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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: res9: insulin

265 codes in list

Code Coding system Description Entity type List name multilexcode bnfcode bnfchapter
10001 CPRD_product_code HUMALOG MIX 50 DISPOSABLE PEN injection suspension 100 units/ml [LILLY] drug res9: insulin 7676001 06010102 Intermediate- and long-acting insulins
10067 CPRD_product_code insulin biphasic aspart human pyr injection 30:70; 100 units/ml drug res9: insulin 10444001 06010102 Intermediate- and long-acting insulins
10175 CPRD_product_code insulin isophane human pyr injection 100 iu/ml drug res9: insulin 9311001 06010102 Intermediate- and long-acting insulins
10184 CPRD_product_code insulin detemir injection solution 100 iu/ml drug res9: insulin 12526001 06010102 Intermediate- and long-acting insulins
10207 CPRD_product_code insulin isophane human cartridge injection suspension 100 units/ml drug res9: insulin 13724001 06010102 Intermediate- and long-acting insulins
10208 CPRD_product_code INSULATARD INNOLET injection suspension 100 units/ml [NOVO] drug res9: insulin 13919001 06010102 Intermediate- and long-acting insulins
10225 CPRD_product_code LANTUS OPTICLIK injection solution 100 units/ml [AVENTIS] drug res9: insulin 13727001 06010102 Intermediate- and long-acting insulins
10229 CPRD_product_code HUMULIN I DISPOSABLE PEN injection suspension 100 units/ml [LILLY] drug res9: insulin 13730001 06010102 Intermediate- and long-acting insulins
10243 CPRD_product_code HUMALOG MIX 25 CARTRIDGE injection suspension 100 units/ml [LILLY] drug res9: insulin 13751001 06010102 Intermediate- and long-acting insulins
10244 CPRD_product_code MIXTARD 40 PENFILL injection suspension 100 units/ml [NOVO] drug res9: insulin 13705001 06010102 Intermediate- and long-acting insulins
10245 CPRD_product_code MIXTARD 10 PENFILL injection suspension 100 units/ml [NOVO] drug res9: insulin 13689001 06010102 Intermediate- and long-acting insulins
10259 CPRD_product_code insulin glargine vial injection solution 100 units/ml drug res9: insulin 13756001 06010102 Intermediate- and long-acting insulins
10264 CPRD_product_code HUMALOG DISPOSABLE PEN injection solution 100 units/ml [LILLY] drug res9: insulin 13748001 06010101 Short-acting insulins
10277 CPRD_product_code HUMULIN M3 CARTRIDGE injection suspension 100 units/ml [LILLY] drug res9: insulin 13698001 06010102 Intermediate- and long-acting insulins
10484 CPRD_product_code PENMIX 20/80 PENFILL PENFILL [NOVO] drug res9: insulin 5671001 06010102 Intermediate- and long-acting insulins
10547 CPRD_product_code HUMULIN LENTE injection 100 units/ml [LILLY] drug res9: insulin 2946001 06010102 Intermediate- and long-acting insulins
10572 CPRD_product_code insulin soluble bovine injection 100 units/ml drug res9: insulin 3934001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
10887 CPRD_product_code PENMIX 40/60 PENFILL injection 100 iu/ml [NOVO] drug res9: insulin 5586001 06010102 Intermediate- and long-acting insulins
10910 CPRD_product_code HUMAJECT M2 pen 100 iu/ml [LILLY] drug res9: insulin 8724002 06010102 Intermediate- and long-acting insulins
10915 CPRD_product_code HUMAJECT M1 pen 100 iu/ml [LILLY] drug res9: insulin 8724001 06010102 Intermediate- and long-acting insulins
11055 CPRD_product_code insulin biphasic isophane human pyr injection 20:80; 100 units/ml drug res9: insulin 9315002 06010102 Intermediate- and long-acting insulins
11056 CPRD_product_code insulin biphasic isophane human pyr injection 30:70; 100 units/ml drug res9: insulin 9315003 06010102 Intermediate- and long-acting insulins
11080 CPRD_product_code insulin isophane human prb injection 100 iu/ml drug res9: insulin 9312001 06010102 Intermediate- and long-acting insulins
11107 CPRD_product_code HUMULIN M4 injection 100 units/ml [LILLY] drug res9: insulin 2948001 06010102 Intermediate- and long-acting insulins
