Assessing the severity of Type 2 diabetes using clinical data‐based measures: a systematic review

Abstract

Aims To identify and critically appraise measures that use clinical data to grade the severity of Type 2 diabetes. Methods We searched MEDLINE, Embase and PubMed between inception and June 2018. Studies reporting on clinical data-based diabetes-specific severity measures in adults with Type 2 diabetes were included. We excluded studies conducted solely in participants with other types of diabetes. After independent screening, the characteristics of the eligible measures including design and severity domains, the clinical utility of developed measures, and the relationship between severity levels and health-related outcomes were assessed. Results We identified 6798 studies, of which 17 studies reporting 18 different severity measures (32 314 participants in 17 countries) were included: a diabetes severity index (eight studies, 44%); severity categories (seven studies, 39%); complication count (two studies, 11%); and a severity checklist (one study, 6%). Nearly 89% of the measures included diabetes-related complications and/or glycaemic control indicators. Two of the severity measures were validated in a separate study population. More severe diabetes was associated with increased healthcare costs, poorer cognitive function and significantly greater risks of hospitalization and mortality. The identified measures differed greatly in terms of the included domains. One study reported on the use of a severity measure prospectively.Conclusions Health records are suitable for assessment of diabetes severity; however, the clinical uptake of existing measures is limited. The need to advance this research area is fundamental as higher levels of diabetes severity are associated with greater risks of adverse outcomes. Diabetes severity assessment could help identify people requiring targeted and intensive therapies and provide a major benchmark for efficient healthcare services.

Influence of ABO blood groups and demographic characteristics on the prevalence of type 2 diabetes in Lagos, southwest Nigeria

“…Section C contains medical/health variables, such as ABO blood groups, rhesus blood groups, and the severity of T2DM among various blood groups. The severity of DM was scored based on the number of diabetes-related complications and frequency of hospital visits (Zghebi et al 2019). DM was considered severe if the patient had at least one diabetes-related complication and visited the hospital monthly.…”

Development and validation of the DIabetes Severity SCOre (DISSCO) in 139 626 individuals with type 2 diabetes: a retrospective cohort study

“…aim 1: diabetes severity assessment Severity domains Key clinically relevant indicators of type 2 diabetes severity (severity domains) were identified from a systematic review of studies that quantified type 2 diabetes severity. 14 We also sought expert clinical opinion in cardiology, diabetes and primary care, supplementing the list of severity domains. HbA 1c and demographic variables were excluded from the severity domains.…”

“…Our recent systematic review found that a few studies have assessed or quantified disease severity among individuals with type 2 diabetes and fewer had useful longitudinal measures. [11][12][13][14] We identified the need for a valid and reliable tool for measuring severity of type 2 diabetes and that can serve as an actionable tool for therapeutic targets, as a covariate in epidemiological research, and for stratifying populations in order to inform resource allocation and support commissioning and public health programs for people with diabetes. 7 Our study aimed to (1) develop a type 2 diabetes severity score (the DIabetes Severity SCOre, DISSCO), (2) evaluate the association and the added clinical utility of the severity score in predicting hospitalization and mortality outcomes beyond that achieved using models incorporating sociodemographic variables and HbA 1c , and (3) validate DISSCO using a separate cohort (validation data set).…”

A nationwide cohort study on diabetes severity and risk of Parkinson disease

“…Assessing diabetes severity is important and could help identify people in need of targeted therapies and healthcare services 8 – 10 . Here, the severity of diabetes refers to diabetes duration, treatment status, and diabetes complications.…”