ClinicalCodes.org
An online clinical codes repository to improve validity and reproducibility of medical database research
Research article:
Glucose, blood pressure and cholesterol levels and their relationships to clinical outcomes in type 2 diabetes: a retrospective cohort study
Reference:
Evangelos Kontopantelis, David A Springate, David Reeves, Darren M Ashcroft, Martin Rutter, Iain Buchan, Tim Doran(2015) Glucose, blood pressure and cholesterol levels and their relationships to clinical outcomes in type 2 diabetes: a retrospective cohort study. Diabetologia, doi: 10.1007/s00125-014-3473-8
- Link to fulltext article
- Abstract
- Background: Observational data have been used to inform target levels for modifiable risk factors in type 2 diabetes but these data are limited by confounding. We aimed to describe the shape of observed relationships between risk factor levels and clinically important outcomes in type 2 diabetes after adjusting for multiple confounders. Methods: We used retrospective longitudinal data on 246,544 adults with type 2 diabetes from 600 practices contributing to the Clinical Practice Research Datalink between 2006 and 2012. Proportional hazards regression models quantified the risks of mortality, microvascular or macrovascular events associated with four modifiable risk factors: glycated haemoglobin (HbA1c), systolic and diastolic blood pressure and total cholesterol, while controlling for numerous patient and practice covariates. Findings: U-shaped relationships were observed between all-cause mortality and levels of the four risk factors. The lowest risks were associated with HbA1c 7.25-7.75%; total cholesterol 3.5-4.5 mmol/L; systolic blood pressure 135-145 mmHg; and diastolic blood pressure 82.5-87.5 mmHg. coronary and stroke mortality related to the four risk factors in a positive, curvilinear way, with the exception of blood pressure which related to coronary deaths in a U-shape. Macrovascular events showed a positive and curvilinear relationship with HbA1c but U-shaped for total cholesterol and systolic blood pressure. Microvascular related to the four risk factors in a curvilinear way: positive for HbA1c and systolic blood pressure but negative for cholesterol and diastolic blood pressure. Interpretation: We identified several relationships which, when considered in the light of relevant trial data, support a call for major changes to clinical practice. Most importantly, our results support trial data indicating that normalisation of glucose and blood pressure can lead to poorer outcomes, which makes a strong case for target ranges for these risk factors rather than target levels.
- Author for correspondence
- Evangelos Kontopantelis
- Email for correspondence
- E.Kontopantelis@manchester.ac.uk
Code list: Osteoarthritis
128 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 7130A | Read | OSTEOARTHRITIS | diagnostic | Osteoarthritis | |||
| 7130AA | Read | OSTEOARTHROSIS ANKLE | diagnostic | Osteoarthritis | |||
| 7130AB | Read | OSTEOARTHROSIS | diagnostic | Osteoarthritis | |||
| 7130AC | Read | OSTEOARTHROSIS ACROMIO CLAVICULAR JOINT | diagnostic | Osteoarthritis | |||
| 7130AG | Read | OSTEOARTHROSIS GENERAL | diagnostic | Osteoarthritis | |||
| 7130AW | Read | OSTEOARTHROSIS WRIST | diagnostic | Osteoarthritis | |||
| 7130B | Read | OSTEOARTHROSIS KNEE(S) | diagnostic | Osteoarthritis | |||
| 7130C | Read | OSTEOARTHROSIS FINGERS | diagnostic | Osteoarthritis | |||
| 7130CT | Read | THUMB OSTEOARTHROSIS | diagnostic | Osteoarthritis | |||
| 7130D | Read | OSTEOARTHROSIS HIP | diagnostic | Osteoarthritis | |||
| 7130DA | Read | OSTEOARTHRITIS HIP | diagnostic | Osteoarthritis | |||
