Print

Diabetes With Complications

Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Carolyn A Chew-Graham, Nav Kapur, Darren M. Ashcroft

Type
Disease or Syndrome
ID
PH879
Version ID
1837
Data Sources
Valid event data range
01/01/2001 - 31/12/2014
Sex
Female, Male
Agreement Date
2018-10-15
Coding system
Read codes v2 ICD10 codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Background:

Self-harm is a major risk factor for suicide, with older adults (older than 65 years) having reportedly greater suicidal intent than any other age group. With the aging population rising and paucity of research focus in this age group, the extent of the problem of self-harm needs to be established. In a primary care cohort of older adults we aimed to investigate the incidence of self-harm, subsequent clinical management, prevalence of mental and physical diagnoses, and unnatural-cause mortality risk, including suicide.

Methods:

The UK Clinical Practice Research Datalink contains anonymised patient records from general practice that routinely capture clinical information pertaining to both primary and secondary care services. We identified 4124 adults aged 65 years and older with a self-harm episode ascertained from Read codes recorded during 2001–14. We calculated standardised incidence and in 2854 adults with at least 12 months follow-up examined the frequency of psychiatric referrals and prescription of psychotropic medication after self-harm. We estimated prevalence of mental and physical illness diagnoses before and after self-harm and, using Cox regression in a matched cohort, we examined cause-specific mortality risks.

Findings:

Overall incidence of self-harm in older adults aged 65 years and older was 4·1 per 10 000 person-years with stable gender-specific rates observed over the 13-year period. After self-harm, 335 (11·7%) of 2854 adults were referred to mental health services, 1692 (59·3%) were prescribed an antidepressant, and 336 (11·8%) were prescribed a tricyclic antidepressant (TCA). Having a diagnosed previous mental illness was twice as prevalent in the self-harm cohort as in the comparison cohort (prevalence ratio 2·10 [95% CI 2·03–2·17]) and with a previous physical health condition prevalence was 20% higher in the self-harm cohort compared to the comparison cohort (1·20 [1·17–1·23]). Adults from the self-harm cohort (n=2454) died from unnatural causes an estimated 20 times more frequently than the comparison cohort (n=48 921) during the first year. A markedly elevated risk of suicide (hazard ratio 145·4 [95% CI 53·9–392·3]) was observed in the self-harm cohort.

Interpretation:

Within primary care, we have identified a group of older adults at high risk from unnatural death, particularly within the first year of self-harm. We have highlighted a high frequency of prescription of TCAs, known to be potentially fatally toxic in overdose. We emphasise the need for early intervention, careful alternative prescribing, and increased support when older adults consult after an episode of self-harm and with other health conditions.

Publications

  • Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Carolyn A Chew-Graham, Nav Kapur, Darren M. Ashcroft, Self-harm in a primary care cohort of older people incidence, clinical management, and risk of suicide and other causes of death. Psychiatry, 5, 2018.

