Data-driven long-term glycaemic control trajectories and their associated health and economic outcomes in Finnish patients with incident type 2 diabetes.
Background Treatments should be customized to patients to improve patients' health outcomes and maximize the treatment benefits. We aimed to identify meaningful data-driven trajectories of incident type 2 diabetes patients with similarities in glycated haemoglobin (HbA1c) patterns since diagnos...
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ftdoajarticles:oai:doaj.org/article:a516551408844bc6bcea4ebfd3ba3357 2023-05-15T17:00:24+02:00 Data-driven long-term glycaemic control trajectories and their associated health and economic outcomes in Finnish patients with incident type 2 diabetes. Piia Lavikainen Emma Aarnio Miika Linna Kari Jalkanen Hilkka Tirkkonen Päivi Rautiainen Tiina Laatikainen Janne Martikainen 2022-01-01T00:00:00Z https://doi.org/10.1371/journal.pone.0269245 https://doaj.org/article/a516551408844bc6bcea4ebfd3ba3357 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pone.0269245 https://doaj.org/toc/1932-6203 1932-6203 doi:10.1371/journal.pone.0269245 https://doaj.org/article/a516551408844bc6bcea4ebfd3ba3357 PLoS ONE, Vol 17, Iss 6, p e0269245 (2022) Medicine R Science Q article 2022 ftdoajarticles https://doi.org/10.1371/journal.pone.0269245 2022-12-31T00:23:57Z Background Treatments should be customized to patients to improve patients' health outcomes and maximize the treatment benefits. We aimed to identify meaningful data-driven trajectories of incident type 2 diabetes patients with similarities in glycated haemoglobin (HbA1c) patterns since diagnosis and to examine their clinical and economic relevance. Materials and methods A cohort of 1540 patients diagnosed in 2011-2012 was retrieved from electronic health records covering primary and specialized healthcare in the North Karelia region, Finland. EHRs data were compiled with medication purchase data. Average HbA1c levels, use of medications, and incidence of micro- and macrovascular complications and deaths were measured annually for seven years since T2D diagnosis. Trajectories were identified applying latent class growth models. Differences in 4-year cumulative healthcare costs with 95% confidence intervals (CIs) were estimated with non-parametric bootstrapping. Results Four distinct trajectories of HbA1c development during 7 years after T2D diagnosis were extracted: patients with "Stable, adequate" (66.1%), "Slowly deteriorating" (24.3%), and "Rapidly deteriorating" glycaemic control (6.2%) as well as "Late diagnosed" patients (3.4%). During the same period, 2.2 (95% CI 1.9-2.6) deaths per 100 person-years occurred in the "Stable, adequate" trajectory increasing to 3.2 (2.4-4.0) in the "Slowly deteriorating", 4.7 (3.1-6.9) in the "Rapidly deteriorating" and 5.2 (2.9-8.7) in the "Late diagnosed" trajectory. Similarly, 3.5 (95% CI 3.0-4.0) micro- and macrovascular complications per 100 person-years occurred in the "Stable, adequate" trajectory increasing to 5.1 (4.1-6.2) in the "Slowly deteriorating", 5.5 (3.6-8.1) in the "Rapidly deteriorating" and 7.3 (4.3-11.8) in the "Late diagnosed" trajectory. Patients in the "Stable, adequate" trajectory had lower accumulated 4-year medication costs than other patients. Conclusions Data-driven patient trajectories have clinical and economic relevance and could be utilized ... Article in Journal/Newspaper karelia* Directory of Open Access Journals: DOAJ Articles PLOS ONE 17 6 e0269245 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
topic |
Medicine R Science Q |
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Medicine R Science Q Piia Lavikainen Emma Aarnio Miika Linna Kari Jalkanen Hilkka Tirkkonen Päivi Rautiainen Tiina Laatikainen Janne Martikainen Data-driven long-term glycaemic control trajectories and their associated health and economic outcomes in Finnish patients with incident type 2 diabetes. |
topic_facet |
Medicine R Science Q |
description |
