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Microvascular Complications

Evangelos Kontopantelis, David A Springate, David Reeves, Darren M. Aschroff, Martin Rutter, Iain Buchan, Tim Doran, Matthias Pierce, Darren M. Ashcroft

Type
Disease or Syndrome
ID
PH548
Version ID
1096
Data Sources
Valid event data range
01/04/2006 - 31/03/2012
Sex
Female, Male
Agreement Date
2014-12-16
Coding system
Read codes v2
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Data source:

We used the Clinical Practice Research Datalink (CPRD), a large primary care database that holds complete electronic patient records (including diagnoses, prescriptions and referrals) from participating family practices across the UK. A hierarchical clinical coding system (Read) is used to record the data. In July 2012, data were available for 644 practices and 13,772,992 patients. Full details of the database have been provided elsewhere.

Diabetes cohort:

We extracted data from 1 April 2006 to 31 March 2012 and, for ease of reporting and analysing, aggregated information into six financial years. Within each year, practice inclusion eligibility was determined by a CPRD assessment algorithm, which informs on practices considered to be of research standard; therefore, our cohort of practices varied over time. For each research standard practice and year, we defined as eligible patients those who were registered with the practice for the full year and were aged 18 years or over in that year. From these patients, using relevant Read codes for type 2 diabetes (e.g. C10F.00: Type 2 diabetes mellitus) and excluding those treated with insulin within 2 years of diagnosis, we identified 246,544 patients over the study period. Diagnoses were not constrained to the study period and a relevant code prior to the study as well as during the study period would flag a patient from the respective year onwards. Data on sex, age and removal from the database due to deaths were available and complete for all patients.We extracted data on diabetes-related macrovascular (myocardial infarction, stroke, peripheral vascular disease or amputation) and microvascular (retinopathy, neuropathy, nephropathy [chronic kidney disease stages 4–5] or foot ulcer) complications as well as comorbidities (asthma, coronary heart disease, chronic kidney disease [excluded from microvascular analysis], chronic obstructive pulmonary disease, depression, dementia, severe mental illness, heart failure, hypertension, stroke [excluded from macrovascular analysis], cancer, epilepsy, osteoarthritis, osteoporosis and hypothyroidism). Although we aimed to include all conditions associated with diabetes, the choice was partially determined by the domains incentivised under the Quality and Outcomes Framework (QOF), for which accuracy of diagnosis is considered high. Information was also extracted on smoking (never smoked, current, exsmoker and missing data),BMI, HbA1c levels (%), cholesterol levels (mmol/l) and systolic/diastolic BP (mmHg). Biometric measurement data were cleaned and we calculated patient means for each year when more than one relevant record was available. Using product lists we determined prescription prevalence (at least one) for relevant medications: ACE inhibitors, acarbose, α-blockers, anticoagulants, antiplatelet agents, β-blockers, calcium-channel blockers, thiazide diuretics, loop diuretics, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide- 1 agonists, statins and other lipid-lowering drugs, meglitinides , metformin, sulfonylureas and thiazolidinediones. For approximately 60% of the practices, records were linked to Office of National Statistics (ONS) mortality data and we had access to death dates for all their patients. For these, using ICD-10 codes (www.who.int/classifications/icd/en/) we were able to estimate deathslinked to specific causes (underlying or in the top three): diabetes (E10–E16), ischaemic heart disease (I21–I22), stroke (I60–I64) or stroke excluding bleeds (excluding I63).

Publications

  • Evangelos Kontopantelis, David A Springate, David Reeves, Darren M. Aschroff, Martin Rutter, Iain Buchan, Tim Doran, Glucose, blood pressure and cholesterol levels and their relationships to clinical outcomes in type 2 diabetes: a retrospective cohort study. Diabetologia, 58:505-518, 2015.