Clinical Code List

Rows: 107
Code Description Entity type Coding System (ICD-10 Read) Category
2BBL.00 O/E - diabetic maculopathy present both eyes res69: diabetes_with_complications Read diagnostic
2BBP.00 O/E - right eye background diabetic retinopathy res69: diabetes_with_complications Read diagnostic
2BBQ.00 O/E - left eye background diabetic retinopathy res69: diabetes_with_complications Read diagnostic
2BBR.00 O/E - right eye preproliferative diabetic retinopathy res69: diabetes_with_complications Read diagnostic
2BBS.00 O/E - left eye preproliferative diabetic retinopathy res69: diabetes_with_complications Read diagnostic
2BBV.00 O/E - left eye proliferative diabetic retinopathy res69: diabetes_with_complications Read diagnostic
2BBk.00 O/E - right eye stable treated prolif diabetic retinopathy res69: diabetes_with_complications Read diagnostic
2BBl.00 O/E - left eye stable treated prolif diabetic retinopathy res69: diabetes_with_complications Read diagnostic
C104.11 Diabetic nephropathy res69: diabetes_with_complications Read diagnostic
C104000 Diabetes mellitus, juvenile type, with renal manifestation res69: diabetes_with_complications Read diagnostic
C104y00 Other specified diabetes mellitus with renal complications res69: diabetes_with_complications Read diagnostic
C104z00 Diabetes mellitus with nephropathy NOS res69: diabetes_with_complications Read diagnostic
C105.00 Diabetes mellitus with ophthalmic manifestation res69: diabetes_with_complications Read diagnostic
C105000 Diabetes mellitus, juvenile type, + ophthalmic manifestation res69: diabetes_with_complications Read diagnostic
C105100 Diabetes mellitus, adult onset, + ophthalmic manifestation res69: diabetes_with_complications Read diagnostic
C105y00 Other specified diabetes mellitus with ophthalmic complicatn res69: diabetes_with_complications Read diagnostic
C105z00 Diabetes mellitus NOS with ophthalmic manifestation res69: diabetes_with_complications Read diagnostic
C106.00 Diabetes mellitus with neurological manifestation res69: diabetes_with_complications Read diagnostic
C106.11 Diabetic amyotrophy res69: diabetes_with_complications Read diagnostic
C106.12 Diabetes mellitus with neuropathy res69: diabetes_with_complications Read diagnostic
C106.13 Diabetes mellitus with polyneuropathy res69: diabetes_with_complications Read diagnostic
C106100 Diabetes mellitus, adult onset, + neurological manifestation res69: diabetes_with_complications Read diagnostic
C106y00 Other specified diabetes mellitus with neurological comps res69: diabetes_with_complications Read diagnostic
C106z00 Diabetes mellitus NOS with neurological manifestation res69: diabetes_with_complications Read diagnostic
C108000 Insulin-dependent diabetes mellitus with renal complications res69: diabetes_with_complications Read diagnostic
C108011 Type I diabetes mellitus with renal complications res69: diabetes_with_complications Read diagnostic
C108012 Type 1 diabetes mellitus with renal complications res69: diabetes_with_complications Read diagnostic
C108100 Insulin-dependent diabetes mellitus with ophthalmic comps res69: diabetes_with_complications Read diagnostic
C108200 Insulin-dependent diabetes mellitus with neurological comps res69: diabetes_with_complications Read diagnostic
C108211 Type I diabetes mellitus with neurological complications res69: diabetes_with_complications Read diagnostic
C108212 Type 1 diabetes mellitus with neurological complications res69: diabetes_with_complications Read diagnostic
C108700 Insulin dependent diabetes mellitus with retinopathy res69: diabetes_with_complications Read diagnostic
C108711 Type I diabetes mellitus with retinopathy res69: diabetes_with_complications Read diagnostic
C108712 Type 1 diabetes mellitus with retinopathy res69: diabetes_with_complications Read diagnostic
C108B00 Insulin dependent diabetes mellitus with mononeuropathy res69: diabetes_with_complications Read diagnostic
C108B11 Type I diabetes mellitus with mononeuropathy res69: diabetes_with_complications Read diagnostic
C108C00 Insulin dependent diabetes mellitus with polyneuropathy res69: diabetes_with_complications Read diagnostic
C108D00 Insulin dependent diabetes mellitus with nephropathy res69: diabetes_with_complications Read diagnostic
C108D11 Type I diabetes mellitus with nephropathy res69: diabetes_with_complications Read diagnostic
C108F00 Insulin dependent diabetes mellitus with diabetic cataract res69: diabetes_with_complications Read diagnostic
C108F11 Type I diabetes mellitus with diabetic cataract res69: diabetes_with_complications Read diagnostic
C108H00 Insulin dependent diabetes mellitus with arthropathy res69: diabetes_with_complications Read diagnostic