Background Treatments should be customized to patients to improve patients' health outcomes and maximize the treatment benefits. We aimed to identify meaningful data-driven trajectories of incident type 2 diabetes patients with similarities in glycated haemoglobin (HbA1c) patterns since diagnosis and to examine their clinical and economic relevance. Materials and methods A cohort of 1540 patients diagnosed in 2011-2012 was retrieved from electronic health records covering primary and specialized healthcare in the North Karelia region, Finland. EHRs data were compiled with medication purchase data. Average HbA1c levels, use of medications, and incidence of micro- and macrovascular complications and deaths were measured annually for seven years since T2D diagnosis. Trajectories were identified applying latent class growth models. Differences in 4-year cumulative healthcare costs with 95% confidence intervals (CIs) were estimated with non-parametric bootstrapping. Results Four distinct trajectories of HbA1c development during 7 years after T2D diagnosis were extracted: patients with "Stable, adequate" (66.1%), "Slowly deteriorating" (24.3%), and "Rapidly deteriorating" glycaemic control (6.2%) as well as "Late diagnosed" patients (3.4%). During the same period, 2.2 (95% CI 1.9-2.6) deaths per 100 person-years occurred in the "Stable, adequate" trajectory increasing to 3.2 (2.4-4.0) in the "Slowly deteriorating", 4.7 (3.1-6.9) in the "Rapidly deteriorating" and 5.2 (2.9-8.7) in the "Late diagnosed" trajectory. Similarly, 3.5 (95% CI 3.0-4.0) micro- and macrovascular complications per 100 person-years occurred in the "Stable, adequate" trajectory increasing to 5.1 (4.1-6.2) in the "Slowly deteriorating", 5.5 (3.6-8.1) in the "Rapidly deteriorating" and 7.3 (4.3-11.8) in the "Late diagnosed" trajectory. Patients in the "Stable, adequate" trajectory had lower accumulated 4-year medication costs than other patients. Conclusions Data-driven patient trajectories have clinical and economic relevance and could be utilized ... |
format |
Article in Journal/Newspaper |
author |
Piia Lavikainen Emma Aarnio Miika Linna Kari Jalkanen Hilkka Tirkkonen Päivi Rautiainen Tiina Laatikainen Janne Martikainen |
author_facet |
Piia Lavikainen Emma Aarnio Miika Linna Kari Jalkanen Hilkka Tirkkonen Päivi Rautiainen Tiina Laatikainen Janne Martikainen |
author_sort |
Piia Lavikainen |
title |
Data-driven long-term glycaemic control trajectories and their associated health and economic outcomes in Finnish patients with incident type 2 diabetes. |
title_short |
Data-driven long-term glycaemic control trajectories and their associated health and economic outcomes in Finnish patients with incident type 2 diabetes. |
title_full |
Data-driven long-term glycaemic control trajectories and their associated health and economic outcomes in Finnish patients with incident type 2 diabetes. |
title_fullStr |
Data-driven long-term glycaemic control trajectories and their associated health and economic outcomes in Finnish patients with incident type 2 diabetes. |
title_full_unstemmed |
Data-driven long-term glycaemic control trajectories and their associated health and economic outcomes in Finnish patients with incident type 2 diabetes. |
title_sort |
data-driven long-term glycaemic control trajectories and their associated health and economic outcomes in finnish patients with incident type 2 diabetes. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2022 |
url |
https://doi.org/10.1371/journal.pone.0269245 https://doaj.org/article/a516551408844bc6bcea4ebfd3ba3357 |
genre |
karelia* |
genre_facet |
karelia* |
op_source |
PLoS ONE, Vol 17, Iss 6, p e0269245 (2022) |
op_relation |
https://doi.org/10.1371/journal.pone.0269245 https://doaj.org/toc/1932-6203 1932-6203 doi:10.1371/journal.pone.0269245 https://doaj.org/article/a516551408844bc6bcea4ebfd3ba3357 |
op_doi |
https://doi.org/10.1371/journal.pone.0269245 |
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PLOS ONE |
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17 |
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6 |
container_start_page |
e0269245 |
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