Delay in treatment intensification increases the risks of cardiovascular events in patients with type 2 diabetes
Sanjoy K Paul, Kerenaftali Klein, Brian L Thorsted, Michael L Wolden, Kamlesh Khunti
CARDIOVASCULAR DIABETOLOGY | BMC | Published : 2015
BACKGROUND: The aim of the study was to evaluate the effect of delay in treatment intensification (IT; clinical inertia) in conjunction with glycaemic burden on the risk of macrovascular events (CVE) in type 2 diabetes (T2DM) patients. METHODS: A retrospective cohort study was carried out using United Kingdom Clinical Practice Research Datalink, including T2DM patients diagnosed from 1990 with follow-up data available until 2012. RESULTS: In the cohort of 105,477 patients mean HbA1c was 8.1% (65 mmol/mol) at diagnosis, 11% had a history of cardiovascular disease, and 7.1% experienced at least one CVE during 5.3 years of median follow-up. In patients with HbA1c consistently above 7/7.5% (53/5..View full abstract
The QIMR Berghofer Medical Research Institute is grateful for support from UK-CPRD, Novo Nordisk A/S and an infrastructure research grant from the Australian Government Department of Education's National Collaborative Research Infrastructure Strategy initiative through Therapeutic Innovation Australia. The Leicester Diabetes Research Centre, University of Leicester is grateful for support from the NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands (CLAHRC-EM). The interpretation and conclusions contained in this study are those of the authors alone.