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Diabetes

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

Type
Disease or Syndrome
ID
PH880
Version ID
1839
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: 144
Code Description Entity type Coding System (ICD-10 Read) Category
1434.00 H/O: diabetes mellitus res69: diabetes Read diagnostic
66A5.00 Diabetic on insulin res69: diabetes Read diagnostic
66AI.00 Diabetic - good control res69: diabetes Read diagnostic
66AJ.00 Diabetic - poor control res69: diabetes Read diagnostic
66AJ.11 Unstable diabetes res69: diabetes Read diagnostic
66AJz00 Diabetic - poor control NOS res69: diabetes Read diagnostic
66AK.00 Diabetic - cooperative patient res69: diabetes Read diagnostic
66AS.00 Diabetic annual review res69: diabetes Read diagnostic
66AV.00 Diabetic on insulin and oral treatment res69: diabetes Read diagnostic
8A13.00 Diabetic stabilisation res69: diabetes Read diagnostic
8BL2.00 Patient on maximal tolerated therapy for diabetes res69: diabetes Read diagnostic
8H2J.00 Admit diabetic emergency res69: diabetes Read diagnostic
C10..00 Diabetes mellitus res69: diabetes Read diagnostic
C100.00 Diabetes mellitus with no mention of complication res69: diabetes Read diagnostic
C100000 Diabetes mellitus, juvenile type, no mention of complication res69: diabetes Read diagnostic
C100011 Insulin dependent diabetes mellitus res69: diabetes Read diagnostic
C100100 Diabetes mellitus, adult onset, no mention of complication res69: diabetes Read diagnostic
C100111 Maturity onset diabetes res69: diabetes Read diagnostic
C100112 Non-insulin dependent diabetes mellitus res69: diabetes Read diagnostic
C100z00 Diabetes mellitus NOS with no mention of complication res69: diabetes Read diagnostic
C101.00 Diabetes mellitus with ketoacidosis res69: diabetes Read diagnostic
C101000 Diabetes mellitus, juvenile type, with ketoacidosis res69: diabetes Read diagnostic
C101100 Diabetes mellitus, adult onset, with ketoacidosis res69: diabetes Read diagnostic
C101y00 Other specified diabetes mellitus with ketoacidosis res69: diabetes Read diagnostic
C101z00 Diabetes mellitus NOS with ketoacidosis res69: diabetes Read diagnostic
C102.00 Diabetes mellitus with hyperosmolar coma res69: diabetes Read diagnostic
C102000 Diabetes mellitus, juvenile type, with hyperosmolar coma res69: diabetes Read diagnostic
C102100 Diabetes mellitus, adult onset, with hyperosmolar coma res69: diabetes Read diagnostic
C102z00 Diabetes mellitus NOS with hyperosmolar coma res69: diabetes Read diagnostic
C103.00 Diabetes mellitus with ketoacidotic coma res69: diabetes Read diagnostic
C103000 Diabetes mellitus, juvenile type, with ketoacidotic coma res69: diabetes Read diagnostic
C103y00 Other specified diabetes mellitus with coma res69: diabetes Read diagnostic
C103z00 Diabetes mellitus NOS with ketoacidotic coma res69: diabetes Read diagnostic
C107.00 Diabetes mellitus with peripheral circulatory disorder res69: diabetes Read diagnostic
C107.11 Diabetes mellitus with gangrene res69: diabetes Read diagnostic
C107000 Diabetes mellitus, juvenile +peripheral circulatory disorder res69: diabetes Read diagnostic
C107100 Diabetes mellitus, adult, + peripheral circulatory disorder res69: diabetes Read diagnostic
C107200 Diabetes mellitus, adult with gangrene res69: diabetes Read diagnostic
C107300 IDDM with peripheral circulatory disorder res69: diabetes Read diagnostic
C107400 NIDDM with peripheral circulatory disorder res69: diabetes Read diagnostic
C107z00 Diabetes mellitus NOS with peripheral circulatory disorder res69: diabetes Read diagnostic
C108.00 Insulin dependent diabetes mellitus res69: diabetes Read diagnostic
C108.11 IDDM-Insulin dependent diabetes mellitus res69: diabetes Read diagnostic
C108.12 Type 1 diabetes mellitus res69: diabetes Read diagnostic
C108.13 Type I diabetes mellitus res69: diabetes Read diagnostic
C108400 Unstable insulin dependent diabetes mellitus res69: diabetes Read diagnostic
C108411 Unstable type I diabetes mellitus res69: diabetes Read diagnostic
C108500 Insulin dependent diabetes mellitus with ulcer res69: diabetes Read diagnostic
C108511 Type I diabetes mellitus with ulcer res69: diabetes Read diagnostic
C108600 Insulin dependent diabetes mellitus with gangrene res69: diabetes Read diagnostic
C108800 Insulin dependent diabetes mellitus - poor control res69: diabetes Read diagnostic
C108811 Type I diabetes mellitus - poor control res69: diabetes Read diagnostic
C108812 Type 1 diabetes mellitus - poor control res69: diabetes Read diagnostic
