Projects per year
Methods: An observational cohort study was performed utilising the electronic medical records from patients in the Genetics of Diabetes Audit and Research in Tayside Study (GoDARTS). A model was derived based on a patient’s observed HbA1c measures from first eligible HbA1c after diabetes diagnosis through to study end (defined as insulin initiation, death, leaving area or end of follow-up). Each HbA1c measure was adjusted time-dependently for the effects of non-insulin antidiabetic drugs, changes in BMI and corticosteroid use. GADA positivity was defined as GAD titres >97.5th centile of the population distribution.
Results: The mean glycaemic deterioration for patients with type 2 diabetes and GADA positive patients was 0.12(95%CI 0.12,0.13)% and 0.25(0.20,0.31)% HbA1c per year respectively. A younger age of diagnosis, lower HDL, higher BMI and earlier calendar year of diabetes diagnosis were independently associated with higher rates of glycaemic deterioration in patients with type 2 diabetes. The rate of deterioration in those diagnosed over 70 years of age was very low; with 66% having a rate of deterioration less than 0.1% HbA1c per year, and only 1.5% progressing more rapidly than 0.4% HbA1c per year.
Conclusions/interpretation: We have developed a novel approach to model diabetes progression in observational data across multiple drug combinations. This approach highlights how glycaemic deterioration in those diagnosed over 70 years of age is minimal supporting a stratified approach to diabetes management.
- Coefficient of failure
- Electronic medical records
- Glycaemic deterioration
- Type 2 diabetes
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1/02/12 → 30/06/23
Stratified Medicine in Type 2 Diabetes: Insights from the Study of Drug Response (New Investigator Award)
16/02/15 → 15/08/21