Multiple Chronic Comorbidities in a T2DM Mediterranean Population

Abstract

Objective: T2DM patients often have multiple comorbidities which may impact patients’ management approach and treatment selection. This is the first study examining the co-prevalence of comorbidities such as CVD and CKD (GFR <60 ml/min and/or UACR ≥ 30 mg/g) across T2DM patients in Spain using a well-validated local database (DB). Methods: Retrospective cross-sectional study using the Spanish local electronic records DB “Information System for the Development of Research in Primary Care”, SIDIAP. Adult patients with T2DM were included and comorbid conditions were assessed using all medical records available from full years 2015-2016. Patient characteristics, laboratory measures and comorbidities were summarized via descriptive analyses, overall and by subgroups of age, gender and HbA1c levels. Results: From 373,185 T2DM identified patients (overall population, OP), 55% were men, their mean age was 70 years, the mean T2DM duration was 9 years and the mean HbA1c value was 7.12% (SD 1.32). The most common comorbid conditions were hypertension (HTN): 72% of patients; hyperlipidemia (HL): 60%; obesity: 39%, CKD: 33% and CVD: 23%. The highest co-prevalence was the combination of HTN/HL (45.2%), followed by HTN/CKD (28.3%), HTN/CVD (18.8%) and CVD/HL (15.1%). CVD was more frequent in older groups (32.3% in patients ³75 years-old) and in men (27.8% vs. 17.6%), while heart failure was more frequent in women (8.0% vs. 6.1%). CKD was found to increase with age, reaching 51.9% in patients ≥75 years. The coexistence of CKD and CVD in the whole population was 11.1%. Among T2DM patients with CVD and available GFR data (79,158, 91% of CVD patients), 57.6% had a GFR ≥ 60 ml/min (around 12% of OP), whereas 20.7% had GFR from 45 to <60, 14.2% had GFR from 30 to <45; 6.2% had GFR from 15 to <30ml/min; and 1.3% had GFR < 15ml/min. Conclusion: The frequency of comorbidities in T2DM patients from a Mediterranean area is high, and both age and gender play a role in overall comorbidity burden. CKD and CVD are frequent comorbid conditions among T2DM patients. Disclosure J. Franch-Nadal: None. M. Mata-Cases: None. J. Real: None. K. Ferreira de Campos: Employee; Self; Merck Sharp & Dohme Corp. M. Cedenilla: Employee; Self; Merck Sharp & Dohme Corp. A. Gómez: Employee; Self; Merck Sharp & Dohme Corp. D. Mauricio: Advisory Panel; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; Eli Lilly and Company, GlaxoSmithKline plc.. Research Support; Self; GlaxoSmithKline plc.. Advisory Panel; Self; Janssen-Cilag Pty Limited. Speaker's Bureau; Self; Merck Sharp & Dohme Corp.. Board Member; Self; Merck Sharp & Dohme Corp.. Research Support; Self; Merck Sharp & Dohme Corp.. Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S. Advisory Panel; Self; Sanofi. Board Member; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Research Support; Self; Sanofi.