C108J12 Type 1 diabetes mellitus with neuropathic arthropathy res69: diabetes_with_complications Read diagnostic
C109000 Non-insulin-dependent diabetes mellitus with renal comps res69: diabetes_with_complications Read diagnostic
C109011 Type II diabetes mellitus with renal complications res69: diabetes_with_complications Read diagnostic
C109012 Type 2 diabetes mellitus with renal complications res69: diabetes_with_complications Read diagnostic
C109100 Non-insulin-dependent diabetes mellitus with ophthalm comps res69: diabetes_with_complications Read diagnostic
C109111 Type II diabetes mellitus with ophthalmic complications res69: diabetes_with_complications Read diagnostic
C109112 Type 2 diabetes mellitus with ophthalmic complications res69: diabetes_with_complications Read diagnostic
C109200 Non-insulin-dependent diabetes mellitus with neuro comps res69: diabetes_with_complications Read diagnostic
C109211 Type II diabetes mellitus with neurological complications res69: diabetes_with_complications Read diagnostic
C109212 Type 2 diabetes mellitus with neurological complications res69: diabetes_with_complications Read diagnostic
C109600 Non-insulin-dependent diabetes mellitus with retinopathy res69: diabetes_with_complications Read diagnostic
C109611 Type II diabetes mellitus with retinopathy res69: diabetes_with_complications Read diagnostic
C109612 Type 2 diabetes mellitus with retinopathy res69: diabetes_with_complications Read diagnostic
C109A00 Non-insulin dependent diabetes mellitus with mononeuropathy res69: diabetes_with_complications Read diagnostic
C109A11 Type II diabetes mellitus with mononeuropathy res69: diabetes_with_complications Read diagnostic
C109B00 Non-insulin dependent diabetes mellitus with polyneuropathy res69: diabetes_with_complications Read diagnostic
C109B11 Type II diabetes mellitus with polyneuropathy res69: diabetes_with_complications Read diagnostic
C109C00 Non-insulin dependent diabetes mellitus with nephropathy res69: diabetes_with_complications Read diagnostic
C109C11 Type II diabetes mellitus with nephropathy res69: diabetes_with_complications Read diagnostic
C109C12 Type 2 diabetes mellitus with nephropathy res69: diabetes_with_complications Read diagnostic
C109E00 Non-insulin depend diabetes mellitus with diabetic cataract res69: diabetes_with_complications Read diagnostic
C109E11 Type II diabetes mellitus with diabetic cataract res69: diabetes_with_complications Read diagnostic
C109E12 Type 2 diabetes mellitus with diabetic cataract res69: diabetes_with_complications Read diagnostic
C109H00 Non-insulin dependent d m with neuropathic arthropathy res69: diabetes_with_complications Read diagnostic
C109H11 Type II diabetes mellitus with neuropathic arthropathy res69: diabetes_with_complications Read diagnostic
C109H12 Type 2 diabetes mellitus with neuropathic arthropathy res69: diabetes_with_complications Read diagnostic
C10E000 Type 1 diabetes mellitus with renal complications res69: diabetes_with_complications Read diagnostic
C10E100 Type 1 diabetes mellitus with ophthalmic complications res69: diabetes_with_complications Read diagnostic
C10E200 Type 1 diabetes mellitus with neurological complications res69: diabetes_with_complications Read diagnostic
C10EB00 Type 1 diabetes mellitus with mononeuropathy res69: diabetes_with_complications Read diagnostic
C10EC00 Type 1 diabetes mellitus with polyneuropathy res69: diabetes_with_complications Read diagnostic
C10ED00 Type 1 diabetes mellitus with nephropathy res69: diabetes_with_complications Read diagnostic
C10EF00 Type 1 diabetes mellitus with diabetic cataract res69: diabetes_with_complications Read diagnostic
C10EQ00 Type 1 diabetes mellitus with gastroparesis res69: diabetes_with_complications Read diagnostic
C10F000 Type 2 diabetes mellitus with renal complications res69: diabetes_with_complications Read diagnostic
C10F011 Type II diabetes mellitus with renal complications res69: diabetes_with_complications Read diagnostic
C10F100 Type 2 diabetes mellitus with ophthalmic complications res69: diabetes_with_complications Read diagnostic
C10F200 Type 2 diabetes mellitus with neurological complications res69: diabetes_with_complications Read diagnostic
C10F600 Type 2 diabetes mellitus with retinopathy res69: diabetes_with_complications Read diagnostic
C10F611 Type II diabetes mellitus with retinopathy res69: diabetes_with_complications Read diagnostic
C10FA00 Type 2 diabetes mellitus with mononeuropathy res69: diabetes_with_complications Read diagnostic
C10FB00 Type 2 diabetes mellitus with polyneuropathy res69: diabetes_with_complications Read diagnostic
