BACKGROUND:
With 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.
METHODS:
In 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.
RESULTS:
Compared 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.
CONCLUSIONS:
Compared 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.
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.
| Code | Description | Entity type | Category | Coding System (Read) |
|---|---|---|---|---|
| 03K1.00 | Dietician | res72: Interventions | diagnostic | Read |
| 138..00 | Exercise grading | res72: Interventions | diagnostic | Read |
| 1383 | Enjoys light exercise | res72: Interventions | diagnostic | Read |
| 1384 | Enjoys moderate exercise | res72: Interventions | diagnostic | Read |
| 1385 | Enjoys heavy exercise | res72: Interventions | diagnostic | Read |
| 1389 | Aerobic exercise 1 time/week | res72: Interventions | diagnostic | Read |
| 138A.00 | Aerobic exercise 2 times/week | res72: Interventions | diagnostic | Read |
| 138B.00 | Aerobic exercise 3+ times/week | res72: Interventions | diagnostic | Read |
| 138D.00 | Anaerobic exercise 1 time/week | res72: Interventions | diagnostic | Read |
| 138E.00 | Anaerobic exercise 2 times/wk | res72: Interventions | diagnostic | Read |
| 138F.00 | Anaerobic exercise 3+ times/wk | res72: Interventions | diagnostic | Read |
| 138G.00 | Attends exercise classes | res72: Interventions | diagnostic | Read |
| 138H.00 | Enjoys intermediate exercise | res72: Interventions | diagnostic | Read |
| 138P.00 | Aerobic exercise three times a week | res72: Interventions | diagnostic | Read |
| 138Q.00 | Aerobic exercise four times a week | res72: Interventions | diagnostic | Read |
| 138R.00 | Aerobic exercise five times a week | res72: Interventions | diagnostic | Read |
| 138Z.00 | Exercise grading NOS | res72: Interventions | diagnostic | Read |
| 13A..00 | Diet - patient initiated | res72: Interventions | diagnostic | Read |
| 13A3.00 | Weight reducing diet | res72: Interventions | diagnostic | Read |
| 13A4.00 | Low fat diet | res72: Interventions | diagnostic | Read |
| 13AB.00 | Diabetic lipid lowering diet | res72: Interventions | diagnostic | Read |
| 13AC.00 | Diabetic weight reducing diet | res72: Interventions | diagnostic | Read |
| 13AZ.00 | Patient initiated diet NOS | res72: Interventions | diagnostic | Read |
| 13B..00 | Diet - medical | res72: Interventions | diagnostic | Read |
| 13B1.00 | Diabetic diet | res72: Interventions | diagnostic | Read |
| 13B4.00 | Lactose free diet | res72: Interventions | diagnostic | Read |
| 13CQ.00 | Physical activity target minimal exercise | res72: Interventions | diagnostic | Read |
| 13CR.00 | Physical activity target light exercise | res72: Interventions | diagnostic | Read |
| 13CS.00 | Physical activity target moderate exercise | res72: Interventions | diagnostic | Read |
| 13CT.00 | Physical activity target strenuous exercise | res72: Interventions | diagnostic | Read |
| 1F11.00 | Diet - low in fat | res72: Interventions | diagnostic | Read |
| 1F7..00 | Restricted diet pattern | res72: Interventions | diagnostic | Read |
| 1F7Z.00 | Dietary restriction NOS | res72: Interventions | diagnostic | Read |
| 1FH..00 | Healthy diet | res72: Interventions | diagnostic | Read |
| 66A8.00 | Has seen dietician - diabetes | res72: Interventions | diagnostic | Read |
| 66AY.00 | Diabetic diet - good compliance | res72: Interventions | diagnostic | Read |
| 66At.00 | Diabetic dietary review | res72: Interventions | diagnostic | Read |
| 66At100 | Type II diabetic dietary review | res72: Interventions | diagnostic | Read |
| 66At111 | Type 2 diabetic dietary review | res72: Interventions | diagnostic | Read |
| 66C4.00 | Has seen dietician - obesity | res72: Interventions | diagnostic | Read |
| 6798 | Health ed. - exercise | res72: Interventions | diagnostic | Read |
| 6799 | Health ed. - diet | res72: Interventions | diagnostic | Read |
| 679R.00 | Patient offered diabetes structured education programme | res72: Interventions | diagnostic | Read |
