[ { "phenotype_id": "PH914", "phenotype_version_id": 1907, "name": "Type 2 Diabetes (Exclusion Codes)", "definition": "Purpose:\n\nThis is a retrospective cohort study using observational data from anonymised primary care records. We identify and extract all patients with type 2 diabetes and associated clinical data from the Clinical Practice Research Datalink (CPRD) to inform models of disease progression and stratification of treatment.\n\n\nParticipants:\n\nData were extracted from CPRD on 8 August 2016. The initial data set contained all patients (n=313 485) in the database who had received a type 2 diabetes medication. Criteria were applied to identify and exclude those with type 1 diabetes, polycystic ovarian syndrome or other forms of diabetes (n=40 204), and for data quality control (n=12). We identified 251 338 patients for inclusion in future analyses of diabetes progression and treatment response.\n\n\nFindings to date:\n\nFor 6-month response to treatment, measured by change in glycated haemoglobin (HbA1c), we have 91 765 patients with 119 785 treatment response episodes. The greatest impact on reduction of HbA1c occurs with first-line and second-line treatments, metformin and sulfonylurea. Patients moving to thirdline treatments tend to have greater weights and higher body mass index. We have investigated the impact of non-adherence to commonly used glucose-lowering medications on HbA1c. For baseline-adjusted HbA1c change over 1 year, non-adherent patients had lower HbA1c reductions than adherent patients, with mean and 95% CI of −4.4 (−4.7 to −4.0) mmol/mol (−0.40 (−0.43 to −0.37) %).\n\n\nFuture plans: \n\nFindings from studies using these data will help inform future treatment plans and guidelines. Additional data are added with updates from CPRD. This will increase the numbers of patients on newer medications and add more data on those already receiving treatment. There are several ongoing studies investigating different hypotheses regarding differential response to treatment and progression of diabetes. For side effects, links to Hospital Episode Statistics data, where severe events such as hypoglycaemia will be recorded, will also be explored.\n\n\n\n\n\n\n\n\n", "implementation": "", "publications": [ { "doi": null, "details": "Lauren L Rodgers, Michael N Weedon, William E Henley, Andrew T Hattersley, Beverley M Shields, Cohort profile for the MASTERMIND study using the Clinical Practice Research Datalink (CPRD) to investigate stratification of response to treatment in patients with type 2 diabetes. BMJ Open, 7:e017989, 2017." } ], "validation": "", "citation_requirements": "", "created": "2022-04-04T07:09:47.823017Z", "author": "Lauren L Rodgers, Michael N Weedon, William E Henley, Andrew T Hattersley, Beverley M Shields", "collections": [ { "name": "ClinicalCodes Repository", "value": 25 }, { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2022-04-04T07:09:47.823042Z", "sex": [ { "name": "Both", "value": "3" } ], "type": [ { "name": "Disease or syndrome", "value": "2" } ], "ontology": null, "phenoflowid": "", "data_sources": [ { "name": "CPRD GOLD", "value": 5, "uid": "a29feafa-7bdd-44e9-b977-c9d26425e67f", "url": "https://healthdatagateway.org/en/dataset/694", "datasource_id": 694 } ], "coding_system": [ { "name": "Read codes v2", "value": 5 } ], "event_date_range": "01/01/1900 - 08/08/2016", "concept_information": [ { "concept_id": 2689, "concept_version_id": 6791, "concept_name": "Type 2 Diabetes (Exclusion Codes) - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH914", "phenotype_version_id": 1907, "phenotype_name": "Type 2 Diabetes (Exclusion Codes)", "code_attribute_header": [ "Entity type", "Category", "Coding System (Read)" ], "codes": [ { "code": "66Ay.00", "description": "Gestational diabetes mellitus annual review", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "8CE0000", "description": "Gestational diabetes information leaflet given", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "8Hgd.00", "description": "Discharge from secondary care diabetes service", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C101y00", "description": "Other specified diabetes mellitus with ketoacidosi", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C103y00", "description": "Other specified diabetes mellitus with coma", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C104y00", "description": "Other specified diabetes mellitus with renal compl", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C105y00", "description": "Other specified diabetes mellitus with ophthalmic ", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C106y00", "description": "Other specified diabetes mellitus with neurologica", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C108y00", "description": "Other specified diabetes mellitus with multiple co", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10A.00", "description": "Malnutrition-related diabetes mellitus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10A000", "description": "Malnutrition-related diabetes mellitus with coma", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10A100", "description": "Malnutrition-related diabetes mellitus with