Clinical Code List

Rows: 84
Code Description Entity type Category Coding System (Read)
1Z13.00 Chronic kidney disease stage 4 microvascular_complications diagnostic Read
1Z14.00 Chronic kidney disease stage 5 microvascular_complications diagnostic Read
1Z1H.00 Chronic kidney disease stage 4 with proteinuria microvascular_complications diagnostic Read
1Z1H.11 CKD stage 4 with proteinuria microvascular_complications diagnostic Read
1Z1J.00 Chronic kidney disease stage 4 without proteinuria microvascular_complications diagnostic Read
1Z1J.11 CKD stage 4 without proteinuria microvascular_complications diagnostic Read
1Z1K.00 Chronic kidney disease stage 5 with proteinuria microvascular_complications diagnostic Read
1Z1K.11 CKD stage 5 with proteinuria microvascular_complications diagnostic Read
1Z1L.00 Chronic kidney disease stage 5 without proteinuria microvascular_complications diagnostic Read
1Z1L.11 CKD stage 5 without proteinuria microvascular_complications diagnostic Read
2BBP.00 O/E - right eye background diabetic retinopathy microvascular_complications diagnostic Read
2BBQ.00 O/E - left eye background diabetic retinopathy microvascular_complications diagnostic Read
2BBR.00 O/E - right eye preproliferative diabetic retinopathy microvascular_complications diagnostic Read
2BBS.00 O/E - left eye preproliferative diabetic retinopathy microvascular_complications diagnostic Read
2BBT.00 O/E - right eye proliferative diabetic retinopathy microvascular_complications diagnostic Read
2BBV.00 O/E - left eye proliferative diabetic retinopathy microvascular_complications diagnostic Read
2BBY.00 O/E - referable retinopathy microvascular_complications diagnostic Read
2BBa.00 O/E- non-referable retinopathy microvascular_complications diagnostic Read
2BBk.00 O/E - right eye stable treated prolif diabetic retinopathy microvascular_complications diagnostic Read
2BBl.00 O/E - left eye stable treated prolif diabetic retinopathy microvascular_complications diagnostic Read
2BBo.00 O/E - sight threatening diabetic retinopathy microvascular_complications diagnostic Read
2BBr.00 Impaired vision due to diabetic retinopathy microvascular_complications diagnostic Read
C104.11 Diabetic nephropathy microvascular_complications diagnostic Read
C104z00 Diabetes mellitus with nephropathy NOS microvascular_complications diagnostic Read
C106.12 Diabetes mellitus with neuropathy microvascular_complications diagnostic Read
C106.13 Diabetes mellitus with polyneuropathy microvascular_complications diagnostic Read
C108D00 Insulin dependent diabetes mellitus with nephropathy microvascular_complications diagnostic Read
C109600 Non-insulin-dependent diabetes mellitus with retinopathy microvascular_complications diagnostic Read
C109611 Type II diabetes mellitus with retinopathy microvascular_complications diagnostic Read
C109612 Type 2 diabetes mellitus with retinopathy microvascular_complications diagnostic Read
C109A00 Non-insulin dependent diabetes mellitus with mononeuropathy microvascular_complications diagnostic Read
C109A11 Type II diabetes mellitus with mononeuropathy microvascular_complications diagnostic Read
C109B00 Non-insulin dependent diabetes mellitus with polyneuropathy microvascular_complications diagnostic Read
C109B11 Type II diabetes mellitus with polyneuropathy microvascular_complications diagnostic Read
C109C00 Non-insulin dependent diabetes mellitus with nephropathy microvascular_complications diagnostic Read
C109C11 Type II diabetes mellitus with nephropathy microvascular_complications diagnostic Read
C109C12 Type 2 diabetes mellitus with nephropathy microvascular_complications diagnostic Read
C109H00 Non-insulin dependent d m with neuropathic arthropathy microvascular_complications diagnostic Read
C109H11 Type II diabetes mellitus with neuropathic arthropathy microvascular_complications diagnostic Read
C109H12 Type 2 diabetes mellitus with neuropathic arthropathy microvascular_complications diagnostic Read
C10F600 Type 2 diabetes mellitus with retinopathy microvascular_complications diagnostic Read
C10F611 Type II diabetes mellitus with retinopathy microvascular_complications diagnostic Read
C10FA00 Type 2 diabetes mellitus with mononeuropathy microvascular_complications diagnostic Read
