Abstract
Type 2 diabetes mellitus is a major concern globally and well known for increasing risk of complications. However, diabetes complications often remain undiagnosed and untreated in a large number of high-risk patients. In this study based on claims data collected in South Korea, we aimed to explore the diagnostic progression and sex- and age-related differences among patients with type 2 diabetes using time-considered patterns of the incidence of comorbidities that evolved after a diagnosis of type 2 diabetes. This study compared 164,593 patients who met the full criteria for type 2 diabetes with age group-, sex-, encounter type-, and diagnosis date-matched controls who had not been diagnosed with type 2 diabetes. We identified 76,423 significant trajectories of four diagnoses from the dataset. The top 30 trajectories with the highest average relative risks comprised microvascular, macrovascular, and miscellaneous complications. Compared with the trajectories of male groups, those of female groups included relatively fewer second-order nodes and contained hubs. Moreover, the trajectories of male groups contained diagnoses belonging to various categories. Our trajectories provide additional information about sex- and age-related differences in the risks of complications and identifying sequential relationships between type 2 diabetes and potentially complications.
Highlights
Diabetes mellitus is among the most prevalent disorders worldwide, affecting approximately 451 million adults in 2017 according to the International Diabetes Federation (IDF)[1,2,3]
Approximately 193 million affected patients remain undiagnosed before developing long-term complications caused by uncontrolled chronic hyperglycemia[4]
The female:male ratio was 50.3:49.7, and the highest proportion of type 2 diabetes diagnoses occurred during middle age (60.3%)
Summary
Diabetes mellitus is among the most prevalent disorders worldwide, affecting approximately 451 million adults (age: 18–99 years) in 2017 according to the International Diabetes Federation (IDF)[1,2,3]. Type 2 diabetes accounts for more than 90% of all newly diagnosed cases of diabetes mellitus in adults[5,6] This condition is associated with an increased risk of various complications, which can be categorized into three major groups: microvascular, macrovascular, and miscellaneous[7]. Jeong et al developed a diagnostic progression network based on claims data with the aim of determining the global patterns of diagnosis in South Korea[20] This network provided only information about the associations between diagnosis pairs, rather than the sequential trajectories. We aimed to construct time-dependent type 2 diabetes trajectories based on population-wide claim data These trajectories would be expected to reveal time-critical associations between type 2 diabetes and other diseases and identify differences in the patterns of progression among various age and sex groups. To overcome the insufficient definition of a diagnosis as a direct complication of type 2 diabetes according to sequential patterns from claims data, we used the term “accompanying comorbidity” rather than “complication” to encompass all possible relationships with type 2 diabetes
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have