrolled 730 patients with a median follow-up time of 87 (40–98) days, and 86 patients (11.8%) died during follow-up. The 90-day survival rate was 88.2% (644/730), and the recovery rate for renal function in survivors was 32.9% (212/644). Multivariate analysis showed that advanced age (HR = 1.064, 95% CI = 1.043–1.085), lower pulse pressure (HR = 0.964, 95% CI = 0.951–0.977), stage 3 AKI (HR = 4.803, 95% CI = 1.678–13.750), lower 25-hydroxyvitamin D3 (HR = 0.944, 95% CI = 0.930–0.960), and multiple organ dysfunction syndrome (HR = 2.056, 95% CI = 1.287–3.286) were independent risk factors affecting the all-cause death of diabetic patients with AKI (all p < 0.01). The C-indices of the prediction cohort and the validation cohort were 0.880 (95% CI = 0.839–0.921) and 0.798 (95% CI = 0.720–0.876), respectively. The calibration plot of the model showed excellent consistency between the prediction probability and the actual probability.ConclusionWe developed a new prediction model that has been internally verified to have good discrimination, calibration, and clinical value for predicting the 90-day survival rate of diabetic patients with AKI.

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Section: Discussionmentioning

confidence: 99%

Development and Validation of a Prediction Model for Survival in Diabetic Patients With Acute Kidney Injury

Pan

Huang

et al. 2021

Front. Endocrinol.

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“…Nevertheless, our study has several limitations. The prevalence of hypertension and diabetes among residents registered in the local EMR database were 11.2% and 3.2% respectively in 2016, which were lower than the disease prevalence shown by epidemiological data [37][38][39]. This implies a participant bias and that our sample may not be fully representative of the general population residing in Taizhou.…”

Section: Discussionmentioning

confidence: 67%

Effects of the Full Coverage Policy of Essential Medicines on Inequality in Medication Adherence: A Longitudinal Study in Taizhou, China

Zhi-gang

Zheng

et al. 2021

Preprint

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Background: The full coverage policy for essential medicines (FCPEMs) was proposed and implemented in Taizhou city of Zhejiang Province of China to promote equal access and adherence to medicines. This study aimed to examine the effects of FCPEMs on the inequality in medication adherence among local patients with hypertension and diabetes, and to explore their influencing factorsMethods: We collected electronic health records of patients with hypertension and diabetes of three districts of Taizhou from 2011-2016. With the implementation time of FCPEMs being different, we applied a retrospective longitudinal study design and selected the records of 1 baseline year before and 3 follow-up years after following the implementation of FCPEMs. All data entries of the same patient were aggregated and generated a dataset with 4-year longitudinal data. The concentration index (CI) and its decomposition method were employed to measure the factors contributing to inequality in medication adherence and the role played by FCPEMs.Results: The sample size of the 4 years retrospective longitudinal data rose from 264,836 to 315,677, 340,512 and 355,676 individuals and the proportion of the patient taking the free medicines were 17.6% to 25.0% and 29.8% after FCPEMs. The proportion of patients with high adherence increased from 39.9% to 51.6%, 57.2%, 60.5% and CI changed from 0.073 to -0.011, -0.029, -0.035, where the rate of the contribution of FCPEMs were 54.792%, 1.223% and -19.092% and ranked 2nd, 7th and 2nd after the implementation of FCPEMs. The changes in CI of medication adherence for every two years were -0.084, -0.018, -0.006, and the contribution of FCPEMs were -0.006, 0.006, 0.007, ranking the 2nd, 2nd and 1st and mainly attributed to the changes of CI of FCPEMs.Conclusions: The medication adherence of patients with hypertension and diabetes improved after the implementation FCPEMs in Taizhou, but the inequality did not show a consistent rate of improvement. In general, FCPEMs contributed to improvements in the inequality in medication adherence. FCPEMs could be a protective factor against the income-related inequalities, but this would need further investigations and to be accompanied by other systematic efforts.

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“…Nevertheless, our study has several limitations. First, the prevalence of hypertension and diabetes among residents registered in the local EMR database was 11.2 and 3.2%, respectively, in 2016, which were lower than the disease prevalence shown by epidemiological data (Li, 2021;Li et al, 2021;Xia et al, 2021). This implies a participant bias and that our sample might not be fully representative of the general population residing in Taizhou.…”

Section: Determinantmentioning

confidence: 76%

Effects of the Full Coverage Policy of Essential Medicines on Inequality in Medication Adherence: A Longitudinal Study in Taizhou, China

Zhi-gang

Zheng

et al. 2022

Front. Pharmacol.

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The full coverage policy for essential medicines (FCPEMs) was proposed and implemented in Taizhou city of Zhejiang Province, China, to promote equal access and adherence to medicines. This study aimed to examine the effects of FCPEMs on the income-related inequality in medication adherence among local patients with hypertension or diabetes. We collected electronic health records of patients with hypertension or diabetes of three districts of Taizhou from 2011 to 2016. As the implementation schedule of the FCPEMs varied across districts, we applied a retrospective longitudinal study design and assigned records from 1 year before to 3 years following the implementation of FCPEMs as baseline and follow-up data. We thus generated a dataset with 4-year longitudinal data. The concentration index (CI) and its decomposition method were employed to measure factors contributing to inequality in medication adherence and the role played by FCPEMs. The sample size rose from 264,836 at the baseline to 315,677, 340,512, and 355,676 by each follow-up year, and the proportion of patients taking free medicines rose from 17.6 to 25.0 and 29.8% after FCPEMs implementation. The proportion of patients with high adherence increased from 39.9% at baseline to 51.6, 57.2, and 60.5%, while CI decreased from 0.073 to −0.011, −0.029, and −0.035. The contribution of FCPEMs ranked at 2nd/13, 7th/13, and 2nd/13 after the implementation of FCPEMs. Changes in CI of medication adherence for every 2 years were −0.084, −0.018, and −0.006, and the contribution of FCPEMs was −0.006, 0.006, and 0.007, ranking at 2nd/13, 2nd/13, and 1st/13, respectively. Most changes in CI of medication adherence can be attributed to FCPEMs. The medication adherence of patients with hypertension or diabetes improved after the implementation FCPEMs in Taizhou, although inequality did not improve consistently. In general, FCPEMs could be a protective factor against income-related inequalities in access and adherence to medicines. Future research is needed to investigate the change mechanism and the optimal design of similar interventions.

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Prevalence and Risk Factors of Type 2 Diabetes and Prediabetes Among 53,288 Middle-Aged and Elderly Adults in China: A Cross-Sectional Study

Cited by 11 publications

References 50 publications

Development and Validation of a Prediction Model for Survival in Diabetic Patients With Acute Kidney Injury

Development and Validation of a Prediction Model for Survival in Diabetic Patients With Acute Kidney Injury

Effects of the Full Coverage Policy of Essential Medicines on Inequality in Medication Adherence: A Longitudinal Study in Taizhou, China

Effects of the Full Coverage Policy of Essential Medicines on Inequality in Medication Adherence: A Longitudinal Study in Taizhou, China

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