C10FA11 Type II diabetes mellitus with mononeuropathy microvascular_complications diagnostic Read
C10FB00 Type 2 diabetes mellitus with polyneuropathy microvascular_complications diagnostic Read
C10FB11 Type II diabetes mellitus with polyneuropathy microvascular_complications diagnostic Read
C10FC00 Type 2 diabetes mellitus with nephropathy microvascular_complications diagnostic Read
C10FC11 Type II diabetes mellitus with nephropathy microvascular_complications diagnostic Read
C10FH00 Type 2 diabetes mellitus with neuropathic arthropathy microvascular_complications diagnostic Read
F171100 Autonomic neuropathy due to diabetes microvascular_complications diagnostic Read
F171z00 Peripheral autonomic neuropathy due to disease NOS microvascular_complications diagnostic Read
F366.00 Polyneuropathy microvascular_complications diagnostic Read
F367.00 Peripheral neuropathy microvascular_complications diagnostic Read
F372.00 Polyneuropathy in diabetes microvascular_complications diagnostic Read
F372.11 Diabetic polyneuropathy microvascular_complications diagnostic Read
F372.12 Diabetic neuropathy microvascular_complications diagnostic Read
F372000 Acute painful diabetic neuropathy microvascular_complications diagnostic Read
F372100 Chronic painful diabetic neuropathy microvascular_complications diagnostic Read
F372200 Asymptomatic diabetic neuropathy microvascular_complications diagnostic Read
F374z00 Polyneuropathy in disease NOS microvascular_complications diagnostic Read
F37y100 Axonal sensorimotor neuropathy microvascular_complications diagnostic Read
F37z.11 Polyneuropathy unspecified microvascular_complications diagnostic Read
F3y0.00 Diabetic mononeuropathy microvascular_complications diagnostic Read
F420.00 Diabetic retinopathy microvascular_complications diagnostic Read
F420000 Background diabetic retinopathy microvascular_complications diagnostic Read
F420100 Proliferative diabetic retinopathy microvascular_complications diagnostic Read
F420200 Preproliferative diabetic retinopathy microvascular_complications diagnostic Read
F420600 Non proliferative diabetic retinopathy microvascular_complications diagnostic Read
F420700 High risk proliferative diabetic retinopathy microvascular_complications diagnostic Read
F420800 High risk non proliferative diabetic retinopathy microvascular_complications diagnostic Read
F420z00 Diabetic retinopathy NOS microvascular_complications diagnostic Read
F422z00 Proliferative retinopathy NOS microvascular_complications diagnostic Read
Fyu6B00 [X]Other mononeuropathies of lower limb microvascular_complications diagnostic Read
Fyu7C00 [X] Polyneuropathy, unspecified microvascular_complications diagnostic Read
FyuAC00 [X]Autonomic neuropathy/endocrine+metabolic diseases CE microvascular_complications diagnostic Read
K02..12 Nephropathy - chronic microvascular_complications diagnostic Read
K03..00 Nephritis and nephropathy unspecified microvascular_complications diagnostic Read
K03..11 Nephritis and nephropathy unspecified microvascular_complications diagnostic Read
K03..12 Nephropathy, unspecified microvascular_complications diagnostic Read
K054.00 Chronic kidney disease stage 4 microvascular_complications diagnostic Read
K055.00 Chronic kidney disease stage 5 microvascular_complications diagnostic Read
K08yA00 Proteinuric diabetic nephropathy microvascular_complications diagnostic Read
N035.00 Neuropathic arthropathy microvascular_complications diagnostic Read
N242300 Neuropathic pain microvascular_complications diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH548/version/1096/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH548/version/1096/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH548', '1096', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH548/version/1096/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH548/version/1096/export/codes/?format=json
CSV site_root/phenotypes/PH548/version/1096/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH548', '1096', api_client=client)

Version History

Version
ID
Name Owner Publish date
1096 Microvascular Complications ieuan.scanlon 2021-10-06 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

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