11337 CPRD_product_code NOVORAPID NOVOLET injection 100 iu/ml [NOVO] drug res9: insulin 8387001 06010101 Short-acting insulins
12035 CPRD_product_code insulin zinc lente bovine vial injection suspension 100 units/ml drug res9: insulin 3953001 06010102 Intermediate- and long-acting insulins
12297 CPRD_product_code HYPURIN BOVINE NEUTRAL injection 100 units/ml [CP PHARM] drug res9: insulin 2474001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
12299 CPRD_product_code SEMITARD MC injection 100 units/ml [NOVO] drug res9: insulin 855001 06010102 Intermediate- and long-acting insulins
12638 CPRD_product_code insulin soluble human pyr injection 100 units/ml drug res9: insulin 9308001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
12654 CPRD_product_code insulin soluble human prb injection 100 units/ml drug res9: insulin 9310001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
12818 CPRD_product_code MIXTARD 50 injection 50:50; 100 units/ml [NOVO] drug res9: insulin 8709003 06010102 Intermediate- and long-acting insulins
13277 CPRD_product_code MIXTARD 50 PENFILL injection suspension 100 units/ml [NOVO] drug res9: insulin 13830001 06010102 Intermediate- and long-acting insulins
13416 CPRD_product_code insulin biphasic injection 100 units/ml drug res9: insulin 3937001 06010102 Intermediate- and long-acting insulins
13516 CPRD_product_code HYPURIN BOVINE ISOPHANE injection 100 units/ml [CP PHARM] drug res9: insulin 2473001 06010102 Intermediate- and long-acting insulins
13622 CPRD_product_code HYPURIN PORCINE NEUTRAL injection 100 units/ml [CP PHARM] drug res9: insulin 11000001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
13729 CPRD_product_code insulin isophane human emp injection 100 units/ml drug res9: insulin 9313001 06010102 Intermediate- and long-acting insulins
13819 CPRD_product_code HYPURIN PORCINE ISOPHANE injection 100 units/ml [WOCKHARDT] drug res9: insulin 11004001 06010102 Intermediate- and long-acting insulins
13837 CPRD_product_code insulin biphasic isophane human prb injection 10:90; 100 units/ml drug res9: insulin 9302001 06010102 Intermediate- and long-acting insulins
14270 CPRD_product_code HUMALOG MIX 25 DISPOSABLE PEN injection suspension 100 units/ml [LILLY] drug res9: insulin 13752001 06010102 Intermediate- and long-acting insulins
14290 CPRD_product_code INSULATARD PENFILL injection suspension 100 units/ml [NOVO] drug res9: insulin 13831001 06010102 Intermediate- and long-acting insulins
14299 CPRD_product_code insulin glulisine cartridge injection solution 100 units/ml drug res9: insulin 13763001 06010101 Short-acting insulins
14301 CPRD_product_code insulin detemir cartridge injection solution 100 units/ml drug res9: insulin 13753001 06010102 Intermediate- and long-acting insulins
14313 CPRD_product_code insulin lispro cartridge injection solution 100 units/ml drug res9: insulin 13744001 06010101 Short-acting insulins
14330 CPRD_product_code insulin detemir disposable pen injection solution 100 units/ml drug res9: insulin 13754001 06010102 Intermediate- and long-acting insulins
14339 CPRD_product_code HYPURIN BOVINE NEUTRAL VIAL injection solution 100 units/ml [WOCKHARDT] drug res9: insulin 13826001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
14340 CPRD_product_code HYPURIN BOVINE ISOPHANE VIAL injection suspension 100 units/ml [WOCKHARDT] drug res9: insulin 13821001 06010102 Intermediate- and long-acting insulins
14345 CPRD_product_code APIDRA CARTRIDGE injection solution 100 units/ml [SANOFI/AVE] drug res9: insulin 13450001 06010101 Short-acting insulins
14357 CPRD_product_code HUMULIN I CARTRIDGE injection suspension 100 units/ml [LILLY] drug res9: insulin 13729001 06010102 Intermediate- and long-acting insulins
14362 CPRD_product_code insulin lispro disposable pen injection solution 100 units/ml drug res9: insulin 13745001 06010101 Short-acting insulins