C108911 Type I diabetes mellitus maturity onset res69: diabetes Read diagnostic
C108E00 Insulin dependent diabetes mellitus with hypoglycaemic coma res69: diabetes Read diagnostic
C108E11 Type I diabetes mellitus with hypoglycaemic coma res69: diabetes Read diagnostic
C108E12 Type 1 diabetes mellitus with hypoglycaemic coma res69: diabetes Read diagnostic
C108G00 Insulin dependent diab mell with peripheral angiopathy res69: diabetes Read diagnostic
C109.00 Non-insulin dependent diabetes mellitus res69: diabetes Read diagnostic
C109.11 NIDDM - Non-insulin dependent diabetes mellitus res69: diabetes Read diagnostic
C109.12 Type 2 diabetes mellitus res69: diabetes Read diagnostic
C109.13 Type II diabetes mellitus res69: diabetes Read diagnostic
C109300 Non-insulin-dependent diabetes mellitus with multiple comps res69: diabetes Read diagnostic
C109400 Non-insulin dependent diabetes mellitus with ulcer res69: diabetes Read diagnostic
C109411 Type II diabetes mellitus with ulcer res69: diabetes Read diagnostic
C109412 Type 2 diabetes mellitus with ulcer res69: diabetes Read diagnostic
C109500 Non-insulin dependent diabetes mellitus with gangrene res69: diabetes Read diagnostic
C109511 Type II diabetes mellitus with gangrene res69: diabetes Read diagnostic
C109700 Non-insulin dependent diabetes mellitus - poor control res69: diabetes Read diagnostic
C109711 Type II diabetes mellitus - poor control res69: diabetes Read diagnostic
C109712 Type 2 diabetes mellitus - poor control res69: diabetes Read diagnostic
C109900 Non-insulin-dependent diabetes mellitus without complication res69: diabetes Read diagnostic
C109D00 Non-insulin dependent diabetes mellitus with hypoglyca coma res69: diabetes Read diagnostic
C109D11 Type II diabetes mellitus with hypoglycaemic coma res69: diabetes Read diagnostic
C109D12 Type 2 diabetes mellitus with hypoglycaemic coma res69: diabetes Read diagnostic
C109F11 Type II diabetes mellitus with peripheral angiopathy res69: diabetes Read diagnostic
C109F12 Type 2 diabetes mellitus with peripheral angiopathy res69: diabetes Read diagnostic
C109G00 Non-insulin dependent diabetes mellitus with arthropathy res69: diabetes Read diagnostic
C109G11 Type II diabetes mellitus with arthropathy res69: diabetes Read diagnostic
C109G12 Type 2 diabetes mellitus with arthropathy res69: diabetes Read diagnostic
C109J00 Insulin treated Type 2 diabetes mellitus res69: diabetes Read diagnostic
C109J11 Insulin treated non-insulin dependent diabetes mellitus res69: diabetes Read diagnostic
C109J12 Insulin treated Type II diabetes mellitus res69: diabetes Read diagnostic
C109K00 Hyperosmolar non-ketotic state in type 2 diabetes mellitus res69: diabetes Read diagnostic
C10A.00 Malnutrition-related diabetes mellitus res69: diabetes Read diagnostic
C10A000 Malnutrition-related diabetes mellitus with coma res69: diabetes Read diagnostic
C10A100 Malnutrition-related diabetes mellitus with ketoacidosis res69: diabetes Read diagnostic
C10B000 Steroid induced diabetes mellitus without complication res69: diabetes Read diagnostic
C10D.00 Diabetes mellitus autosomal dominant type 2 res69: diabetes Read diagnostic
C10D.11 Maturity onset diabetes in youth type 2 res69: diabetes Read diagnostic
C10E.00 Type 1 diabetes mellitus res69: diabetes Read diagnostic
C10E.11 Type I diabetes mellitus res69: diabetes Read diagnostic
C10E.12 Insulin dependent diabetes mellitus res69: diabetes Read diagnostic
C10E400 Unstable type 1 diabetes mellitus res69: diabetes Read diagnostic
C10E412 Unstable insulin dependent diabetes mellitus res69: diabetes Read diagnostic
C10E500 Type 1 diabetes mellitus with ulcer res69: diabetes Read diagnostic
C10E600 Type 1 diabetes mellitus with gangrene res69: diabetes Read diagnostic
C10E800 Type 1 diabetes mellitus - poor control res69: diabetes Read diagnostic
C10E812 Insulin dependent diabetes mellitus - poor control res69: diabetes Read diagnostic
C10E900 Type 1 diabetes mellitus maturity onset res69: diabetes Read diagnostic
C10EA00 Type 1 diabetes mellitus without complication res69: diabetes Read diagnostic
C10EE00 Type 1 diabetes mellitus with hypoglycaemic coma res69: diabetes Read diagnostic
C10EG00 Type 1 diabetes mellitus with peripheral angiopathy res69: diabetes Read diagnostic
C10EK00 Type 1 diabetes mellitus with persistent proteinuria res69: diabetes Read diagnostic
C10EL00 Type 1 diabetes mellitus with persistent microalbuminuria res69: diabetes Read diagnostic
C10EM00 Type 1 diabetes mellitus with ketoacidosis res69: diabetes Read diagnostic
