| アブストラクト | OBJECTIVES: To compare the patterns of 18 physical and mental health comorbidities between people with recently diagnosed type 2 diabetes (T2D) and people without diabetes and how these change by age, gender and deprivation over time between 2004 and 2014. Also, to develop a metric to identify most prevalent comorbidities in people with T2D. DESIGN: Population-based cohort study. SETTING: Primary and secondary care, England, UK. PARTICIPANTS: 108 588 people with T2D and 528 667 comparators registered in 391 English general practices. Each patient with T2D aged >/=16 years between January 2004 and December 2014 registered in Clinical Practice Research Datalink GOLD practices was matched to up to five comparators without diabetes on age, gender and general practice. PRIMARY AND SECONDARY OUTCOME MEASURES: Prevalence of 18 physical and mental health comorbidities in people with T2D and comparators categorised by age, gender and deprivation. Odds for association between T2D diagnosis and comorbidities versus comparators. A metric for comorbidities with prevalence of >/=5% and/or odds >/=2 in patients with T2D. RESULTS: Overall, 77% of patients with T2D had >/=1 comorbidity and all comorbidities were more prevalent in patients with T2D than in comparators. Across both groups, prevalence rates were higher in older people, women and those most socially deprived. Conditional logistic regression models fitted to estimate (OR, 95% CI) for association between T2D diagnosis and comorbidities showed that T2D diagnosis was significantly associated with higher odds for all conditions including myocardial infarction (OR 2.13, 95% CI 1.85 to 2.46); heart failure (OR 2.12, 1.84 to 2.43); depression (OR 1.75, 1.62 to 1.89), but non-significant for cancer (OR 1.12, 0.98 to 1.28). In addition to cardiovascular disease, the metric identified osteoarthritis, hypothyroidism, anxiety, schizophrenia and respiratory conditions as highly prevalent comorbidities in people with T2D. CONCLUSIONS: T2D diagnosis is associated with higher likelihood of experiencing other physical and mental illnesses. People with T2D are twice as likely to have cardiovascular disease as the general population. The findings highlight highly prevalent and under-reported comorbidities in people with T2D. These findings can inform future research and clinical guidelines and can have important implications on healthcare resource allocation and highlight the need for more holistic clinical care for people with recently diagnosed T2D. |
|---|
| 組織名 | Centre for Primary Care and Health Services Research, Division of Population;Health, Health Services Research and Primary Care, School of Health Sciences,;Faculty of Biology, Medicine and Health, Manchester Academic Health Science;Centre (MAHSC), University of Manchester, Manchester, UK;salwa.zghebi@manchester.ac.uk.;Department of Pharmaceutics, Faculty of Pharmacy, University of Tripoli, Tripoli,;Libya.;Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and;Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health,;Manchester Academic Health Sciences Centre (MAHSC), University of Manchester,;Manchester, UK.;Division of Diabetes, Endocrinology and Gastroenterology, School of Medical;Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health;Science Centre (MAHSC), University of Manchester, Manchester, UK.;Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS;Foundation Trust, Manchester Academic Health Science Centre (MAHSC), Manchester,;UK. |
|---|