| 67H2.00 | Lifestyle advice regarding exercise | res72: Interventions | diagnostic | Read |
| 67H7.00 | Lifestyle advice regarding diet | res72: Interventions | diagnostic | Read |
| 67W1.00 | Recommendation self-refer for diabetes structured education | res72: Interventions | diagnostic | Read |
| 8581 | Assisted exercise in pool | res72: Interventions | diagnostic | Read |
| 8582 | Free exercises in pool | res72: Interventions | diagnostic | Read |
| 8B57.00 | Weight reducing diet | res72: Interventions | diagnostic | Read |
| 8B5A.00 | Glycaemic index diet | res72: Interventions | diagnostic | Read |
| 8B5C.00 | Calorie restricted diet | res72: Interventions | diagnostic | Read |
| 8B5C.11 | Low calorie diet | res72: Interventions | diagnostic | Read |
| 8B5C011 | Very low calorie diet | res72: Interventions | diagnostic | Read |
| 8B5Z.00 | Dietary regime NOS | res72: Interventions | diagnostic | Read |
| 8B91.00 | Low carbohydrate diet -prophyl | res72: Interventions | diagnostic | Read |
| 8B92.00 | Low calorie diet - prophylaxis | res72: Interventions | diagnostic | Read |
| 8B93.00 | Low salt diet - prophylaxis | res72: Interventions | diagnostic | Read |
| 8B94.00 | Salt free diet - prophylaxis | res72: Interventions | diagnostic | Read |
| 8B96.00 | Unsaturated fat diet - prophyl | res72: Interventions | diagnostic | Read |
| 8BAH.00 | Exercise on prescription | res72: Interventions | diagnostic | Read |
| 8CA4.00 | Patient advised re diet | res72: Interventions | diagnostic | Read |
| 8CA4000 | Pt advised re wt reducing diet | res72: Interventions | diagnostic | Read |
| 8CA4100 | Pt advised re diabetic diet | res72: Interventions | diagnostic | Read |
| 8CA4200 | Pt advised re gluten free diet | res72: Interventions | diagnostic | Read |
| 8CA4600 | Pt advised re low fat diet | res72: Interventions | diagnostic | Read |
| 8CA4700 | Patient advised re low cholesterol diet | res72: Interventions | diagnostic | Read |
| 8CA4900 | Pt advised - lactose free diet | res72: Interventions | diagnostic | Read |
| 8CA4A00 | Pt advis-low carbohydrate diet | res72: Interventions | diagnostic | Read |
| 8CA4V11 | Dietary advice to maximise nutritional intake | res72: Interventions | diagnostic | Read |
| 8CA4z00 | Pt advised re diet NOS | res72: Interventions | diagnostic | Read |
| 8CA5.00 | Patient advised re exercise | res72: Interventions | diagnostic | Read |
| 8CA5000 | Advice about aerobic exercise | res72: Interventions | diagnostic | Read |
| 8CA5200 | Education about chair based exercise programme | res72: Interventions | diagnostic | Read |
| 8CE4.00 | Diet leaflet given | res72: Interventions | diagnostic | Read |
| 8E7..00 | Physical exercises | res72: Interventions | diagnostic | Read |
| 8E71.00 | Therapeutic exercise | res72: Interventions | diagnostic | Read |
| 8E72.00 | Active exercise | res72: Interventions | diagnostic | Read |
| 8E79.00 | Home exercise programme | res72: Interventions | diagnostic | Read |
| 8E7A.00 | Group exercise programme | res72: Interventions | diagnostic | Read |
| 8E7B.00 | Graded exercise therapy | res72: Interventions | diagnostic | Read |
| 8E7C.00 | Aerobic exercises | res72: Interventions | diagnostic | Read |
| 8E7Z.00 | Physical exercise NOS | res72: Interventions | diagnostic | Read |
| 8E8..00 | Passive exercise | res72: Interventions | diagnostic | Read |
| 8E8Z.00 | Passive exercise NOS | res72: Interventions | diagnostic | Read |
| 8H76.00 | Refer to dietician | res72: Interventions | diagnostic | Read |
| 8H76000 | Referral to community dietician | res72: Interventions | diagnostic | Read |
| 8H7q.00 | Referral for exercise therapy | res72: Interventions | diagnostic | Read |
| 8H7q000 | Referral for graded exercise therapy | res72: Interventions | diagnostic | Read |
| 8HHc.00 | Referred for exercise programme | res72: Interventions | diagnostic | Read |
| 8HgF.00 | Discharge by dietitian | res72: Interventions | diagnostic | Read |
| 8HgL.00 | Discharge from dietetics service | res72: Interventions | diagnostic | Read |