14505 CPRD_product_code insulin protamine zinc bovine vial injection suspension 100 units/ml drug res9: insulin 3948001 06010102 Intermediate- and long-acting insulins
14619 CPRD_product_code insulin biphasic isophane porcine injection 30:70; 100 units/ml drug res9: insulin 3946002 06010102 Intermediate- and long-acting insulins
14644 CPRD_product_code insulin biphasic isophane human prb injection 20:80; 100 units/ml drug res9: insulin 9302002 06010102 Intermediate- and long-acting insulins
14649 CPRD_product_code insulin biphasic isophane human pyr injection 10:90; 100 units/ml drug res9: insulin 9315001 06010102 Intermediate- and long-acting insulins
14918 CPRD_product_code HUMULIN I VIAL injection suspension 100 units/ml [LILLY] drug res9: insulin 13728001 06010102 Intermediate- and long-acting insulins
14925 CPRD_product_code insulin isophane human vial injection suspension 100 units/ml drug res9: insulin 13723001 06010102 Intermediate- and long-acting insulins
14928 CPRD_product_code INSULATARD VIAL injection suspension 100 units/ml [NOVO] drug res9: insulin 13918001 06010102 Intermediate- and long-acting insulins
14930 CPRD_product_code HYPURIN PORCINE NEUTRAL CARTRIDGE injection solution 100 units/ml [WOCKHARDT] drug res9: insulin 13817001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
14933 CPRD_product_code HYPURIN PORCINE ISOPHANE CARTRIDGE injection suspension 100 units/ml [WOCKHARDT] drug res9: insulin 13809001 06010102 Intermediate- and long-acting insulins
14938 CPRD_product_code insulin soluble bovine cartridge injection solution 100 units/ml drug res9: insulin 13824001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
14944 CPRD_product_code HUMULIN S CARTRIDGE injection solution 100 units/ml [LILLY] drug res9: insulin 13684001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
15199 CPRD_product_code INSUMAN COMB 25 injection 100 iu/ml [AVENTIS] drug res9: insulin 8298001 06010102 Intermediate- and long-acting insulins
15484 CPRD_product_code insulin isophane bovine injection 100 units/ml drug res9: insulin 3943001 06010102 Intermediate- and long-acting insulins
15710 CPRD_product_code insulin soluble human emp injection 100 units/ml drug res9: insulin 9309001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
1587 CPRD_product_code MONOTARD injection 100 units/ml [NOVO] drug res9: insulin 443001 06010102 Intermediate- and long-acting insulins
1588 CPRD_product_code ACTRAPID injection 100 iu/ml [NOVO] drug res9: insulin 442001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
1592 CPRD_product_code ACTRAPID PENFILL 100 iu/ml [NOVO] drug res9: insulin 2677001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
1593 CPRD_product_code INSULATARD PENFILL 100 iu/ml [NOVO] drug res9: insulin 1771003 06010102 Intermediate- and long-acting insulins
1594 CPRD_product_code ACTRAPID NOVOLET 100 iu/ml [NOVO] drug res9: insulin 2677002 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
1595 CPRD_product_code INSULATARD NOVOLET 100 iu/ml [NOVO] drug res9: insulin 8704001 06010102 Intermediate- and long-acting insulins
15961 CPRD_product_code insulin isophane human crb injection 100 iu/ml drug res9: insulin 5677001 06010102 Intermediate- and long-acting insulins
16129 CPRD_product_code insulin soluble human cartridge injection solution 100 units/ml drug res9: insulin 13682001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
16142 CPRD_product_code insulin aspart cartridge injection solution 100 units/ml drug res9: insulin 13735001 06010101 Short-acting insulins
16152 CPRD_product_code insulin biphasic isophane human cartridge injection suspension 30:70; 100 units/ml drug res9: insulin 13693001 06010102 Intermediate- and long-acting insulins
16160 CPRD_product_code HUMULIN M3 DISPOSABLE PEN injection suspension 100 units/ml [LILLY] drug res9: insulin 13701001 06010102 Intermediate- and long-acting insulins
1649 CPRD_product_code HUMAN ACTRAPHANE injection 100 iu/ml [NOVO] drug res9: insulin 2676001 06010102 Intermediate- and long-acting insulins