| 7130E | Read | OSTEOARTHROSIS SHOULDER | diagnostic | Osteoarthritis | |||
| 7130EA | Read | STERNOCLAVICULAR JOINT OSTEOARTHROSIS | diagnostic | Osteoarthritis | |||
| 7130EL | Read | OSTEOARTHROSIS ELBOW | diagnostic | Osteoarthritis | |||
| 7130FT | Read | OSTEOARTHROSIS FOOT | diagnostic | Osteoarthritis | |||
| 7130H | Read | OSTEOARTHROSIS TOE | diagnostic | Osteoarthritis | |||
| 7130MD | Read | TEMPOROMANDIBULAR OSTEOARTHROSIS | diagnostic | Osteoarthritis | |||
| 7130N | Read | OSTEOARTHROSIS HANDS | diagnostic | Osteoarthritis | |||
| 7130PA | Read | OSTEOARTHRITIC PROTRUSION ACETABULUM | diagnostic | Osteoarthritis | |||
| 7131A | Read | OSTEOARTHROSIS NECK | diagnostic | Osteoarthritis | |||
| 7131BR | Read | SPONDYLITIS OSTEOARTHRITIC | diagnostic | Osteoarthritis | |||
| 7131C | Read | OSTEOARTHROSIS SPINE | diagnostic | Osteoarthritis | |||
| 7131DL | Read | LUMBAR OSTEOARTHRITIS | diagnostic | Osteoarthritis | |||
| N05..00 | Read | Osteoarthritis and allied disorders | diagnostic | Osteoarthritis | |||
| N050.00 | Read | Generalised osteoarthritis - OA | diagnostic | Osteoarthritis | |||
| N050000 | Read | Generalised osteoarthritis of unspecified site | diagnostic | Osteoarthritis | |||
| N050100 | Read | Generalised osteoarthritis of the hand | diagnostic | Osteoarthritis | |||
| N050200 | Read | Generalised osteoarthritis of multiple sites | diagnostic | Osteoarthritis | |||
| N050400 | Read | Primary generalized osteoarthrosis | diagnostic | Osteoarthritis | |||
| N050600 | Read | Erosive osteoarthrosis | diagnostic | Osteoarthritis | |||
| N050z00 | Read | Generalised osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N051.00 | Read | Localised; primary osteoarthritis | diagnostic | Osteoarthritis | |||
| N051000 | Read | Localised; primary osteoarthritis of unspecified site | diagnostic | Osteoarthritis | |||
| N05..11 | Read | Osteoarthritis | diagnostic | Osteoarthritis | |||
| N051100 | Read | Localised; primary osteoarthritis of the shoulder region | diagnostic | Osteoarthritis | |||
| N051200 | Read | Localised; primary osteoarthritis of the upper arm | diagnostic | Osteoarthritis | |||
| N051300 | Read | Localised; primary osteoarthritis of the forearm | diagnostic | Osteoarthritis | |||
| N051400 | Read | Localised; primary osteoarthritis of the hand | diagnostic | Osteoarthritis | |||
| N051500 | Read | Localised; primary osteoarthritis of the pelvic region/thigh | diagnostic | Osteoarthritis | |||
| N051600 | Read | Localised; primary osteoarthritis of the lower leg | diagnostic | Osteoarthritis | |||
| N051700 | Read | Localised; primary osteoarthritis of the ankle and foot | diagnostic | Osteoarthritis | |||
| N051800 | Read | Localised; primary osteoarthritis of other specified site | diagnostic | Osteoarthritis | |||
| N051D00 | Read | Localised; primary osteoarthritis of the wrist | diagnostic | Osteoarthritis | |||
| N051E00 | Read | Localised; primary osteoarthritis of toe | diagnostic | Osteoarthritis | |||
| N051F00 | Read | Localised; primary osteoarthritis of elbow | diagnostic | Osteoarthritis | |||
| N051z00 | Read | Localised; primary osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N052.00 | Read | Localised; secondary osteoarthritis | diagnostic | Osteoarthritis | |||
| N052000 | Read | Localised; secondary osteoarthritis of unspecified site | diagnostic | Osteoarthritis | |||
| N052100 | Read | Localised; secondary osteoarthritis of the shoulder region | diagnostic | Osteoarthritis | |||
| N052200 | Read | Localised; secondary osteoarthritis of the upper arm | diagnostic | Osteoarthritis | |||
| N052300 | Read | Localised; secondary osteoarthritis of the forearm | diagnostic | Osteoarthritis | |||