ketoac", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10B.00", "description": "Diabetes mellitus induced by steroids", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10B000", "description": "Steroid induced diabetes mellitus without complica", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10C.11", "description": "Maturity onset diabetes in youth", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10C.12", "description": "Maturity onset diabetes in youth type 1", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10D.11", "description": "Maturity onset diabetes in youth type 2", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10G.00", "description": "Secondary pancreatic diabetes mellitus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10G000", "description": "Secondary pancreatic diabetes mellitus without com", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10H.00", "description": "Diabetes mellitus induced by non-steroid drugs", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10N.00", "description": "Secondary diabetes mellitus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10N000", "description": "Secondary diabetes mellitus without complication", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10N100", "description": "Cystic fibrosis related diabetes mellitus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10y.00", "description": "Diabetes mellitus with other specified manifestati", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10y000", "description": "Diabetes mellitus, juvenile, + other specified man", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10y100", "description": "Diabetes mellitus, adult, + other specified manife", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10yy00", "description": "Other specified diabetes mellitus with other spec ", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10yz00", "description": "Diabetes mellitus NOS with other specified manifes", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10zy00", "description": "Other specified diabetes mellitus with unspecified", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C11y000", "description": "Steroid induced diabetes", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C135.00", "description": "Diabetes insipidus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C135000", "description": "Cranial diabetes insipidus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C135.12", "description": "Diabetes insipidus - pituitary", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C164.00", "description": "Polycystic ovaries", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C164.13", "description": "Multicystic ovaries", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Cyu2000", "description": "[X]Other specified diabetes mellitus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F381300", "description": "Myasthenic syndrome due to diabetic amyotrophy", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "K01x100", "description": "Nephrotic syndrome in diabetes mellitus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "K081.00", "description": "Nephrogenic diabetes insipidus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "K081000", "description": "Acquired nephrogenic diabetes insipidus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "L180700", "description": "Pre-existing malnutrition-related diabetes mellitu", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "L180811", "description": "Gestational diabetes mellitus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "L180900", "description": "Gestational diabetes mellitus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "PKyP.00", "description": "Diab insipidus,diab mell,optic atrophy and deafnes", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Q440.00", "description": "'Infant of a diabetic mother' syndrome", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Q441.00", "description": "Neonatal diabetes mellitus", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Q44B.00", "description": "Syndrome of infant of mother with gestational diab", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Q44y100", "description": "Transitory metabolic disturbance-infant pre-diabet", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R003.00", "description": "[D]Convulsions", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "ZC2CB00", "description": "Dietary advice for gestational diabetes", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "ZV13F00", "description": "[V]Personal history of gestational diabetes mellit", "attributes": { "Entity type": "res62: exclusion_codes", "Category": "diagnostic", "Coding System (Read)": "Read" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/1p70-ch47", "is_deleted": null, "publish_status": 2, "owner": "ieuan.scanlon", "template": { "id": 1, "name": "Clinical-Coded Phenotype", "description": "Phenotype definitions that are based on lists of clinical codes, or algorithms using clinical codes.", "version_id": 1 }, "versions": [ { "version_id": 1907, "version_name": "Type 2 Diabetes (Exclusion Codes)", "version_date": "2022-04-04T07:09:47.849218Z", "is_published": true, "is_latest": true } ] } ]