16682 CPRD_product_code TEMPULIN injection 100 units/ml [KNOLL] drug res9: insulin 1494001 06010102 Intermediate- and long-acting insulins
16700 CPRD_product_code insulin zinc mixed bovine vial injection suspension 100 units/ml drug res9: insulin 3938001 06010102 Intermediate- and long-acting insulins
17336 CPRD_product_code NOVOPEN injection device 100 units/ml [NOVO] drug res9: insulin 3951001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
17712 CPRD_product_code HYPURIN BOVINE LENTE VIAL injection suspension 100 units/ml [WOCKHARDT] drug res9: insulin 2472001 06010102 Intermediate- and long-acting insulins
17731 CPRD_product_code PENMIX 50/50 injection 100 iu/ml [NOVO] drug res9: insulin 7093001 06010102 Intermediate- and long-acting insulins
17809 CPRD_product_code HUMAJECT M4 pen 100 iu/ml [LILLY] drug res9: insulin 8726001 06010102 Intermediate- and long-acting insulins
1805 CPRD_product_code MIXTARD 30/70 injection 100 units/ml [NOVO] drug res9: insulin 1773001 06010102 Intermediate- and long-acting insulins
1806 CPRD_product_code PENMIX 30/70 PENFILL injection 100 iu/ml [NOVO] drug res9: insulin 7067001 06010102 Intermediate- and long-acting insulins
18224 CPRD_product_code HUMALOG VIAL injection solution 100 units/ml [LILLY] drug res9: insulin 13746001 06010101 Short-acting insulins
1840 CPRD_product_code HUMULIN S injection 100 units/ml [LILLY] drug res9: insulin 446001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
1842 CPRD_product_code PORK VELOSULIN injection 100 units/ml [NOVO] drug res9: insulin 1017001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
1843 CPRD_product_code PORK INSULATARD VIAL injection suspension 100 units/ml [NOVO] drug res9: insulin 467001 06010102 Intermediate- and long-acting insulins
1844 CPRD_product_code ULTRATARD injection 100 units/ml [NOVO] drug res9: insulin 1731001 06010102 Intermediate- and long-acting insulins
18461 CPRD_product_code insulin zinc suspension mixed human prb injection 100 units/ml drug res9: insulin 9314001 06010102 Intermediate- and long-acting insulins
18590 CPRD_product_code insulin isophane bovine vial injection suspension 100 units/ml drug res9: insulin 13819001 06010102 Intermediate- and long-acting insulins
18592 CPRD_product_code insulin soluble bovine vial injection solution 100 units/ml drug res9: insulin 13823001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
18593 CPRD_product_code HUMALOG MIX 50 CARTRIDGE injection suspension 100 units/ml [LILLY] drug res9: insulin 13971001 06010102 Intermediate- and long-acting insulins
1886 CPRD_product_code INSULATARD ge injection 100 iu/ml [NOVO] drug res9: insulin 1771002 06010102 Intermediate- and long-acting insulins
18931 CPRD_product_code insulin zinc suspension crystalline human prb - intermediate acting injection 100 units/ml drug res9: insulin 3942001 06010102 Intermediate- and long-acting insulins
19491 CPRD_product_code APIDRA VIAL injection solution 100 units/ml [SANOFI/AVE] drug res9: insulin 13448001 06010101 Short-acting insulins
19513 CPRD_product_code HUMULIN M3 VIAL injection suspension 100 units/ml [LILLY] drug res9: insulin 13699001 06010102 Intermediate- and long-acting insulins
19877 CPRD_product_code insulin aspart disposable pen injection solution 100 units/ml drug res9: insulin 13736001 06010101 Short-acting insulins
19878 CPRD_product_code insulin biphasic isophane human disposable pen injection suspension 30:70; 100 units/ml drug res9: insulin 13695001 06010102 Intermediate- and long-acting insulins
20422 CPRD_product_code INSUMAN COMB 15 injection 100 iu/ml [AVENTIS] drug res9: insulin 8710001 06010102 Intermediate- and long-acting insulins
20995 CPRD_product_code HYPURIN PORCINE 30/70 MIX CARTRIDGE injection suspension 100 units/ml [WOCKHARDT] drug res9: insulin 13813001 06010102 Intermediate- and long-acting insulins
21110 CPRD_product_code insulin biphasic isophane human prb injection 50:50; 100 units/ml drug res9: insulin 9317002 06010102 Intermediate- and long-acting insulins
21232 CPRD_product_code insulin biphasic isophane human vial injection suspension 30:70; 100 units/ml drug res9: insulin 13694001 06010102 Intermediate- and long-acting insulins
21235 CPRD_product_code HUMULIN S VIAL injection solution 100 units/ml [LILLY] drug res9: insulin 13683001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
21347 CPRD_product_code PENMIX 40/60 injection 100 iu/ml [NOVO] drug res9: insulin 7092001 06010102 Intermediate- and long-acting insulins
21374 CPRD_product_code insulin biphasic isophane human prb injection 40:60; 100 units/ml drug res9: insulin 9317001 06010102 Intermediate- and long-acting insulins
21395 CPRD_product_code insulin biphasic isophane human pyr injection 40:60; 100 units/ml drug res9: insulin 9316001 06010102 Intermediate- and long-acting insulins
21422 CPRD_product_code insulin biphasic isophane human cartridge injection suspension 40:60; 100 units/ml drug res9: insulin 13704001 06010102 Intermediate- and long-acting insulins
21554 CPRD_product_code INSUMAN COMB 50 injection 100 iu/ml [AVENTIS] drug res9: insulin 8299001 06010102 Intermediate- and long-acting insulins
21583 CPRD_product_code APIDRA OPTISET injection solution 100 units/ml [SANOFI/AVE] drug res9: insulin 13784001 06010101 Short-acting insulins
21590 CPRD_product_code insulin glulisine disposable pen injection solution 100 units/ml drug res9: insulin 13785001 06010101 Short-acting insulins
22058 CPRD_product_code PUR-IN MIX 15/85 injection [CP PHARM] drug res9: insulin 5702001 06010102 Intermediate- and long-acting insulins
22155 CPRD_product_code HUMAJECT M5 pen 100 iu/ml [LILLY] drug res9: insulin 8726002 06010102 Intermediate- and long-acting insulins
2220 CPRD_product_code PENMIX 20/80 pen [NOVO] drug res9: insulin 7091001 06010102 Intermediate- and long-acting insulins
2221 CPRD_product_code MIXTARD 30 NOVOLET 100 iu/ml [NOVO] drug res9: insulin 8707002 06010102 Intermediate- and long-acting insulins
22697 CPRD_product_code insulin biphasic isophane human pyr injection 50:50; 100 units/ml drug res9: insulin 9316002 06010102 Intermediate- and long-acting insulins
22945 CPRD_product_code INSUMAN RAPID injection 100 iu/ml [AVENTIS] drug res9: insulin 11148001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
22983 CPRD_product_code INSUMAN RAPID CARTRIDGE injection solution 100 units/ml [AVENTIS] drug res9: insulin 13685001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
23099 CPRD_product_code insulin biphasic aspart disposable pen injection suspension 30:70; 100 units/ml drug res9: insulin 13738001 06010102 Intermediate- and long-acting insulins
23231 CPRD_product_code HYPURIN BOVINE NEUTRAL CARTRIDGE injection solution 100 units/ml [WOCKHARDT] drug res9: insulin 13825001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
23992 CPRD_product_code INSUMAN BASAL OPTISET injection suspension 100 units/ml [AVENTIS] drug res9: insulin 13733001 06010102 Intermediate- and long-acting insulins
23993 CPRD_product_code INSUMAN RAPID OPTISET injection solution 100 units/ml [AVENTIS] drug res9: insulin 13686001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
24002 CPRD_product_code INSUMAN COMB 25 VIAL injection suspension 100 units/ml [AVENTIS] drug res9: insulin 13719001 06010102 Intermediate- and long-acting insulins
2454 CPRD_product_code MIXTARD 30 PENFILL 100 iu/ml [NOVO] drug res9: insulin 8707001 06010102 Intermediate- and long-acting insulins
2455 CPRD_product_code MIXTARD 20 NOVOLET 100 iu/ml [NOVO] drug res9: insulin 8706002 06010102 Intermediate- and long-acting insulins
2456 CPRD_product_code MIXTARD 10 NOVOLET 100 iu/ml [NOVO] drug res9: insulin 8705002 06010102 Intermediate- and long-acting insulins
2459 CPRD_product_code PORK MIXTARD 30 VIAL injection suspension 100 units/ml [NOVO] drug res9: insulin 584001 06010102 Intermediate- and long-acting insulins
24593 CPRD_product_code neutral insulin bovine injection 100 iu/ml drug res9: insulin 3949001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
24795 CPRD_product_code insulin biphasic aspart cartridge injection suspension 30:70; 100 units/ml drug res9: insulin 13737001 06010102 Intermediate- and long-acting insulins
24800 CPRD_product_code HYPURIN PORCINE 30/70 MIX VIAL injection suspension 100 units/ml [WOCKHARDT] drug res9: insulin 13812001 06010102 Intermediate- and long-acting insulins
24846 CPRD_product_code PUR-IN NEUTRAL injection 100 units/ml [CP PHARM] drug res9: insulin 5707001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
24993 CPRD_product_code INSUMAN COMB 25 CARTRIDGE injection suspension 100 units/ml [AVENTIS] drug res9: insulin 13720001 06010102 Intermediate- and long-acting insulins
25133 CPRD_product_code INSUMAN COMB 25 OPTISET injection suspension 100 units/ml [AVENTIS] drug res9: insulin 13721001 06010102 Intermediate- and long-acting insulins
25479 CPRD_product_code insulin soluble porcine cartridge injection solution 100 units/ml drug res9: insulin 13815001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
25735 CPRD_product_code insulin biphasic isophane human cartridge injection suspension 20:80; 100 units/ml drug res9: insulin 13690001 06010102 Intermediate- and long-acting insulins
25736 CPRD_product_code insulin biphasic isophane human cartridge injection suspension 10:90; 100 units/ml drug res9: insulin 13688001 06010102 Intermediate- and long-acting insulins
25812 CPRD_product_code insulin isophane human disposable pen injection suspension 100 units/ml drug res9: insulin 13725001 06010102 Intermediate- and long-acting insulins
26060 CPRD_product_code insulin lispro vial injection solution 100 units/ml drug res9: insulin 13743001 06010101 Short-acting insulins
26098 CPRD_product_code HYPURIN PORCINE NEUTRAL VIAL injection solution 100 units/ml [WOCKHARDT] drug res9: insulin 13816001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
26403 CPRD_product_code PUR-IN MIX 25/75 injection [CP PHARM] drug res9: insulin 5701001 06010102 Intermediate- and long-acting insulins
26498 CPRD_product_code insulin zinc suspension mixed bovine and porcine injection 100 units/ml drug res9: insulin 9301001 06010102 Intermediate- and long-acting insulins
26621 CPRD_product_code insulin soluble human crb injection 100 iu/ml drug res9: insulin 11996001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
27177 CPRD_product_code insulin biphasic lispro human prb injection 50:50; 100 units/ml drug res9: insulin 10009002 06010102 Intermediate- and long-acting insulins
27280 CPRD_product_code insulin biphasic isophane porcine vial injection suspension 30:70; 100 units/ml drug res9: insulin 13810001 06010102 Intermediate- and long-acting insulins
27396 CPRD_product_code insulin soluble porcine vial injection solution 100 units/ml drug res9: insulin 13814001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
27402 CPRD_product_code insulin soluble human vial injection solution 100 units/ml drug res9: insulin 13680001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
27461 CPRD_product_code INSUMAN BASAL CARTRIDGE injection suspension 100 units/ml [AVENTIS] drug res9: insulin 13731001 06010102 Intermediate- and long-acting insulins
27614 CPRD_product_code PENMIX 30/70 injection 100 iu/ml [NOVO] drug res9: insulin 5662001 06010102 Intermediate- and long-acting insulins
28096 CPRD_product_code insulin biphasic isophane human cartridge injection suspension 50:50; 100 units/ml drug res9: insulin 13708001 06010102 Intermediate- and long-acting insulins
28101 CPRD_product_code insulin glulisine vial injection solution 100 units/ml drug res9: insulin 13762001 06010101 Short-acting insulins
2812 CPRD_product_code MIXTARD 40 NOVOLET 100 iu/ml [NOVO] drug res9: insulin 8708002 06010102 Intermediate- and long-acting insulins