C10FB11 Type II diabetes mellitus with polyneuropathy res69: diabetes_with_complications Read diagnostic
C10FC00 Type 2 diabetes mellitus with nephropathy res69: diabetes_with_complications Read diagnostic
C10FC11 Type II diabetes mellitus with nephropathy res69: diabetes_with_complications Read diagnostic
C10FE00 Type 2 diabetes mellitus with diabetic cataract res69: diabetes_with_complications Read diagnostic
C10FH00 Type 2 diabetes mellitus with neuropathic arthropathy res69: diabetes_with_complications Read diagnostic
C10FR00 Type 2 diabetes mellitus with gastroparesis res69: diabetes_with_complications Read diagnostic
F372.11 Diabetic polyneuropathy res69: diabetes_with_complications Read diagnostic
F372.12 Diabetic neuropathy res69: diabetes_with_complications Read diagnostic
F374z00 Polyneuropathy in disease NOS res69: diabetes_with_complications Read diagnostic
F381300 Myasthenic syndrome due to diabetic amyotrophy res69: diabetes_with_complications Read diagnostic
F381311 Diabetic amyotrophy res69: diabetes_with_complications Read diagnostic
F3y0.00 Diabetic mononeuropathy res69: diabetes_with_complications Read diagnostic
F420.00 Diabetic retinopathy res69: diabetes_with_complications Read diagnostic
F420100 Proliferative diabetic retinopathy res69: diabetes_with_complications Read diagnostic
F420200 Preproliferative diabetic retinopathy res69: diabetes_with_complications Read diagnostic
F420300 Advanced diabetic maculopathy res69: diabetes_with_complications Read diagnostic
F420400 Diabetic maculopathy res69: diabetes_with_complications Read diagnostic
F420600 Non proliferative diabetic retinopathy res69: diabetes_with_complications Read diagnostic
F420700 High risk proliferative diabetic retinopathy res69: diabetes_with_complications Read diagnostic
F420800 High risk non proliferative diabetic retinopathy res69: diabetes_with_complications Read diagnostic
F420z00 Diabetic retinopathy NOS res69: diabetes_with_complications Read diagnostic
F464000 Diabetic cataract res69: diabetes_with_complications Read diagnostic
K01x111 Kimmelstiel - Wilson disease res69: diabetes_with_complications Read diagnostic
Rows: 14
Code Description Entity type Coding System (ICD-10 Read) Category
E10.2 Insulin-dependent diabetes mellitus with renal complications res69: diabetes_with_complications ICD-10 diagnostic
E10.3 Insulin-dependent diabetes mellitus with ophthalmic complications res69: diabetes_with_complications ICD-10 diagnostic
E10.4 Insulin-dependent diabetes mellitus with neurological complications res69: diabetes_with_complications ICD-10 diagnostic
E10.5 Insulin-dependent diabetes mellitus with peripheral circulatory complications res69: diabetes_with_complications ICD-10 diagnostic
E10.6 Insulin-dependent diabetes mellitus with other specified complications res69: diabetes_with_complications ICD-10 diagnostic
E10.7 Insulin-dependent diabetes mellitus with multiple complications res69: diabetes_with_complications ICD-10 diagnostic
E10.8 Insulin-dependent diabetes mellitus with unspecified complications res69: diabetes_with_complications ICD-10 diagnostic
E11.2 Non-insulin depend diabetes mellitus with renal complications res69: diabetes_with_complications ICD-10 diagnostic
E11.3 Non-insulin depend diabetes mellitus with ophthalmic complications res69: diabetes_with_complications ICD-10 diagnostic
E11.4 Non-insulin depend diabetes mellitus with neurological complications res69: diabetes_with_complications ICD-10 diagnostic
E11.5 Non-insulin depend diabetes mellitus with peripheral circulatory complications res69: diabetes_with_complications ICD-10 diagnostic
E11.6 Non-insulin depend diabetes mellitus with other specified complications res69: diabetes_with_complications ICD-10 diagnostic
E11.7 Non-insulin depend diabetes mellitus with multiple complications res69: diabetes_with_complications ICD-10 diagnostic
E11.8 Non-insulin depend diabetes mellitus with unspecified complications res69: diabetes_with_complications ICD-10 diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH879/version/1837/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH879/version/1837/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('PH879', '1837', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH879/version/1837/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH879/version/1837/export/codes/?format=json
CSV site_root/phenotypes/PH879/version/1837/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('PH879', '1837', api_client=client)

Version History

Version
ID
Name Owner Publish date
1837 Diabetes With Complications ieuan.scanlon 2022-04-04 currently shown

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

Print - Print page.