| N052400 | Read | Localised; secondary osteoarthritis of the hand | diagnostic | Osteoarthritis | |||
| N052500 | Read | Localised; secondary osteoarthritis of pelvic region/thigh | diagnostic | Osteoarthritis | |||
| N052600 | Read | Localised; secondary osteoarthritis of the lower leg | diagnostic | Osteoarthritis | |||
| N052700 | Read | Localised; secondary osteoarthritis of the ankle and foot | diagnostic | Osteoarthritis | |||
| N052800 | Read | Localised; secondary osteoarthritis of other specified site | diagnostic | Osteoarthritis | |||
| N052z00 | Read | Localised; secondary osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N053.00 | Read | Localised osteoarthritis; unspecified | diagnostic | Osteoarthritis | |||
| N053000 | Read | Localised osteoarthritis; unspecified; of unspecified site | diagnostic | Osteoarthritis | |||
| N053100 | Read | Localised osteoarthritis; unspecified; of shoulder region | diagnostic | Osteoarthritis | |||
| N053200 | Read | Localised osteoarthritis; unspecified; of the upper arm | diagnostic | Osteoarthritis | |||
| N053300 | Read | Localised osteoarthritis; unspecified; of the forearm | diagnostic | Osteoarthritis | |||
| N053400 | Read | Localised osteoarthritis; unspecified; of the hand | diagnostic | Osteoarthritis | |||
| N053500 | Read | Localised osteoarthritis; unspecified; pelvic region/thigh | diagnostic | Osteoarthritis | |||
| N053600 | Read | Localised osteoarthritis; unspecified; of the lower leg | diagnostic | Osteoarthritis | |||
| N053611 | Read | Patellofemoral osteoarthritis | diagnostic | Osteoarthritis | |||
| N053700 | Read | Localised osteoarthritis; unspecified; of the ankle and foot | diagnostic | Osteoarthritis | |||
| N053800 | Read | Localised osteoarthritis; unspecified; of other spec site | diagnostic | Osteoarthritis | |||
| N053z00 | Read | Localised osteoarthritis; unspecified; NOS | diagnostic | Osteoarthritis | |||
| N054.00 | Read | Oligoarticular osteoarthritis; unspecified | diagnostic | Osteoarthritis | |||
| N054000 | Read | Oligoarticular osteoarthritis; unspec; of unspecified sites | diagnostic | Osteoarthritis | |||
| N054100 | Read | Oligoarticular osteoarthritis; unspecified; of shoulder | diagnostic | Osteoarthritis | |||
| N054200 | Read | Oligoarticular osteoarthritis; unspecified; of upper arm | diagnostic | Osteoarthritis | |||
| N054400 | Read | Oligoarticular osteoarthritis; unspecified; of hand | diagnostic | Osteoarthritis | |||
| N054500 | Read | Oligoarticular osteoarthritis; unspecified; of pelvis/thigh | diagnostic | Osteoarthritis | |||
| N054600 | Read | Oligoarticular osteoarthritis; unspecified; of lower leg | diagnostic | Osteoarthritis | |||
| N054700 | Read | Oligoarticular osteoarthritis; unspecified; of ankle/foot | diagnostic | Osteoarthritis | |||
| N054800 | Read | Oligoarticular osteoarthritis; unspecified; other spec sites | diagnostic | Osteoarthritis | |||
| N054900 | Read | Oligoarticular osteoarthritis; unspecified; multiple sites | diagnostic | Osteoarthritis | |||
| N054z00 | Read | Osteoarthritis of more than one site; unspecified; NOS | diagnostic | Osteoarthritis | |||
| N05z.00 | Read | Osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N05z000 | Read | Osteoarthritis NOS; of unspecified site | diagnostic | Osteoarthritis | |||
| N05z100 | Read | Osteoarthritis NOS; of shoulder region | diagnostic | Osteoarthritis | |||
| N05z200 | Read | Osteoarthritis NOS; of the upper arm | diagnostic | Osteoarthritis | |||
| N05z211 | Read | Elbow osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N05z300 | Read | Osteoarthritis NOS; of the forearm | diagnostic | Osteoarthritis | |||
