FACTORS ASSOCIATED WITH THE RISK OF DIABETES-RELATED EVENTS- A RETROSPECTIVE ANALYSIS
Author(s)
Mueller S1, Wilke T2, Groth A1, Fuchs A3, Seitz L4, Kienhoefer J4, Maywald U3, Lundershausen R5, Wehling M6
1IPAM, Wismar, Germany, 2Ingress Health, Wismar, Germany, 3AOK PLUS, Dresden, Germany, 4Novo Nordisk Pharma GmbH, Mainz, Germany, 5Diabetes Centre Erfurt/Bad Berka, Erfurt, Germany, 6Clinical Pharmacology, Mannheim/Center for Gerontopharmacology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
OBJECTIVES: The aim of this study was to analyse which factors predict the real-world macro-/microvascular event, hospitalisation and death risk in patients with type 2 diabetes mellitus (T2DM). METHODS: We used a German claims/clinical data set (AOK Plus) covering the years 2010-12. Factors associated with event risk were analysed by a Kaplan-Meier curve analysis and by multivariable Cox regression models. RESULTS: in the sample was 7.00%; 11.1% of observed patients had a mean HbA<6.0%, 75.3% <7.5%, and 4.5% ≥The mean observational period per patient from 01/04/2011 until 31/12/2012 or until first observed all-cause event was 581.9 days (SD: 148.4). 39,589 patients of the study sample (17.3%) were affected by at least one T2DM-related event in this period (event frequency per 1,000 patient years: 82.7 macrovascular events; 10.8 microvascular events; 28.4 hospitalisations with T2DM as main diagnosis; 40.7 deaths). Among factors that increased the composite event risk were patients’ age, male gender, the adapted Charlson-Comorbidity-Index, the adapted Diabetes-Complication-Severity Index, previous events, and number of prescribed chronic medications. For systolic blood pressure/HbA, a double-J/U-curve pattern was detected: HbA of 6-6.5% and systolic blood pressure of 130-140mmHg were associated with the lowest event risk, values below/above that range were associated with higher risk. However, this pattern was mainly driven by the death risk and was much less clearly observed for the macrovascular/microvascular/hospitalization risk and for young/less comorbid patients. CONCLUSIONS: Both blood pressure and HbA seem to be very important treatment targets, especially in comorbid old patients. Both over- and under-treatment pose a threat to patients with type 2 diabetes mellitus.
Conference/Value in Health Info
2015-11, ISPOR Europe 2015, Milan, Italy
Value in Health, Vol. 18, No. 7 (November 2015)
Code
PDB21
Topic
Epidemiology & Public Health
Disease
Diabetes/Endocrine/Metabolic Disorders