The Health and Health Care of Adults With Type 1 And 2 Diabetes Across the Spectrum of Estimated Glomerular Filtration Rates

Clemens, Kristin K.; Ouedraogo, Alexandra; Nash, Danielle M.; Garg, Amit X.; Shariff, Salimah Z.

doi:10.1016/j.jcjd.2018.06.005

Cited by 11 publications

(18 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent study described the HCRU in older diabetes patients (aged >50 years), including those on dialysis, in Ontario, Canada 11 . They found high HCRU for these patients, including a higher number of physician visits, hospitalizations and diabetes‐related complications, similar to our results.…”

Section: Discussionsupporting

confidence: 89%

“…Two recent Canadian studies, using administrative healthcare databases, evaluated outcomes in relation to renal function among people with diabetes. An Alberta study described the prevalence of CVD and chronic kidney disease (CKD) among patients with type 2 diabetes (T2D), while an Ontario study investigated the HCRU of older adults living with both type 1 diabetes (T1D) and T2D across the spectrum of eGFR values 10,11 . There are insufficient data on the prevalence and burden of illness (BOI) associated with T2D, eGFR < 90 mL/min/1.73 m 2 and related adverse outcomes in Canada.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A retrospective observational population‐based study to assess the prevalence and burden of illness of type 2 diabetes with an estimated glomerular filtration rate < 90 mL/min/1.73 m² in Ontario, Canada

Rapattoni¹,

Zante²,

Tomas³

et al. 2021

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

Aim To better understand the healthcare burden of people with type 2 diabetes (T2D) and estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2 in Ontario, Canada. Materials and Methods We used administrative data to evaluate the prevalence of T2D, eGFR < 90 mL/min/1.73 m2 and adverse cardiovascular co‐morbidities in individuals aged ≥ 30 years living in Ontario, Canada. We also examined incremental healthcare costs and healthcare resource utilization (HCRU) for these patients with specific incident cardiovascular and renal outcomes, in comparison with controls without these outcomes. Results While the prevalence of T2D in the general population aged ≥ 30 years in Ontario increased by 1.8% over a 5‐year period (2011‐2012 to 2015‐2016), the prevalence of eGFR < 90 mL/min/1.73 m2 among people with T2D increased by 35%. In comparison with corresponding controls without these outcomes, the per patient average total costs (Canadian dollars) over a 2‐year analysis period were higher for patients with cardiovascular disease/chronic kidney disease related death ($69 827; n = 32 407), doubling of serum creatinine ($52 260; n = 22 825), those who started dialysis ($150 627; n = 3499) or received a kidney transplant ($50 664; n = 651). Similarly, HCRU was significantly greater for patients with these incident outcomes. Conclusions This real‐world retrospective study highlights an increasing prevalence of T2D, eGFR < 90 mL/min/1.73 m2, and the substantially higher healthcare costs and HCRU when these patients have adverse cardiovascular and renal outcomes. The existence of such a large economic burden underpins the importance of preventing these diabetes‐related complications.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

A retrospective observational population‐based study to assess the prevalence and burden of illness of type 2 diabetes with an estimated glomerular filtration rate < 90 mL/min/1.73 m² in Ontario, Canada

Rapattoni¹,

Zante²,

Tomas³

et al. 2021

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

show abstract

“…Educating patients with T2D and their healthcare providers is crucial to avoid metformin‐associated lactic acidosis when there is a risk of AKI. Patients with diabetes and low kidney function are a vulnerable population but these patients are often better monitored than T2D patients with normal kidney function, who face health system challenges and care gaps …”

Section: Discussionmentioning

confidence: 99%

“…Patients with diabetes and low kidney function are a vulnerable population but these patients are often better monitored than T2D patients with normal kidney function, who face health system challenges and care gaps. [26][27][28][29]…”

Section: Discussionmentioning

confidence: 99%

Metformin overdose: A serious iatrogenic complication—Western France Poison Control Centre Data Analysis

Stevens

Hamel

Touré

et al. 2019

Basic Clin Pharma Tox

View full text Add to dashboard Cite

Introduction The prevalence of type 2 diabetes (T2D) continues to rise across the world. Metformin is still considered the “gold standard” and is, therefore, increasingly prescribed. Monitoring of metformin continues to be debated because of its association with lactic acidosis (MALA), a rare but life‐threatening complication. The aim of this study was to identify the main individual characteristics associated with severe poisoning in self‐poisonings and therapeutic accidents reported at the Western France Poison Control Centre (PCC). Methods Retrospective study of metformin poisoning from September 1999 to September 2016 at the Western France PCC recorded in the French PCC’s database (SICAP). The end‐point was clinically high severity (mortality and/or cardiovascular shock and/or GCS ≤ 7/15). Results Of the 382 cases included, 197 concerned acute accidental exposures, 127 self‐poisonings and 58 therapeutic accidents. MALA concerned 63 patients: 44 therapeutic accidents and 19 self‐poisonings. High severity concerned 59 patients: 47 therapeutic accidents and 12 self‐poisonings. T2D and age > 60 significantly increase the risk of high severity (OR 7.7, CI [1.54‐38.41]; P = 0.013; OR 3.5, CI [1.60‐7.84]; P = 0.002, respectively). Conclusions Metformin may lead to MALA and severe poisoning in therapeutic accidents but also in self‐poisoning circumstances. Among reported cases, T2D history and age >60 increase the risk of serious poisoning. Monitoring of their treatment should be taken seriously especially in the event of digestive symptoms such as diarrhoea.

show abstract

“…is consistent with what has been reported at a population level in Canada. 10 Given their health care experience, participants suggested that coordinated care, self-management support and education might be helpful strategies to support their diabetes in a patient-centred manner. There has been little research investigating the challenges of living with both diabetes and advanced kidney disease from the patient perspective.…”

Section: Researchmentioning

confidence: 99%

Clinical care gaps and solutions in diabetes and advanced chronic kidney disease: a patient-oriented qualitative research study

Clemens

Getchell

Robinson

et al. 2019

cmajo

Self Cite

View full text Add to dashboard Cite

Plain language summary: Diabetes care can benefit people with both diabetes and advanced kidney disease, but getting this care can be an ordeal. In this study, we explored the health care experiences of these patients and reviewed how to better support their diabetes care. We partnered with 2 patients with advanced kidney disease and diabetes by inviting them to join our study team as full research partners. They were involved in all aspects of this study from its beginnings. We then interviewed 12 patients with diabetes and advanced kidney disease including those using dialysis. Patients reported being burdened by too many medical appointments, noted communication issues between their care providers and felt each of their providers addressed only 1 aspect of their disease. They faced challenges caring for their diabetes and found therapies difficult to afford. Patients suggested that coordinated diabetes care, self-management support and diabetes education might help them manage their diabetes. In this project, we learned of many challenges that patients with diabetes and kidney disease face in our health care system. Researchers and policy-makers should consider patient suggestions when developing new diabetes care strategies. W ith better treatments and improved survival, patients with diabetes often live longer than in the past, but with other medical conditions. 1 A common comorbidity, affecting 25%-50% of patients with diabetes, is chronic kidney disease. 2 Patients with diabetes and kidney disease are at high risk of diabetes-related complications, 3-5 are often socioeconomically

show abstract

The Health and Health Care of Adults With Type 1 And 2 Diabetes Across the Spectrum of Estimated Glomerular Filtration Rates

Cited by 11 publications

References 37 publications

A retrospective observational population‐based study to assess the prevalence and burden of illness of type 2 diabetes with an estimated glomerular filtration rate < 90 mL/min/1.73 m² in Ontario, Canada

A retrospective observational population‐based study to assess the prevalence and burden of illness of type 2 diabetes with an estimated glomerular filtration rate < 90 mL/min/1.73 m² in Ontario, Canada

Metformin overdose: A serious iatrogenic complication—Western France Poison Control Centre Data Analysis

Clinical care gaps and solutions in diabetes and advanced chronic kidney disease: a patient-oriented qualitative research study

Contact Info

Product

Resources

About

The Health and Health Care of Adults With Type 1 And 2 Diabetes Across the Spectrum of Estimated Glomerular Filtration Rates

Cited by 11 publications

References 37 publications

A retrospective observational population‐based study to assess the prevalence and burden of illness of type 2 diabetes with an estimated glomerular filtration rate < 90 mL/min/1.73 m2 in Ontario, Canada

A retrospective observational population‐based study to assess the prevalence and burden of illness of type 2 diabetes with an estimated glomerular filtration rate < 90 mL/min/1.73 m2 in Ontario, Canada

Metformin overdose: A serious iatrogenic complication—Western France Poison Control Centre Data Analysis

Clinical care gaps and solutions in diabetes and advanced chronic kidney disease: a patient-oriented qualitative research study

Contact Info

Product

Resources

About

A retrospective observational population‐based study to assess the prevalence and burden of illness of type 2 diabetes with an estimated glomerular filtration rate < 90 mL/min/1.73 m² in Ontario, Canada

A retrospective observational population‐based study to assess the prevalence and burden of illness of type 2 diabetes with an estimated glomerular filtration rate < 90 mL/min/1.73 m² in Ontario, Canada