28183 CPRD_product_code HYPURIN PORCINE ISOPHANE VIAL injection suspension 100 units/ml [WOCKHARDT] drug res9: insulin 13808001 06010102 Intermediate- and long-acting insulins
28185 CPRD_product_code insulin biphasic lispro cartridge injection suspension 25:75; 100 units/ml drug res9: insulin 13749001 06010102 Intermediate- and long-acting insulins
28442 CPRD_product_code insulin glulisine injection solution 100 units/ml drug res9: insulin 13446001 06010101 Short-acting insulins
28588 CPRD_product_code HYPURIN BOVINE ISOPHANE CARTRIDGE injection suspension 100 units/ml [WOCKHARDT] drug res9: insulin 13822001 06010102 Intermediate- and long-acting insulins
2929 CPRD_product_code MIXTARD 30 ge injection 100 iu/ml [NOVO] drug res9: insulin 8707003 06010102 Intermediate- and long-acting insulins
29567 CPRD_product_code insulin aspart vial injection solution 100 units/ml drug res9: insulin 13734001 06010101 Short-acting insulins
29837 CPRD_product_code insulin biphasic isophane human prb injection 25:75; 100 units/ml drug res9: insulin 12032001 06010102 Intermediate- and long-acting insulins
29953 CPRD_product_code APIDRA OPTICLIK injection solution 100 units/ml [SANOFI/AVE] drug res9: insulin 14408001 06010101 Short-acting insulins
30209 CPRD_product_code ACTRAPID MC injection 100 units/ml [ARUN] drug res9: insulin 1519001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
30236 CPRD_product_code isophane insulin injection 100 iu/ml drug res9: insulin 3954001 06010102 Intermediate- and long-acting insulins
30686 CPRD_product_code insulin isophane porcine cartridge injection suspension 100 units/ml drug res9: insulin 13806001 06010102 Intermediate- and long-acting insulins
30819 CPRD_product_code INSUMAN COMB 15 OPTISET injection suspension 100 units/ml [AVENTIS] drug res9: insulin 13715001 06010102 Intermediate- and long-acting insulins
31205 CPRD_product_code INSUMAN COMB 50 OPTISET injection suspension 100 units/ml [AVENTIS] drug res9: insulin 13713001 06010102 Intermediate- and long-acting insulins
31258 CPRD_product_code insulin biphasic lispro disposable pen injection suspension 25:75; 100 units/ml drug res9: insulin 13750001 06010102 Intermediate- and long-acting insulins
31465 CPRD_product_code EXUBERA powder for inhalation 1mg [PFIZER] drug res9: insulin 13954001 06010101 Short-acting insulins
31467 CPRD_product_code EXUBERA powder for inhalation 3mg [PFIZER] drug res9: insulin 13955001 06010101 Short-acting insulins
322 CPRD_product_code HUMALOG injection 100 iu/ml [LILLY] drug res9: insulin 9984001 06010101 Short-acting insulins
33167 CPRD_product_code insulin biphasic isophane human crb injection 25:75; 100 units/ml drug res9: insulin 7623002 06010102 Intermediate- and long-acting insulins
33232 CPRD_product_code insulin biphasic isophane human crb injection 50:50; 100 units/ml drug res9: insulin 7623003 06010102 Intermediate- and long-acting insulins
3396 CPRD_product_code PENMIX 10/90 PENFILL PENFILL [NOVO] drug res9: insulin 5680001 06010102 Intermediate- and long-acting insulins
33966 CPRD_product_code INSULATARD injection 100 units/ml [NOVO] drug res9: insulin 1771001 06010102 Intermediate- and long-acting insulins
34031 CPRD_product_code MONOTARD MC injection 100 units/ml [NOVO] drug res9: insulin 598001 06010102 Intermediate- and long-acting insulins
34097 CPRD_product_code HUMAN INITARD 50/50 injection 100 units/ml [NOVO] drug res9: insulin 1774001 06010102 Intermediate- and long-acting insulins
3439 CPRD_product_code PENMIX 10/90 pen [NOVO] drug res9: insulin 7090001 06010102 Intermediate- and long-acting insulins
35253 CPRD_product_code INSUMAN COMB 50 CARTRIDGE injection suspension 100 units/ml [AVENTIS] drug res9: insulin 13712001 06010102 Intermediate- and long-acting insulins
35260 CPRD_product_code LEVEMIR INNOLET injection solution 100 units/ml [NOVO] drug res9: insulin 15220001 06010102 Intermediate- and long-acting insulins
