Antidiabetic treatment patterns and specialty care utilization among patients with type 2 diabetes and cardiovascular disease.
Antidiabetic treatment patterns and specialty care utilization among patients with type 2 diabetes and cardiovascular disease.
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DOI：
10.1186/s12933-018-0699-7
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发表时间：
2018-04-10
影响因子：
9.3
通讯作者：
Zimmerman RS
中科院分区：
文献类型：
--
作者：
Pantalone KM;Misra-Hebert AD;Hobbs TM;Ji X;Kong SX;Milinovich A;Weng W;Bauman J;Ganguly R;Burguera B;Kattan MW;Zimmerman RS
评价2型糖尿病合并心血管疾病（CVD）患者的真实患者特征、药物使用和卫生保健利用模式。对2005年至2016年在克利夫兰诊所就诊的2型糖尿病患者进行横断面分析，分为两个队列：有CVD和无CVD。2016年12月记录了患者人口统计学和降糖药物;科室就诊包括2016年1月1日至2016年12月31日的所有访视。通过糖尿病并发症严重程度指数（DCSI）评分评估合并症负担。在95，569例2型糖尿病患者中，40，910例（42.8%）被确定患有CVD。CVD患者与无CVD患者相比年龄较大（中位年龄69.1岁与58.2岁），主要为男性（53.8%与42.6%），更有可能拥有医疗保险（69.4%与35.3%）。有CVD队列中DCSI评分≥ 3的患者比例高于无CVD队列（65.0% vs. 10.3%）。胰高血糖素样肽-1受体激动剂和钠-葡萄糖协同转运蛋白-2抑制剂的使用率在有CVD（4.1%和2.5%）和无CVD队列（5.4%和4.1%）中分别较低。大多数患者就诊（75%）由初级保健提供者看到。在1年的观察期内，81.9%和62.0%的2型糖尿病和CVD患者分别未被内分泌科或心脏科发现。这些数据表明，专家和降糖药物的利用不足，据报告，2型糖尿病和CVD患者的CV获益。最近更新的指南和心血管结局试验结果对此类患者管理模式的影响仍有待观察。
To evaluate real-world patient characteristics, medication use, and health care utilization patterns in patients with type 2 diabetes with established cardiovascular disease (CVD). Cross-sectional analysis of patients with type 2 diabetes seen at Cleveland Clinic from 2005 to 2016, divided into two cohorts: with-CVD and without-CVD. Patient demographics and antidiabetic medications were recorded in December 2016; department encounters included all visits from 1/1/2016 to 12/31/2016. Comorbidity burden was assessed by the diabetes complications severity index (DCSI) score. Of 95,569 patients with type 2 diabetes, 40,910 (42.8%) were identified as having established CVD. Patients with CVD vs. those without were older (median age 69.1 vs. 58.2 years), predominantly male (53.8% vs. 42.6%), and more likely to have Medicare insurance (69.4% vs. 35.3%). The with-CVD cohort had a higher proportion of patients with a DCSI score ≥ 3 than the without-CVD cohort (65.0% vs. 10.3%). Utilization rates of glucagon-like peptide-1 receptor agonists and sodium–glucose co-transporter-2 inhibitors were low in both with-CVD (4.1 and 2.5%) and without-CVD cohorts (5.4 and 4.1%), respectively. The majority of patient visits (75%) were seen by a primary care provider. During the 1-year observation period, 81.9 and 62.0% of patients with type 2 diabetes and CVD were not seen by endocrinology or cardiology, respectively. These data indicated underutilization of specialists and antidiabetic medications reported to confer CV benefit in patients with type 2 diabetes and CVD. The impact of recently updated guidelines and cardiovascular outcome trial results on management patterns in such patients remains to be seen.
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DOI：
10.1056/nejmoa1603827
发表时间：
2016-07-28
期刊：
The New England journal of medicine
影响因子：
--
作者：
Marso SP;Daniels GH;Brown-Frandsen K;Kristensen P;Mann JF;Nauck MA;Nissen SE;Pocock S;Poulter NR;Ravn LS;Steinberg WM;Stockner M;Zinman B;Bergenstal RM;Buse JB;LEADER Steering Committee;LEADER Trial Investigators
通讯作者：
LEADER Trial Investigators
影响因子：
158.5
作者：
Duckworth, William;Abraira, Carlos;Huang, Grant D.
通讯作者：
Huang, Grant D.
影响因子：
158.5
作者：
Gerstein, Hertzel C.;Miller, Michael E.;Friedewald, William T.
通讯作者：
Friedewald, William T.
DOI：
10.1136/amiajnl-2011-000439
发表时间：
2012-03-01
影响因子：
6.4
作者：
Kho, Abel N.;Hayes, M. Geoffrey;Lowe, William L.
通讯作者：
Lowe, William L.
影响因子：
39.2
作者：
Levey AS;Stevens LA;Schmid CH;Zhang YL;Castro AF 3rd;Feldman HI;Kusek JW;Eggers P;Van Lente F;Greene T;Coresh J;CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
通讯作者：
CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)