Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
Diagnostic Center, Regional Hospital Central Jutland, Silkeborg, Denmark.
Diabetes Obes Metab. 2021 Feb;23(2):520-529. doi: 10.1111/dom.14245. Epub 2020 Nov 17.
To investigate temporal trends in time to initiation of sodium-glucose co-transporter-2 inhibitors and glucagon-like peptide 1 analogues (cardioprotective glucose-lowering drugs [GLDs]) in patients with a new dual diagnosis of type 2 diabetes (T2DM) and cardiovascular disease (CVD).
In a cohort study, we identified patients with a new dual diagnosis of T2DM and CVD using linked healthcare data from nationwide registries on drug prescriptions and diagnosis codes. For each calendar year between 2012 and 2018, we examined time to initiation and cumulative user proportions (CUPs) for cardioprotective GLD use 1 and 2 years after the dual diagnosis.
Among all individuals living in Denmark in the period 2012 to 2018, 41 733 patients with a new dual diagnosis of T2DM and CVD were identified (median [interquartile range] age 71 [64-79] years, 61% male, and 57% with CVD as the latest diagnosis). Incidence curve slopes and 1- and 2-year CUPs for cardioprotective GLDs increased during the study period (1-year CUP 4.0%, 95% confidence interval [CI] 3.6-4.5) in 2012 to 14.7, 95% CI 13.7-15.7, in 2018; 2-year CUP 5.5, 95% CI 5.0-6.1, in 2012 to 16.7, 95% CI 15.8-17.7, in 2017). T2DM patients with CVD as the second (latest) diagnosis had higher 1-year CUPs than CVD patients with T2DM as the latest diagnosis: 2012: 7.0 (95% CI 6.2-8.0) versus 1.4 (95% CI 1.0-1.8); 2018: 18.1 (95% CI 16.8-19.6) versus 10.0 (95% CI 8.8-11.3).
In patients with T2DM and CVD, the incidence of cardioprotective GLD initiation increased between 2012 and 2018, however, within 2 years of dual diagnosis, it remained low.
研究 2 型糖尿病（T2DM）合并心血管疾病（CVD）新诊断患者开始使用钠-葡萄糖共转运蛋白-2 抑制剂和胰高血糖素样肽 1 类似物（心脏保护降糖药物[GLD]）的时间趋势。
在一项队列研究中，我们使用来自全国范围内药物处方和诊断代码登记处的相关医疗保健数据，确定了 T2DM 和 CVD 双重诊断的新患者。对于 2012 年至 2018 年的每个历年，我们检查了心脏保护 GLD 使用的起始时间和 1 年和 2 年后的累积使用者比例（CUP）。
在 2012 年至 2018 年期间，丹麦所有人群中，确定了 41733 名 T2DM 和 CVD 双重诊断的新患者（中位[四分位数范围]年龄 71[64-79]岁，61%为男性，57%以 CVD 为最新诊断）。在研究期间，心脏保护 GLD 的发生率曲线斜率和 1 年和 2 年 CUP 增加（1 年 CUP 4.0%，95%置信区间[CI] 3.6-4.5）在 2012 年至 2018 年为 14.7%，95%CI 13.7-15.7%；2 年 CUP 5.5%，95%CI 5.0-6.1%，2012 年至 16.7%，95%CI 15.8-17.7%，在 2017 年）。以 CVD 为第二个（最新）诊断的 T2DM 患者的 1 年 CUP 高于以 CVD 为最新诊断的 T2DM 患者：2012 年：7.0%（95%CI 6.2-8.0）与 1.4%（95%CI 1.0-1.8）；2018 年：18.1%（95%CI 16.8-19.6）与 10.0%（95%CI 8.8-11.3）。
在 T2DM 合并 CVD 的患者中，心脏保护 GLD 的起始发生率在 2012 年至 2018 年间有所增加，但在双重诊断后的 2 年内仍然较低。
