Type-2 diabetes (T2D) patients are prone to many chronic health issues that affect different organ systems, such as heart and kidney related systems. Recent studies have highlighted that T2D patients are also prone to problems in their immune response, and therefore are also at risk of worse health outcomes. However, little is documented with respect to other chronic disorders that are present in T2D patients and their role in worsening health outcomes within these patients. The study addresses a research gap by examining a common chronic lung disorder, chronic obstructive pulmonary disease (COPD), and its role in affecting different health outcomes within T2D patients.Specifically, we are interested in seeing if mortality and hospitalisations are worse in people with T2D and COPD than those with T2D alone, since these two chronic conditions so commonly co-occur.
The study aims to examine the effect of co-morbid chronic obstructive pulmonary disease (COPD) status on morbidity and mortality outcomes in a Type-2 diabetes (T2D) population in England. The study will also examine the proportion of those outcomes explained by cardiovascular, respiratory, and renal causes. A cohort study spanning the entire period from January 1, 2017, to December 31, 2019, will be assessed for our primary outcomes of all-cause mortality, cardiovascular and respiratory cause mortality and all-cause hospitalization rates and risk rate ratios. Additionally, we will calculate the cardiovascular and renal incidence rates in both exposure and comparator groups. The secondary outcomes will be to measure the proportion of mortality and first hospitalization rates due to cardiovascular, respiratory and renal causes. The primary outcomes will be determined using Kaplan-Meier survival probabilities will also be determined for both COPD-T2D and non-COPD-T2D patients to illustrate cumulative incidences descriptively and will then use the Poisson regression to estimate the rates and rate ratios, adjusted for potential confounders. The secondary outcomes will be calculating the proportions of specific-cause mortalities and specific-cause of hospitalization rates. These outcomes will be measured in COPD-T2D patients that meet specific inclusion/exclusion criteria, taking into account FEV1 status and prior smoking history in their COPD status as well as other potential pre-existing conditions.
• Prevalence of COPD-T2D in England
• All-cause Mortality rates, and cause-specific mortality rates (cardiovascular, renal and respiratory) and all-cause hospitalization rates and risk rate ratios by COPD status in patients with T2D
• Cardiovascular disease (CVD) and renal incidence rates in exposure (COPD-T2D) and comparator (non-COPD-T2D) groups
• Proportion of mortality and hospitalization rates due to Cardiovascular, respiratory and renal causes (defined using ICD-10 codes).
Jennifer Quint - Chief Investigator - Imperial College London
- Corresponding Applicant -
Abdul Sattar Raslan - Collaborator - Imperial College London
HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation