Care processes in people in remission from type 2 diabetes: a cohort study using the National Diabetes Audit

Holman, N. , Khunti, K., Wild, S. H., Sattar, N. , Knighton, P., Young, B., Gregg, E. W., Bakhai, C. and Valabhji, J. (2023) Care processes in people in remission from type 2 diabetes: a cohort study using the National Diabetes Audit. Diabetic Medicine, 40(3), e15016. (doi: 10.1111/dme.15016) (PMID:36440921) (PMCID:PMC10108144)

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Abstract

Aims: People with type 2 diabetes can enter remission but may relapse or develop legacy complications. This analysis assesses whether people with remission from type 2 diabetes continue receiving annual care processes recommended in national guidelines and the potential impacts of formal recognition of remission. Methods: People with type 2 diabetes with and without formal recognition (diagnostic code) of remission, and with and without evidence of remission (HbA1c < 48 mmol/mol without prescription for glucose-lowering drugs in preceding 26 weeks), included in the 2018/19 National Diabetes Audit (NDA) for England and Wales were followed up to identify care processes received between 1 January 2019 and 31 March 2020. Results: Of the 2,822,145 people with type 2 diabetes in the cohort, 16,460 (0.58%) were coded with remission in the 2018/19 NDA. After adjustment for age, sex, socioeconomic deprivation and ethnicity, people coded with remission were less likely to receive each care process than those without such coding irrespective of HbA1c measurements (relative risk (RR) of receiving all 8 care processes 0.70 (95% CI 0.69–0.72)). For the 339,235 people with evidence of remission, irrespective of diagnostic coding compared to those without such evidence, the RR for receiving all 8 care processes was 0.94 (95% CI 0.93–0.94). Conclusions: People coded with remission of type 2 diabetes were less likely to receive diabetes care processes than those without such coding. People with evidence of remission had only a slightly reduced likelihood of receiving care processes. Formal recognition of remission may affect the provision or uptake of care processes.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Sattar, Professor Naveed and Holman, Ms Naomi
Authors: Holman, N., Khunti, K., Wild, S. H., Sattar, N., Knighton, P., Young, B., Gregg, E. W., Bakhai, C., and Valabhji, J.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Diabetic Medicine
Publisher:Wiley
ISSN:0742-3071
ISSN (Online):1464-5491
Published Online:28 November 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Diabetic Medicine 40(3): e15016
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
303944BHF Centre of ExcellenceColin BerryBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science