| N05z311 | Read | Wrist osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N05z400 | Read | Osteoarthritis NOS; of the hand | diagnostic | Osteoarthritis | |||
| N05z411 | Read | Finger osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N05z412 | Read | Thumb osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N05z500 | Read | Osteoarthritis NOS; pelvic region/thigh | diagnostic | Osteoarthritis | |||
| N05z511 | Read | Hip osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N05z600 | Read | Osteoarthritis NOS; of the lower leg | diagnostic | Osteoarthritis | |||
| N05z611 | Read | Knee osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N05z700 | Read | Osteoarthritis NOS; of ankle and foot | diagnostic | Osteoarthritis | |||
| N05z711 | Read | Ankle osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N05z712 | Read | Foot osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N05z713 | Read | Toe osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N05z800 | Read | Osteoarthritis NOS; other specified site | diagnostic | Osteoarthritis | |||
| N05z900 | Read | Osteoarthritis NOS; of shoulder | diagnostic | Osteoarthritis | |||
| N05zA00 | Read | Osteoarthritis NOS; of sternoclavicular joint | diagnostic | Osteoarthritis | |||
| N05zB00 | Read | Osteoarthritis NOS; of acromioclavicular joint | diagnostic | Osteoarthritis | |||
| N05zC00 | Read | Osteoarthritis NOS; of elbow | diagnostic | Osteoarthritis | |||
| N05zD00 | Read | Osteoarthritis NOS; of distal radio-ulnar joint | diagnostic | Osteoarthritis | |||
| N05zE00 | Read | Osteoarthritis NOS; of wrist | diagnostic | Osteoarthritis | |||
| N05zF00 | Read | Osteoarthritis NOS; of MCP joint | diagnostic | Osteoarthritis | |||
| N05zG00 | Read | Osteoarthritis NOS; of PIP joint of finger | diagnostic | Osteoarthritis | |||
| N05zH00 | Read | Osteoarthritis NOS; of DIP joint of finger | diagnostic | Osteoarthritis | |||
| N05zJ00 | Read | Osteoarthritis NOS; of hip | diagnostic | Osteoarthritis | |||
| N05zK00 | Read | Osteoarthritis NOS; of sacro-iliac joint | diagnostic | Osteoarthritis | |||
| N05zL00 | Read | Osteoarthritis NOS; of knee | diagnostic | Osteoarthritis | |||
| N05zM00 | Read | Osteoarthritis NOS; of tibio-fibular joint | diagnostic | Osteoarthritis | |||
| N05zN00 | Read | Osteoarthritis NOS; of ankle | diagnostic | Osteoarthritis | |||
| N05zP00 | Read | Osteoarthritis NOS; of subtalar joint | diagnostic | Osteoarthritis | |||
| N05zQ00 | Read | Osteoarthritis NOS; of talonavicular joint | diagnostic | Osteoarthritis | |||
| N05zR00 | Read | Osteoarthritis NOS; of other tarsal joint | diagnostic | Osteoarthritis | |||
| N05zS00 | Read | Osteoarthritis NOS; of 1st MTP joint | diagnostic | Osteoarthritis | |||
| N05zT00 | Read | Osteoarthritis NOS; of lesser MTP joint | diagnostic | Osteoarthritis | |||
| N05zU00 | Read | Osteoarthritis NOS; of IP joint of toe | diagnostic | Osteoarthritis | |||
| N05zz00 | Read | Osteoarthritis NOS | diagnostic | Osteoarthritis | |||
| N110.12 | Read | Osteoarthritis cervical spine | diagnostic | Osteoarthritis | |||
| N11..12 | Read | Osteoarthritis of spine | diagnostic | Osteoarthritis | |||
| N11D.00 | Read | Osteoarthritis of spine | diagnostic | Osteoarthritis | |||
| N11D000 | Read | Osteoarthritis of cervical spine | diagnostic | Osteoarthritis | |||
| N11D100 | Read | Osteoarthritis of thoracic spine | diagnostic | Osteoarthritis | |||
| N11D200 | Read | Osteoarthritis of lumbar spine | diagnostic | Osteoarthritis | |||
| N11D300 | Read | Osteoarthritis of spine NOS | diagnostic | Osteoarthritis | |||
| N11z.11 | Read | Osteoarthritis spine | diagnostic | Osteoarthritis |
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