Treatment outcomes of type 2 diabetes : do the achievements differ by age, sex, or comorbidity?

• Main Author: Nazu, Nazma
• Other Authors: Järveläinen, Hannu, University of Helsinki, Faculty of Medicine, Department of Public Health, Doctoral Program in Population Health, Helsingin yliopisto, lääketieteellinen tiedekunta, Väestön terveyden tohtoriohjelma, Helsingfors universitet, medicinska fakulteten, Doktorandprogrammet i befolkningshälsan, Laatikainen, Tiina, Lindström, Jaana
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: Helsingin yliopisto 2022
• Subjects: public health care; karelia*
• Online Access: http://hdl.handle.net/10138/352094

Type 2 diabetes (T2D) is a major public health problem. The main concern of T2D is the increasing prevalence, life threatening complications, and huge costs of the management of T2D. Several factors, such as age, sex, socioeconomic status, area of living and obesity may affect the achievement of treatment targets for T2D patients. In addition, co-morbidities are very common in T2D patients which further complicates the treatment and increases the cost of management of T2D. Cardiovascular diseases (CVDs) and mental disorders are common co-morbidities associated with T2D. CVD is a major contributor of T2D mortality and mental disorders affect the self-management of T2D patients. T2D patients with comorbid diseases are often reported having worse quality of diabetes care, more complications and poor achievement of treatment targets. The aim of this study is to explore the treatment outcomes for different patient groups of the T2D cohort of North Karelia, Finland from 2011–12 to 2015–16, encompassing all T2D patients in the 13 municipalities of the region. Specifically, the study assesses the disparities between the process of care and treatment outcomes among T2D patients with and without CVD or mental disorders, also considering the age and sex. This study is designed as a register-based retrospective cohort study using the data from the regional electronic health records (EHR) of North Karelia, Finland from the period of 2011 to 2016. All the patients who had visited the public healthcare with a diagnosis of T2D (ICD-10 code E11) were identified from the regional EHRs. The study included 10,190 T2D patients who were alive at the end of 2012 and aged more than 20 at baseline (2011–12). At the end of 2016 there were 8,429 T2D patients alive and available for the follow up. Data on patients’ age, sex, HbA1c and LDL levels, permanent diagnoses and e-prescriptions were used in the study. Two process indicators and two intermediate outcome of care indicators were used to assess the quality of T2D care. HbA1c and LDL ...