| 8Hj0.00 | Referral to diabetes structured education programme | res72: Interventions | diagnostic | Read |
| 8Hj1.00 | Family/carer referral to diabetes structured education prog | res72: Interventions | diagnostic | Read |
| 8Hj4.00 | Referral to DESMOND diabetes structured education programme | res72: Interventions | diagnostic | Read |
| 8Hj5.00 | Referral to XPERT diabetes structured education programme | res72: Interventions | diagnostic | Read |
| 8HkX.00 | Referral to exercise on referral programme | res72: Interventions | diagnostic | Read |
| 8I81.00 | Did not complete diabetes structured education programme | res72: Interventions | diagnostic | Read |
| 8I84.00 | Did not complete XPERT diabetes structured education program | res72: Interventions | diagnostic | Read |
| 9N0H.00 | Seen in dietician clinic | res72: Interventions | diagnostic | Read |
| 9N27.00 | Seen by dietician | res72: Interventions | diagnostic | Read |
| 9N6t.00 | Referral by community-based dietitian | res72: Interventions | diagnostic | Read |
| 9NJ6.00 | In-house dietetics | res72: Interventions | diagnostic | Read |
| 9NJh.00 | In-house dietetics first appointment | res72: Interventions | diagnostic | Read |
| 9NJi.00 | In-house dietetics discharge appointment | res72: Interventions | diagnostic | Read |
| 9NNF.00 | Under care of dietitian | res72: Interventions | diagnostic | Read |
| 9NiA.00 | Did not attend diabetes structured education programme | res72: Interventions | diagnostic | Read |
| 9NiD.00 | Did not attend DESMOND diabetes structured education program | res72: Interventions | diagnostic | Read |
| 9NiE.00 | Did not attend XPERT diabetes structured education programme | res72: Interventions | diagnostic | Read |
| 9OLB.00 | Attended diabetes structured education programme | res72: Interventions | diagnostic | Read |
| 9OLC.00 | Family/carer attended diabetes structured education prog | res72: Interventions | diagnostic | Read |
| 9OLF.00 | Diabetes structured education programme completed | res72: Interventions | diagnostic | Read |
| 9OLG.00 | Attended XPERT diabetes structured education programme | res72: Interventions | diagnostic | Read |
| 9OLK.00 | DESMOND diabetes structured education programme completed | res72: Interventions | diagnostic | Read |
| 9OLL.00 | XPERT diabetes structured education programme completed | res72: Interventions | diagnostic | Read |
| 9OLM.00 | Diabetes structured education programme declined | res72: Interventions | diagnostic | Read |
| Z65..00 | Exercise therapy | res72: Interventions | diagnostic | Read |
| Z658.00 | Aerobic exercises | res72: Interventions | diagnostic | Read |
| Z65B.00 | Home exercise programme | res72: Interventions | diagnostic | Read |
| Z66..00 | Exercise regime | res72: Interventions | diagnostic | Read |
| Z67..00 | Exercise class | res72: Interventions | diagnostic | Read |
| Z67..11 | Group exercise | res72: Interventions | diagnostic | Read |
| Z68..00 | Exercises | res72: Interventions | diagnostic | Read |
| Z6D1.00 | Hydrotherapy exercises | res72: Interventions | diagnostic | Read |
| Z6D3100 | Aquaerobic exercises | res72: Interventions | diagnostic | Read |
| ZA11925 | Advice on diet | res72: Interventions | diagnostic | Read |
| ZC2..00 | Dietary advice | res72: Interventions | diagnostic | Read |
| ZC2..11 | Advice on diet | res72: Interventions | diagnostic | Read |
| ZC2..12 | Advice about diet | res72: Interventions | diagnostic | Read |
| ZC2C.00 | Dietary advice for disorder | res72: Interventions | diagnostic | Read |
| ZC2C100 | Dietary treatment for disorder | res72: Interventions | diagnostic | Read |
| ZC2C700 | Patient advised about weight-reducing diet | res72: Interventions | diagnostic | Read |
| ZC2C711 | Dietary advice for weight reduction | res72: Interventions | diagnostic | Read |
| ZC2C800 | Dietary advice for diabetes mellitus | res72: Interventions | diagnostic | Read |
| ZC2CA00 | Dietary advice for type II diabetes | res72: Interventions | diagnostic | Read |
| ZC2CI00 | Dietary advice for lipid disorder | res72: Interventions | diagnostic | Read |
