The diabetes audit and research in Tayside Scotland (darts) study: electronic record linkage to create a diabetes register

Morris, Andrew D.; Boyle, Douglas; MacAlpine, Ritchie; Emslie-Smith, Alistair; Jung, R. T.; Newton, R. W.; MacDonald, Thomas M.

doi:10.1136/bmj.315.7107.524

Cited by 271 publications

(271 citation statements)

References 16 publications

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“…In the Tayside region (population about 400,000) of Scotland there is a registry operating [13] that is based on record linkage from more sources than the Danish register. This has shown [14] a similar prevalence of diabetes in 1996 (1.94% compared with 1.89% in Denmark) and similar increase in prevalence (6.7% per year compared with 6.3% per year [men] and 6.6% per year [women] in Denmark).…”

Section: Discussionmentioning

confidence: 99%

The Danish National Diabetes Register: trends in incidence, prevalence and mortality

et al. 2008

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Aims/hypothesis The aim of the study was to describe trends in the incidence rate, prevalence and mortality rate for diabetes in Denmark. Methods Healthcare registers at the National Board of Health were used to compile a register of diabetic patients in the Danish population (5.4 million people). Age-and sex-specific prevalence, incidence rates, mortality rates and standardised mortality ratios relative to the non-diabetic part of the population were calculated. Results The register contains records for about 360,000 persons with diabetes; 230,000 were alive at 1 January 2007, corresponding to an overall prevalence of 4.2%. The prevalence increased by 6% per year. In 2004 the incidence rates were 1.8 per 100,000 at age 40 years and 10.0 per 100,000 at age 70 years. The incidence rate increased 5% per year before 2004 and then stabilised. The mortality rate in the diabetic population decreased 4% per year, compared with 2% per year in the non-diabetic part of the population. The mortality rate decreased 40% during the first 3 years after inclusion in the register. The standardised mortality ratio decreased with age, from 4.0 at age 50 years to 2.5 at age 70 years and just under 2 at age 85 years, identically for men and women. The standardised mortality ratio decreased 1% per calendar year. The lifetime risk of diabetes was 30%. Conclusions/interpretation The prevalence of diabetes in Denmark rose in 1995-2006, but the mortality rate in diabetic patients decreased faster than that of the nondiabetic population. The mortality rate decreased markedly just after inclusion in the register. Incidence rates have shown a tendency to decrease during the last few years, but this finding should be viewed with caution.

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Section: Discussionmentioning

confidence: 99%

The Danish National Diabetes Register: trends in incidence, prevalence and mortality

et al. 2008

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“…We used the data resources of the Diabetes Audit and Research in Tayside, Scotland (DARTS) / the Medicines Monitoring Unit (MEMO) Collaboration for this study [10,11]. This collaboration has developed the record linkage of multiple, routinely collected data sets in the population of Tayside (approximately 400,000 people).…”

Section: Methodsmentioning

confidence: 99%

“…The DARTS dataset contains detailed clinical information on every patient diagnosed with diabetes in Tayside from January 1993 [11]. Data collection for this dataset includes collation and validation of routine data, and ongoing retrieval of information directly from medical records in primary care by a dedicated team of research nurses.…”

Section: Methodsmentioning

confidence: 99%

Risk of mortality and adverse cardiovascular outcomes in type 2 diabetes: a comparison of patients treated with sulfonylureas and metformin

et al. 2006

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Aims/hypothesis: The aim of this study was to evaluate the risk of adverse cardiovascular outcomes in patients with type 2 diabetes newly treated with sulfonylureas and metformin. Subjects and methods: The Diabetes Audit and Research in Tayside Scotland (DARTS) diabetes information system and the Medicines Monitoring Unit (MEMO) dispensed prescribing database for the population of Tayside, Scotland (400,000 people) were employed. Patients newly prescribed with oral hypoglycaemic agents between 1994 and 2001 were classified into five study cohorts according to the treatment received: metformin only, sulfonylureas only, sulfonylureas added to metformin, metformin added to sulfonylureas, and both drugs simultaneously. In Cox regression analyses, we estimated relative risks for all-cause mortality, cardiovascular mortality and cardiovascular hospital admission for patients in the five study cohorts, with metformin monotherapy as the reference group. Results: Of the 5,730 study patients, 1,000 died during a maximum of 8 years follow-up. Patients in the sulfonylureas only cohort had increased risks of mortality and cardiovascular mortality, with unadjusted relative risks of 3.12 (95% CI 2.54-3.84) and 3.71 (95% CI 2.64-5.22), respectively. After adjusting for differences between groups (age, sex, duration of diabetes, blood pressure, cholesterol, HbA 1c , smoking, previous hospital admission, treatment with cardiovascular medication), these relative risks were 1.43 (95% CI 1.15-1.77) and 1.70 (95% CI 1.18-2.45), respectively. Patients in the combination cohorts had significantly increased risks of cardiovascular hospital admission, as well as increased risks of mortality and cardiovascular mortality. Conclusions/interpretation: In this cohort study of patients newly treated with oral hypoglycaemic agents, those treated with sulfonylureas only, or combinations of sulfonylureas and metformin, were at higher risk of adverse cardiovascular outcomes than those treated with metformin alone.

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“…The Diabetes Audit and Research in Tayside, Scotland (DARTS) diabetes clinical information system [11] was set up in 1993 in Tayside, a region of Scotland, UK. We used this system to determine prospectively changes in prevalence, incidence and mortality of type 2 diabetes over a 12-year period; we also examined the relative contributions of increasing incidence and declining mortality to changes in prevalence.…”

Section: Introductionmentioning

confidence: 99%

Increasing prevalence of type 2 diabetes in a Scottish population: effect of increasing incidence or decreasing mortality?

et al. 2007

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Aims/hypothesis We examined incidence, prevalence and mortality from type 2 diabetes mellitus in a Scottish population over 12 years, and evaluated the effects on prevalence of increasing incidence and decreasing mortality. Materials and methods We used a diabetes clinical information system in Tayside (population 387,908), Scotland, to identify new cases of type 2 diabetes between 1993 and 2004 and to calculate incidence rates and mid-year prevalence. We defined mortality rates as the number of deaths of diabetic people divided by mid-year prevalence. We used logistic and Poisson regression to analyse trends. We then modelled the increase in prevalence for each year for three scenarios, based on whether mortality or incidence rates remained unchanged from 1993. Results There was a doubling in incidence and prevalence of type 2 diabetes in Tayside over the 12 years, with statistically significant increasing trends of 6.3 and 6.7% per year respectively. The mortality rate decreased. If incidence and mortality had remained at 1993 levels, there would have been an increase in prevalence of 855 per 100,000 in 2003, accounting for 60.1% of the actual increase of 1,423 per 100,000. If there had been no mortality decrease, prevalence in 2003 would have been very similar to the actual prevalence observed. Conclusions/interpretation Decreasing mortality rates in Tayside had less effect on the increase in prevalence than did increasing incidence. Even if incidence and mortality remain unchanged, prevalence will increase by over 20% in the next decade.

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The diabetes audit and research in Tayside Scotland (darts) study: electronic record linkage to create a diabetes register

Abstract: Electronic record linkage was more sensitive than general practice registers in identifying diabetic subjects and identified an additional 0.18% of the population with a history of hyperglycaemia who might warrant screening for undiagnosed diabetes.

Cited by 271 publications

References 16 publications

The Danish National Diabetes Register: trends in incidence, prevalence and mortality

The Danish National Diabetes Register: trends in incidence, prevalence and mortality

Risk of mortality and adverse cardiovascular outcomes in type 2 diabetes: a comparison of patients treated with sulfonylureas and metformin

Increasing prevalence of type 2 diabetes in a Scottish population: effect of increasing incidence or decreasing mortality?

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