[ { "phenotype_id": "PH928", "phenotype_version_id": 1935, "name": "Microvascular Complications", "definition": "BACKGROUND: \n\nWith recent changes in the United Kingdom’s clinical practice for diabetes mellitus care, contemporary estimates of sex disparities in cardiovascular risk and risk factor management are needed.\n\n\nMETHODS: \n\nIn this retrospective cohort study, using the Clinical Practice Research Datalink linked to hospital and death records for people in England, we identified 79 985 patients with incident type 2 diabetes mellitus (T2DM) between 2006 to 2013 matched to 386 547 patients without diabetes mellitus. Sex-stratified Cox models were used to assess cardiovascular risk.\n\n\nRESULTS: \n\nCompared with women without T2DM, women with T2DM had a higher cardiovascular event risk (adjusted hazard ratio, 1.20 [95% confidence interval, 1.12–1.28]) with similar corresponding data in men (hazard ratio, 1.12 [1.06–1.19]), leading to a nonsignificant higher relative risk in women (risk ratio, 1.07 [0.98–1.17]). However, some important sex differences in the management of risk factors were observed. Compared with men with T2DM, women with T2DM were more likely to be obese, hypertensive, and have hypercholesterolemia, but were less likely to be prescribed lipid-lowering medication and angiotensin-converting enzyme inhibitors, especially if they had cardiovascular disease.\n\n\nCONCLUSIONS: \n\nCompared with men developing T2DM, women with T2DM do not have a significantly higher relative increase in cardiovascular risk, but ongoing sex disparities in prescribing should prompt heightened efforts to improve the standard and equity of diabetes mellitus care in women and men.\n\n\n\n\n\n\n\n\n", "implementation": "", "publications": [ { "doi": null, "details": "Alison K Wright,Evangelos Kontopantelis, Richard Emsley, Ian Buchan, Mamas A Mamas, Naveed Sattar, Darren M Ashcroft, Martin K Rutter, , Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes Mellitus A Population-Based Cohort Study Assessing Sex Disparities. Circulation, 139:2742-2753, 2019." } ], "validation": "", "citation_requirements": "", "created": "2022-04-04T07:11:09.931592Z", "author": "Alison K Wright, Evangelos Kontopantelis, Richard Emsley, Ian Buchan, Mamas A Mamas, Naveed Sattar, Darren M Ashcroft, Martin M Rutter", "collections": [ { "name": "ClinicalCodes Repository", "value": 25 }, { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2022-04-04T07:11:09.931617Z", "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": "01/01/2006 - 31/12/2013", "concept_information": [ { "concept_id": 2704, "concept_version_id": 6821, "concept_name": "Microvascular Complications - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH928", "phenotype_version_id": 1935, "phenotype_name": "Microvascular Complications", "code_attribute_header": [ "Entity type", "Category", "Coding System (Read)" ], "codes": [ { "code": "2BBa.00", "description": "O/E- non-referable retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "2BBk.00", "description": "O/E - right eye stable treated prolif diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "2BBl.00", "description": "O/E - left eye stable treated prolif diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "2BBo.00", "description": "O/E - sight threatening diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "2BBP.00", "description": "O/E - right eye background diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "2BBQ.00", "description": "O/E - left eye background diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "2BBr.00", "description": "Impaired vision due to diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "2BBR.00", "description": "O/E - right eye preproliferative diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "2BBS.00", "description": "O/E - left eye preproliferative diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "2BBT.00", "description": "O/E - right eye proliferative diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "2BBV.00", "description": "O/E - left eye proliferative diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "2BBY.00", "description": "O/E - referable retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C106.12", "description": "Diabetes mellitus with neuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C106.13", "description": "Diabetes mellitus with polyneuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C108700", "description": "Insulin dependent diabetes mellitus with retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C108711", "description": "Type I diabetes mellitus with retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C108712", "description": "Type 1 diabetes mellitus with retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C108B00", "description": "Insulin dependent diabetes mellitus with mononeuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C108B11", "description": "Type I diabetes mellitus with mononeuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C108C00", "description": "Insulin dependent diabetes mellitus with polyneuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C109600", "description": "Non-insulin-dependent diabetes mellitus with retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C109611", "description": "Type II diabetes mellitus with retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C109612", "description": "Type 2 diabetes mellitus with retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C109A00", "description": "Non-insulin dependent diabetes mellitus with mononeuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C109A11", "description": "Type II diabetes mellitus with mononeuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C109B00", "description": "Non-insulin dependent diabetes mellitus with polyneuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C109B11", "description": "Type II diabetes mellitus with polyneuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C109B12", "description": "Type 2 diabetes mellitus with polyneuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10E700", "description": "Type 1 diabetes mellitus with retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10E711", "description": "Type I diabetes mellitus with retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10E712", "description": "Insulin dependent diabetes mellitus with retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10EB00", "description": "Type 1 diabetes mellitus with mononeuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10EC00", "description": "Type 1 diabetes mellitus with polyneuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10EC11", "description": "Type I diabetes mellitus with polyneuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10EC12", "description": "Insulin dependent diabetes mellitus with polyneuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10F600", "description": "Type 2 diabetes mellitus with retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10F611", "description": "Type II diabetes mellitus with retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10FA00", "description": "Type 2 diabetes mellitus with mononeuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10FA11", "description": "Type II diabetes mellitus with mononeuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10FB00", "description": "Type 2 diabetes mellitus with polyneuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "C10FB11", "description": "Type II diabetes mellitus with polyneuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F171.00", "description": "Peripheral autonomic neuropathy disease EC", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F171100", "description": "Autonomic neuropathy due to diabetes", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F366.00", "description": "Polyneuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F367.00", "description": "Peripheral neuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F372.00", "description": "Polyneuropathy in diabetes", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F372000", "description": "Acute painful diabetic neuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F372100", "description": "Chronic painful diabetic neuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F372.11", "description": "Diabetic polyneuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F372.12", "description": "Diabetic neuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F372200", "description": "Asymptomatic diabetic neuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F374500", "description": "Polyneuropathy in hypoglycaemia", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F3y0.00", "description": "Diabetic mononeuropathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F420.00", "description": "Diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F420000", "description": "Background diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F420100", "description": "Proliferative diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F420200", "description": "Preproliferative diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F420600", "description": "Non proliferative diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F420700", "description": "High risk proliferative diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F420800", "description": "High risk non proliferative diabetic retinopathy", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F420z00", "description": "Diabetic retinopathy NOS", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F422z00", "description": "Proliferative retinopathy NOS", "attributes": { "Entity type": "res72: Microvascular complications", "Category": "diagnostic", "Coding System (Read)": "Read" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/fafk-fr11", "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": 1935, "version_name": "Microvascular Complications", "version_date": "2022-04-04T07:11:09.957953Z", "is_published": true, "is_latest": true } ] } ]