| ZC2CJ00 | Dietary advice for hyperlipidaemia | res72: Interventions | diagnostic | Read |
| ZC2CM00 | Dietary advice for obesity | res72: Interventions | diagnostic | Read |
| ZC2CO00 | Dietary advice for weight loss | res72: Interventions | diagnostic | Read |
| ZC33.00 | Dietary intake assessment using food models | res72: Interventions | diagnostic | Read |
| ZC35.00 | Dietary intake assessment using food diary | res72: Interventions | diagnostic | Read |
| ZC36.00 | Diet in ass usng food fr quest | res72: Interventions | diagnostic | Read |
| ZC4..00 | Dietary health promotion advice | res72: Interventions | diagnostic | Read |
| ZG16.00 | Advice about exercise | res72: Interventions | diagnostic | Read |
| ZG16100 | Advice to exercise | res72: Interventions | diagnostic | Read |
| ZL45.00 | Under care of dietitian | res72: Interventions | diagnostic | Read |
| ZL45100 | Under care of community-based dietitian | res72: Interventions | diagnostic | Read |
| ZL45111 | Under care of community dietitian | res72: Interventions | diagnostic | Read |
| ZL45200 | Under care of hospital-based dietitian | res72: Interventions | diagnostic | Read |
| ZL45211 | Under care of hospital dietitian | res72: Interventions | diagnostic | Read |
| ZL82.00 | Referral to dietitian | res72: Interventions | diagnostic | Read |
| ZL82.11 | Refer to dietician | res72: Interventions | diagnostic | Read |
| ZL82.12 | Refer to dietitian | res72: Interventions | diagnostic | Read |
| ZL82100 | Referral to community-based dietitian | res72: Interventions | diagnostic | Read |
| ZL82111 | Referral to community dietitian | res72: Interventions | diagnostic | Read |
| ZL82200 | Referral to hospital-based dietitian | res72: Interventions | diagnostic | Read |
| ZL82211 | Referral to hospital dietitian | res72: Interventions | diagnostic | Read |
| ZLDH.00 | Discharge by dietitian | res72: Interventions | diagnostic | Read |
| ZLDH100 | Discharge by hospital-based dietitian | res72: Interventions | diagnostic | Read |
| ZLDH111 | Discharge by hospital dietitian | res72: Interventions | diagnostic | Read |
| ZLDH200 | Discharge by community-based dietitian | res72: Interventions | diagnostic | Read |
| ZLDH211 | Discharge by community dietitian | res72: Interventions | diagnostic | Read |
| ZLEH.00 | Discharge from dietetics service | res72: Interventions | diagnostic | Read |
| ZLEH100 | Discharge from hospital dietetics service | res72: Interventions | diagnostic | Read |
| ZLEH200 | Discharge from community dietetics service | res72: Interventions | diagnostic | Read |
| ZRBB.11 | DINE-Diet instr nutr educ ques | res72: Interventions | diagnostic | Read |
| ZV65300 | [V]Dietary surveillance and counselling | res72: Interventions | diagnostic | Read |
| ZV65312 | [V]Dietary counselling in diabetes mellitus | res72: Interventions | diagnostic | Read |
| ZV65313 | [V]Dietary counselling | res72: Interventions | diagnostic | Read |
| ZV65314 | [V]Dietary surveillance | res72: Interventions | diagnostic | Read |
| ZV65317 | [V]Dietary surveillance in hypercholesterolaemia | res72: Interventions | diagnostic | Read |
| ZV65318 | [V]Dietary counselling in hypoglycaemia | res72: Interventions | diagnostic | Read |
| ZV65319 | [V]Dietary counselling in obesity | res72: Interventions | diagnostic | Read |
To Export Phenotype Details:
| Format | API |
|---|---|
| XML | site_root/api/v1/public/phenotypes/PH925/version/1929/detail/?format=xml |
| JSON | site_root/api/v1/public/phenotypes/PH925/version/1929/detail/?format=json |
| R Package |
|
To Export Phenotype Code List:
| Format | API |
|---|---|
| XML | site_root/api/v1/public/phenotypes/PH925/version/1929/export/codes/?format=xml |
| JSON | site_root/api/v1/public/phenotypes/PH925/version/1929/export/codes/?format=json |
| CSV | site_root/phenotypes/PH925/version/1929/export/codes/ |
| R Package |
|
| Version ID |
Name | Owner | Publish date | |
|---|---|---|---|---|
| 1929 | Interventions | 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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