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Abstract
Objective: The objective of this study was to describe the pattern of comorbidities in patients with type 2 diabetes mellitus with and without atherosclerotic cardiovascular disease.
Methods: This was a retrospective, cross-sectional analysis of the IQVIA Commercial Data Delivery database. Patients were ≥18 years on their last encounter between 1 October 2014 and 30 September 2015 and had either a type 2 diabetes mellitus diagnosis or a prescription for an oral diabetes medication. Atherosclerotic cardiovascular disease was confirmed by diagnosis codes. Comorbidities were identified using diagnosis codes, clinical measurements, and/or medication use.
Results: A total of 1,522,526 type 2 diabetes mellitus patients were included in the analysis, 25% of whom had atherosclerotic cardiovascular disease. The most common comorbidities were hypertension, hyperlipidemia, overweight/obesity, chronic kidney disease, congestive heart failure, and neuropathy. These were present, respectively, in the following percentages of patients with and without cardiovascular disease: 98.3 and 91.0%, 94.8 and 78.5%, 80.5 and 80.6%, 38.5 and 18.9, 20.2, and 4.3%, and 13.7 and 8.6%. Thus, the frequencies of hyperlipidemia, chronic kidney disease, and congestive heart failure were notably higher in patients with cardiovascular disease. This trend held true for patients grouped by sex, age, and race.
Conclusions: Patients with type 2 diabetes mellitus and atherosclerotic cardiovascular disease have different rates of certain comorbidities compared to those without atherosclerotic cardiovascular disease.
Transparency
Declaration of financial and other interest
Samuel S. Engel, Xueying Li, David O’Connell, Lori M. Moore, and Swapnil Rajpathak are employees and stockholders of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.
At the time of the study, Kristy Iglay and Hakima Hannachi were employees and stockholders of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.
Author contributions
All authors participated in the conception and design of the study; interpretation of the data; and critically revised the manuscript. All authors approved the final version of the manuscript.
Acknowledgements
The authors thank Melissa Stauffer, PhD, and Anna Kaufman, MPH, in collaboration with ScribCo, for medical writing assistance.
Data availability statement
The data are not publicly available. The datasets generated and/or analyzed during the current study were accessed from the IQVIA Commercial Data Delivery (formerly referred to as the GE Centricity Electronic Medical Record database repository). The data generated was extracted and delivered by IQVIA to its data partners.
Ethics approval and consent to participate
This is a retrospective study of Electronic Medical Record data without any intervention. No study subjects will be placed at risk as a result of the study. In addition, this is a database study using HIPPA compliant Electronic Medical Record database. Specifically, confidentiality of information on study subjects is safeguarded by several measures. The database contains de-identified data, which provides a significant level of protection against the release of personal information to outside entities. Examination of any of the characteristics in this analysis would not lead investigators to examine identifiable personal health information. Moreover, this study has no direct patient involvement. As a result of the anonymized nature of the data, approval by an ethics committee was not required, however, the study conformed to the principles of the Declaration of Helsinki.
The data generated was extracted and delivered by IQVIA to its data partners. Access to the data was approved by IQVIA.