Inequalities in the management of diabetic kidney disease in UK primary care: a cross-sectional analysis of a large primary care database
Phillips, Katherine Hazlehurst, Jonathan M Sheppard, Christelle Bellary, Srikanth Hanif, Wasim Karamat, Muhammad Ali Crowe, Francesca L Stone, Anna Thomas, G Neil Peracha, Javeria
Phillips, Katherine
Hazlehurst, Jonathan M
Sheppard, Christelle
Bellary, Srikanth
Hanif, Wasim
Karamat, Muhammad Ali
Crowe, Francesca L
Stone, Anna
Thomas, G Neil
Peracha, Javeria
Abstract
Of the 2.3 million participants, 161,278 had type 1 or 2 diabetes, of which 32,905 had DKD. Of people with DKD, 60% had albumin creatinine ratio (ACR) measured, 64% achieved blood pressure (BP, <140/90 mmHg) target, 58% achieved glycosylated haemoglobin (HbA1c, <58 mmol/mol) target, 68% prescribed renin-angiotensin-aldosterone system (RAAS) inhibitor in the previous year. Compared to men, women were less likely to have creatinine: aRR 0.99 (95% CI 0.98-0.99), ACR: aRR 0.94 (0.92-0.96), BP: aRR 0.98 (0.97-0.99), HbA1c : aRR 0.99 (0.98-0.99) and serum cholesterol: aRR 0.97 (0.96-0.98) measured; achieve BP: aRR 0.95 (0.94-0.98) or total cholesterol (<5 mmol/L) targets: aRR 0.86 (0.84-0.87); or be prescribed RAAS inhibitors: aRR 0.92 (0.90-0.94) or statins: aRR 0.94 (0.92-0.95). Compared to the least deprived areas, people from the most deprived areas were less likely to have BP measurements: aRR 0.98 (0.96-0.99); achieve BP: aRR 0.91 (0.8-0.95) or HbA1c : aRR 0.88 (0.85-0.92) targets, or be prescribed RAAS inhibitors: aRR 0.91 (0.87-0.95). Compared to people of white ethnicity; those of black ethnicity were less likely to be prescribed statins aRR 0.91 (0.85-0.97).
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Date
2023-05-24
Type
Article
Subject
Endocrinology, Diseases & disorders of systemic, metabolic or environmental origin, Urology
Citation
Phillips K, Hazlehurst JM, Sheppard C, Bellary S, Hanif W, Karamat MA, Crowe FL, Stone A, Thomas GN, Peracha J, Fenton A, Sainsbury C, Nirantharakumar K, Dasgupta I. Inequalities in the management of diabetic kidney disease in UK primary care: A cross-sectional analysis of a large primary care database. Diabet Med. 2024 Jan;41(1):e15153. doi: 10.1111/dme.15153. Epub 2023 Jun 14.
Journal / Source Title
Diabetic Medicine
DOI
10.1111/dme.15153
PMID
37223892
Publisher
Wiley
Publisher’s URL
http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1464-5491