Real-world study of the multimorbidity and health service utilisation among individuals with non-diabetic hyperglycemia and type 2 diabetes mellitus in North West London.

Autor:	Dattani R; Institute of Global Health Innovation (IGHI), Imperial College London, London, UK rakesh.dattani@imperial.ac.uk.; Imperial College Healthcare NHS Trust, London, UK., Ul-Haq Z; Imperial College Health Partners, London, UK., Shah M; Imperial College Health Partners, London, UK., Kamalati T; Imperial College Health Partners, London, UK., Pierce B; Imperial College Health Partners, London, UK., Lucas A; Imperial College Health Partners, London, UK., Baruwa A; Imperial College Health Partners, London, UK., Bickford-Smith L; AstraZeneca PLC, Cambridge, UK., Chilcott J; AstraZeneca PLC, Cambridge, UK., Griffiths T; AstraZeneca PLC, Cambridge, UK., Frankel AH; Imperial College Healthcare NHS Trust, London, UK., Willis T; North West London CCG, London, UK., Tam FWK; Imperial College Healthcare NHS Trust, London, UK.; Department of Immunology and Inflammation, Imperial College London, London, UK.
Jazyk:	angličtina
Zdroj:	BMJ open diabetes research & care [BMJ Open Diabetes Res Care] 2024 Aug 08; Vol. 12 (4). Date of Electronic Publication: 2024 Aug 08.
DOI:	10.1136/bmjdrc-2023-003873
Abstrakt:	Introduction: The prevalence of non-diabetic hyperglycemia (NDH) and type 2 diabetes mellitus (T2DM) is increasing. While T2DM is recognised to be associated with multimorbidity and early mortality, people with NDH are frequently thought to be devoid of such complications, potentially exposing individuals with NDH to suboptimal care. We therefore used the Discover London Secure Data Environment (SDE) dataset to appreciate the relationship of NDH/T2DM with multimorbidity, healthcare usage, and clinical outcomes. Research Design and Methods: The dataset was retrospectively analysed between January 1, 2015 and December 31, 2020 to understand the relationship between NDH/T2DM and multimorbidity primary/secondary healthcare usage and clinical outcomes. This was compared with a cohort of individuals with thyroid disease but no NDH/T2DM. Results: The dataset identified 152,384 and 124,190 adults with NDH and T2DM compared with 11,626 individuals with thyroid disease (control group). Individuals with NDH and individuals with T2DM had a high burden of disease, with only 13.1% of individuals with either NDH or T2DM not found to be suffering from at least one of the disease states of interest. The three most common comorbidities experienced by individuals with NDH were hypertension (41.4%), hypercholesterolemia (37.5%), and obesity (29.8%) compared with retinopathy (68.7%), hypertension (59.4%), and obesity (45.8%) in individuals with T2DM. Comparatively, the most common comorbidities in the control group were depression (30.8%), hypercholesterolemia (24.4%), and hypertension (17.1%). 28 (control group), 12 (NDH), and 16 (T2DM) primary care contacts per individual per year were identified, with 27,881, 282,371, and 314,880 inpatient admissions for the control, NDH, and T2DM cohorts, respectively. Prescription of drugs used to treat T2DM in individuals with NDH and T2DM was 27,772 (18.2%) and 109,361 (88.1%), respectively, accounting for approximately one in five individuals with NDH developing T2DM. Conclusion: Both NDH and T2DM were associated with significant multimorbidity alongside primary and secondary care utilisation. Given the morbidity highlighted with NDH, we highlight the need for earlier detection of NDH, recognition of multimorbidity associated with both NDH and T2DM, as well as the need for the further implementation of interventions to prevent progression to T2DM/multimorbidity. Competing Interests: Competing interests: FWKT has received research project grants from AstraZeneca Limited, Baxter Biosciences, Boehringer Ingelheim, MedImmune, OncoOne, Rigel Pharmaceuticals, and Thornton and Ross Ltd and has consultancy agreements with Novartis, OncoOne and Rigel Pharmaceuticals. AHF has been in receipt of research grants, prepared educational materials, and attended drug advisory boards for Boehringer Ingleheim, Lilly, AstraZeneca Limited, NAPP, VP UK, Bayer and GSK. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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