Real-world use of cardioprotective glucose-lowering drugs in patients with type 2 diabetes and cardiovascular disease: A Danish nationwide cohort study, 2012 to 2019.

Real-world use of cardioprotective glucose-lowering drugs in patients with type 2 diabetes and cardiovascular disease: A Danish nationwide cohort study, 2012 to 2019.
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DOI:
10.1111/dom.14245
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发表时间:
2021-03
期刊:
Diabetes, obesity & metabolism
影响因子:
--
通讯作者:
Grove EL
Grove EL
中科院分区:
其他
文献类型:
--
作者:
Funck KL;Knudsen JS;Hansen TK;Thomsen RW;Grove EL

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在新诊断为2型糖尿病(T2 DM)和心血管疾病(CVD)的患者中,研究至开始使用钠-葡萄糖协同转运蛋白-2抑制剂和胰高血糖素样肽1类似物(心脏保护性降糖药物[GLD])的时间的时间趋势。在一项队列研究中,我们使用来自全国登记处的药物处方和诊断代码的相关医疗保健数据,识别出患有新的T2 DM和CVD双重诊断的患者。对于2012年至2018年的每个日历年,我们检查了双重诊断后1年和2年使用心脏保护性GLD的启动时间和累积用户比例(CUP)。在2012年至2018年期间生活在丹麦的所有个体中,确定了41733例新的T2 DM和CVD双重诊断患者(中位[四分位距]年龄71 [64-79]岁,61%为男性,57%的最新诊断为CVD)。研究期间,心脏保护性GLD的发生率曲线斜率和1年和2年CUP增加(2012年的1年CUP 4.0%,95%置信区间[CI] 3.6-4.5)至2018年的14.7,95% CI 13.7-15.7; 2年CUP 5.5,95% CI 5.0-6.1,2012年至16.7,95% CI 15.8-17.7,2017年)。以CVD作为第二(最新)诊断的T2 DM患者的1年CUP高于以CVD作为最新诊断的T2 DM患者:2012年:7.0(95% CI 6.2-8.0)vs 1.4(95% CI 1.0-1.8); 2018年:18.1(95% CI 16.8-19.6)vs 10.0(95% CI 8.8 - 11.3)。在T2 DM和CVD患者中,2012年至2018年期间,心脏保护性GLD启动的发生率增加,但在双重诊断的2年内,它仍然很低。
To investigate temporal trends in time to initiation of sodium‐glucose co‐transporter‐2 inhibitors and glucagon‐like peptide 1 analogues (cardioprotective glucose‐lowering drugs [GLDs]) in patients with a new dual diagnosis of type 2 diabetes (T2DM) and cardiovascular disease (CVD). In a cohort study, we identified patients with a new dual diagnosis of T2DM and CVD using linked healthcare data from nationwide registries on drug prescriptions and diagnosis codes. For each calendar year between 2012 and 2018, we examined time to initiation and cumulative user proportions (CUPs) for cardioprotective GLD use 1 and 2 years after the dual diagnosis. Among all individuals living in Denmark in the period 2012 to 2018, 41 733 patients with a new dual diagnosis of T2DM and CVD were identified (median [interquartile range] age 71 [64–79] years, 61% male, and 57% with CVD as the latest diagnosis). Incidence curve slopes and 1‐ and 2‐year CUPs for cardioprotective GLDs increased during the study period (1‐year CUP 4.0%, 95% confidence interval [CI] 3.6–4.5) in 2012 to 14.7, 95% CI 13.7–15.7, in 2018; 2‐year CUP 5.5, 95% CI 5.0–6.1, in 2012 to 16.7, 95% CI 15.8–17.7, in 2017). T2DM patients with CVD as the second (latest) diagnosis had higher 1‐year CUPs than CVD patients with T2DM as the latest diagnosis: 2012: 7.0 (95% CI 6.2–8.0) versus 1.4 (95% CI 1.0–1.8); 2018: 18.1 (95% CI 16.8–19.6) versus 10.0 (95% CI 8.8‐11.3). In patients with T2DM and CVD, the incidence of cardioprotective GLD initiation increased between 2012 and 2018, however, within 2 years of dual diagnosis, it remained low.
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