Comparison of clinical-metabolic monitoring and outcomes and coronary risk status in people with type 2 diabetes from Australia, France and Latin America

Gagliardino, Juan José; Kleinebreil, Line; Colagiuri, Stephen; Flack, Jeff R.; Caporale, Joaquín; Siri, Fernando; Clark, Charles M.

doi:10.1016/j.diabres.2009.12.024

Cited by 12 publications

(10 citation statements)

References 25 publications

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“…For cardiovascular risk management programs it is important to evaluate the impact of their interventions over time to achieve optimal primary cardiovascular prevention in patients under the care of the program [26]. There may be variation in the management plans of cardiovascular risk programs even within a given region beyond differences in health budget and system characteristics [27]. The use of statins in the LMIC is low in comparison with the HIC [28].…”

Section: Discussionmentioning

confidence: 99%

First cardiovascular event in patients with type 2 diabetes mellitus of a cardiovascular risk management program of a poor Colombian population: a cohort study

Machado¹,

Salcedo-Mejía²,

Wilches

et al. 2019

BMC Cardiovasc Disord

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BackgroundAccording to several studies in population of high-income countries (HIC), patients with Type 2 diabetes mellitus (DM) have a considerably higher risk of cardiovascular morbidity and mortality. However, it is not clear if the magnitude of this association can be widespread in other populations. The objective of this study was to determine the independent association between Type 2 DM and first cardiovascular event in Colombian Caribbean poor population with no records of previous cardiovascular events reported.MethodsWe retrospectively reviewed the individual records from the hospitalizations database of 64,668 patients of cardiovascular risk management program from July 2014 to December 2015. We used a propensity score matching cohort analysis for this study. The Kaplan–Meier curves were constructed for the cardiovascular events related endpoints and matched Cox-regression analysis to estimate associations of a history of Type 2 DM with cardiovascular outcomes during 1.5 years of follow-up. A formal sensitivity analysis using The Breslow-Day and Tarone Homogeneity tests was conducted.ResultsOut of 56,351 patients with no previous cardiovascular events records, 19,368 (34.4%) patients were found to suffer Type 2 DM. Using propensity scores for Type 2 DM, we gathered a cohort of 18,449 pairs of patients with and without Type 2 DM who were balanced on 22 baseline characteristics. A first cardiovascular event occurred in 650 (3.5%) and 403 (2.1%) matched patients with and without Type 2 DM, respectively, during 1.5 years of follow-up. Type 2 DM was associated with first cardiovascular event (HR 1.69; 95% CI 1.43–2.00; p = 0.000), AMI (HR 1.79; 95% CI 1.45–2.20; p = 0.000) and stroke (HR 1.54; 95% CI 1.18–2.02; p = 0.001). Hazard ratios (95% CIs) for the association of Type 2 DM with all-cause mortality, cardiovascular mortality and all-cause hospitalization were 1.36 (1.21–1.53; p < 0.001), 1.52 (1.12–2.08; p 0.004), and 1.20 (1.21–1.53; p < 0.001), respectively.ConclusionType 2 DM resulted to be a significant independent risk factor for first cardiovascular event in Colombian Caribbean poor population with no previous records of cardiovascular events.

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Section: Discussionmentioning

confidence: 99%

First cardiovascular event in patients with type 2 diabetes mellitus of a cardiovascular risk management program of a poor Colombian population: a cohort study

Machado¹,

Salcedo-Mejía²,

Wilches

et al. 2019

BMC Cardiovasc Disord

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“…The collected data have been used by the Australian Institute of Health and Welfare to report on several national diabetes indicators. ANDIAB has also been used to compare clinical diabetes outcomes in different countries .…”

Section: Discussionmentioning

confidence: 99%

Successful implementation of diabetes audits in Australia: the Australian National Diabetes Information Audit and Benchmarking (ANDIAB) initiative

2018

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“…The negative impact of the development and progression of chronic complications can be effectively prevented by tight control of hyperglycaemia and the associated CVRFs [ 33 - 37 ]. However, the frequent combination of late diagnosis, inappropriate quality of care provided to people with diabetes and uneven access to care and treatment play against the effectiveness and feasibility of secondary prevention [ 12 , 13 , 18 - 20 , 22 , 25 , 38 - 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…But if such an increase were feasible, it would not necessarily provide a real solution. In fact, using data from countries with higher health care budgets than Argentina, CENEXA has demonstrated that the quality of care provided was similarly poor in all of them [ 22 ]. These findings thus showed that the size of the health budget is not the main constraint for delivering good quality diabetes care and that there is a need to find more efficient interventions to improve health care quality.…”

Section: Discussionmentioning

confidence: 99%

Diabetes in Argentina: cost and management of diabetes and its complications and challenges for health policy

2013

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BackgroundDiabetes is an expensive disease in Argentina as well as worldwide, and its prevalence is continuously rising affecting the quality of life of people with the disease and their life expectancy. It also imposes a heavy burden to the national health care budget and on the economy in the form of productivity losses.AimsTo review and discuss a) the reported evidence on diabetes prevalence, the degree of control, the cost of care and outcomes, b) available strategies to decrease the health and economic disease burden, and c) how the disease fits in the Argentinian health care system and policy. Finally, to propose evidence-based policy options to reduce the burden of diabetes, both from an epidemiological as well as an economic perspective, on the Argentinian society. The evidence presented is expected to help the local authorities to develop and implement effective diabetes care programmes.MethodologyA comprehensive literature review was performed using databases such as MEDLINE, EMBASE and LILACS (Latin American and Caribbean Health Sciences). Literature published from 1980 to 2011 was included. This information was complemented with grey literature, including data from national and provincial official sources, personal communications and contacts with health authorities and diabetes experts in Argentina.ResultsOverall diabetes prevalence increased from 8.4% in 2005 to 9.6% 2009 at national level. In 2009, diabetes was the seventh leading cause of death with a mortality rate of 19.2 per 100,000 inhabitants, and it accounted for 1,328,802 DALYs lost in the adult population, mainly affecting women aged over fifty. The per capita hospitalisation cost for people with diabetes was significantly higher than for people without the disease, US$ 1,628 vs. US$ 833 in 2004. Evidence shows that implementation of combined educative interventions improved quality of care and outcomes, decreased treatment costs and optimised the use of economic resources.ConclusionsBased on the evidence reviewed, we believe that the implementation of structured health care programmes including diabetes education at every level, could improve quality of care as well as its clinical, metabolic and economic outcomes. If implemented across the country, these programmes could decrease the disease burden and optimise the use of human and economic resources.

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Comparison of clinical-metabolic monitoring and outcomes and coronary risk status in people with type 2 diabetes from Australia, France and Latin America

Cited by 12 publications

References 25 publications

First cardiovascular event in patients with type 2 diabetes mellitus of a cardiovascular risk management program of a poor Colombian population: a cohort study

First cardiovascular event in patients with type 2 diabetes mellitus of a cardiovascular risk management program of a poor Colombian population: a cohort study

Successful implementation of diabetes audits in Australia: the Australian National Diabetes Information Audit and Benchmarking (ANDIAB) initiative

Diabetes in Argentina: cost and management of diabetes and its complications and challenges for health policy

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