Care processes in people in remission from type 2 diabetes: A cohort study using the National Diabetes Audit

被引:4
作者
Holman, Naomi [1 ,10 ]
Khunti, Kamlesh [2 ]
Wild, Sarah H. [3 ]
Sattar, Naveed [1 ]
Knighton, Peter [4 ]
Young, Bob [5 ]
Gregg, Edward W. [6 ]
Bakhai, Chirag [7 ]
Valabhji, Jonathan [7 ,8 ,9 ]
机构
[1] Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow G12 8TA, Scotland
[2] Univ Leicester, Diabet Res Ctr, Leicester, England
[3] Univ Edinburgh, Usher Inst, Coll Med & Vet Med, Edinburgh, Scotland
[4] NHS Digital, Leeds, England
[5] Diabet UK, London, England
[6] Imperial Coll London, Sch Publ Hlth, London, England
[7] NHS England & NHS Improvement, London, England
[8] Imperial Coll Healthcare NHS Trust, St Marys Hosp, Dept Diabet & Endocrinol, London, England
[9] Imperial Coll London, Div Metab Digest & Reprod, London, England
[10] Imperial Coll London, Sch Publ Hlth, London W12 7TA, England
关键词
remission; routine care; type; 2; diabetes; INTENSIVE LIFE-STYLE; BARIATRIC SURGERY; INTERVENTION; ASSOCIATION;
D O I
10.1111/dme.15016
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
AimsPeople with type 2 diabetes can enter remission but may relapse or develop legacy complications. This analysis assesses whether people with remission from type 2 diabetes continue receiving annual care processes recommended in national guidelines and the potential impacts of formal recognition of remission. MethodsPeople with type 2 diabetes with and without formal recognition (diagnostic code) of remission, and with and without evidence of remission (HbA(1c) < 48 mmol/mol without prescription for glucose-lowering drugs in preceding 26 weeks), included in the 2018/19 National Diabetes Audit (NDA) for England and Wales were followed up to identify care processes received between 1 January 2019 and 31 March 2020. ResultsOf the 2,822,145 people with type 2 diabetes in the cohort, 16,460 (0.58%) were coded with remission in the 2018/19 NDA. After adjustment for age, sex, socioeconomic deprivation and ethnicity, people coded with remission were less likely to receive each care process than those without such coding irrespective of HbA(1c) measurements (relative risk (RR) of receiving all 8 care processes 0.70 (95% CI 0.69-0.72)). For the 339,235 people with evidence of remission, irrespective of diagnostic coding compared to those without such evidence, the RR for receiving all 8 care processes was 0.94 (95% CI 0.93-0.94). ConclusionsPeople coded with remission of type 2 diabetes were less likely to receive diabetes care processes than those without such coding. People with evidence of remission had only a slightly reduced likelihood of receiving care processes. Formal recognition of remission may affect the provision or uptake of care processes.
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页数:8
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