C10EM11 Type I diabetes mellitus with ketoacidosis res69: diabetes Read diagnostic
C10EN00 Type 1 diabetes mellitus with ketoacidotic coma res69: diabetes Read diagnostic
C10EN11 Type I diabetes mellitus with ketoacidotic coma res69: diabetes Read diagnostic
C10F.00 Type 2 diabetes mellitus res69: diabetes Read diagnostic
C10F.11 Type II diabetes mellitus res69: diabetes Read diagnostic
C10F400 Type 2 diabetes mellitus with ulcer res69: diabetes Read diagnostic
C10F500 Type 2 diabetes mellitus with gangrene res69: diabetes Read diagnostic
C10F700 Type 2 diabetes mellitus - poor control res69: diabetes Read diagnostic
C10F711 Type II diabetes mellitus - poor control res69: diabetes Read diagnostic
C10F900 Type 2 diabetes mellitus without complication res69: diabetes Read diagnostic
C10FD00 Type 2 diabetes mellitus with hypoglycaemic coma res69: diabetes Read diagnostic
C10FF00 Type 2 diabetes mellitus with peripheral angiopathy res69: diabetes Read diagnostic
C10FG00 Type 2 diabetes mellitus with arthropathy res69: diabetes Read diagnostic
C10FJ00 Insulin treated Type 2 diabetes mellitus res69: diabetes Read diagnostic
C10FJ11 Insulin treated Type II diabetes mellitus res69: diabetes Read diagnostic
C10FL00 Type 2 diabetes mellitus with persistent proteinuria res69: diabetes Read diagnostic
C10FL11 Type II diabetes mellitus with persistent proteinuria res69: diabetes Read diagnostic
C10FM00 Type 2 diabetes mellitus with persistent microalbuminuria res69: diabetes Read diagnostic
C10FN00 Type 2 diabetes mellitus with ketoacidosis res69: diabetes Read diagnostic
C10FP00 Type 2 diabetes mellitus with ketoacidotic coma res69: diabetes Read diagnostic
C10G.00 Secondary pancreatic diabetes mellitus res69: diabetes Read diagnostic
C10H.00 Diabetes mellitus induced by non-steroid drugs res69: diabetes Read diagnostic
C10M.00 Lipoatrophic diabetes mellitus res69: diabetes Read diagnostic
C10N.00 Secondary diabetes mellitus res69: diabetes Read diagnostic
C10y.00 Diabetes mellitus with other specified manifestation res69: diabetes Read diagnostic
C10y100 Diabetes mellitus, adult, + other specified manifestation res69: diabetes Read diagnostic
C10yy00 Other specified diabetes mellitus with other spec comps res69: diabetes Read diagnostic
C10yz00 Diabetes mellitus NOS with other specified manifestation res69: diabetes Read diagnostic
C10z.00 Diabetes mellitus with unspecified complication res69: diabetes Read diagnostic
C10z100 Diabetes mellitus, adult onset, + unspecified complication res69: diabetes Read diagnostic
C10zy00 Other specified diabetes mellitus with unspecified comps res69: diabetes Read diagnostic
C10zz00 Diabetes mellitus NOS with unspecified complication res69: diabetes Read diagnostic
Cyu2.00 [X]Diabetes mellitus res69: diabetes Read diagnostic
Cyu2000 [X]Other specified diabetes mellitus res69: diabetes Read diagnostic
G73y000 Diabetic peripheral angiopathy res69: diabetes Read diagnostic
L180500 Pre-existing diabetes mellitus, insulin-dependent res69: diabetes Read diagnostic
L180600 Pre-existing diabetes mellitus, non-insulin-dependent res69: diabetes Read diagnostic
L180X00 Pre-existing diabetes mellitus, unspecified res69: diabetes Read diagnostic
Rows: 6
Code Description Entity type Coding System (ICD-10 Read) Category
E10.0 Insulin-dependent diabetes mellitus with coma res69: diabetes ICD-10 diagnostic
E10.1 Insulin-dependent diabetes mellitus with ketoacidosis res69: diabetes ICD-10 diagnostic
E10.9 Insulin-dependent diabetes mellitus without complications res69: diabetes ICD-10 diagnostic
E11.0 Non-insulin-dependent diabetes mellitus with coma res69: diabetes ICD-10 diagnostic
E11.1 Non-insulin-dependent diabetes mellitus with ketoacidosis res69: diabetes ICD-10 diagnostic
E11.9 Non-insulin-dependent diabetes mellitus with coma res69: diabetes ICD-10 diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH880/version/1839/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH880/version/1839/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('PH880', '1839', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH880/version/1839/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH880/version/1839/export/codes/?format=json
CSV site_root/phenotypes/PH880/version/1839/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('PH880', '1839', api_client=client)

Version History

Version
ID
Name Owner Publish date
1839 Diabetes ieuan.scanlon 2022-04-04 currently shown

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

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