35468 CPRD_product_code INSUMAN BASAL VIAL injection suspension 100 units/ml [AVENTIS] drug res9: insulin 13732001 06010102 Intermediate- and long-acting insulins
3550 CPRD_product_code MIXTARD 40 PENFILL 100 iu/ml [NOVO] drug res9: insulin 8708001 06010102 Intermediate- and long-acting insulins
3551 CPRD_product_code MIXTARD 20 PENFILL 100 iu/ml [NOVO] drug res9: insulin 8706001 06010102 Intermediate- and long-acting insulins
35701 CPRD_product_code insulin biphasic lispro disposable pen injection suspension 50:50; 100 units/ml drug res9: insulin 13922001 06010102 Intermediate- and long-acting insulins
36031 CPRD_product_code insulin biphasic isophane porcine cartridge injection suspension 30:70; 100 units/ml drug res9: insulin 13811001 06010102 Intermediate- and long-acting insulins
36066 CPRD_product_code insulin isophane bovine cartridge injection suspension 100 units/ml drug res9: insulin 13820001 06010102 Intermediate- and long-acting insulins
36146 CPRD_product_code insulin biphasic lispro cartridge injection suspension 50:50; 100 units/ml drug res9: insulin 13970001 06010102 Intermediate- and long-acting insulins
36194 CPRD_product_code insulin biphasic isophane human cartridge injection suspension 25:75; 100 units/ml drug res9: insulin 13717001 06010102 Intermediate- and long-acting insulins
36355 CPRD_product_code insulin human powder for inhalation 1mg drug res9: insulin 13952001 06010101 Short-acting insulins
36356 CPRD_product_code insulin human powder for inhalation 3mg drug res9: insulin 13953001 06010101 Short-acting insulins
36430 CPRD_product_code insulin soluble human disposable pen injection solution 100 units/ml drug res9: insulin 13681001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
36513 CPRD_product_code VELOSULIN CARTRIDGE injection 100 units/ml [NOVO] drug res9: insulin 3950001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
36853 CPRD_product_code LANTUS SOLOSTAR injection solution 100 units/ml [SANOFI/AVE] drug res9: insulin 15577001 06010102 Intermediate- and long-acting insulins
36920 CPRD_product_code APIDRA SOLOSTAR injection solution 100 units/ml [SANOFI/AVE] drug res9: insulin 15578001 06010101 Short-acting insulins
38422 CPRD_product_code ISOPHANE injection 100 iu/ml [CELLTECH] drug res9: insulin 1951009 06010102 Intermediate- and long-acting insulins
38986 CPRD_product_code HUMALOG KWIKPEN injection solution 100 units/ml [LILLY] drug res9: insulin 16596001 06010101 Short-acting insulins
39006 CPRD_product_code HUMALOG MIX 25 KWIKPEN injection suspension 100 units/ml [LILLY] drug res9: insulin 16595001 06010102 Intermediate- and long-acting insulins
39086 CPRD_product_code HUMALOG MIX 50 KWIKPEN injection suspension 100 units/ml [LILLY] drug res9: insulin 16594001 06010102 Intermediate- and long-acting insulins
4093 CPRD_product_code HUMULIN M2 injection 100 units/ml [LILLY] drug res9: insulin 2947002 06010102 Intermediate- and long-acting insulins
41120 CPRD_product_code insulin biphasic isophane human disposable pen injection suspension 50:50; 100 units/ml drug res9: insulin 13711001 06010102 Intermediate- and long-acting insulins
4129 CPRD_product_code insulin soluble porcine injection 100 units/ml drug res9: insulin 5051001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
4163 CPRD_product_code RAPITARD MC injection 100 units/ml [NOVO] drug res9: insulin 803001 06010102 Intermediate- and long-acting insulins
41834 CPRD_product_code INSULIN ZINC SUSPENSION LENTE injection 100 iu/ml [CELLTECH] drug res9: insulin 1474009 06010102 Intermediate- and long-acting insulins
41959 CPRD_product_code PENJECT injection device 100 units/ml [HYPOGUARD] drug res9: insulin 3952001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
4198 CPRD_product_code HUMULIN M3 injection 100 units/ml [LILLY] drug res9: insulin 2947003 06010102 Intermediate- and long-acting insulins
4199 CPRD_product_code HUMULIN M1 injection 100 units/ml [LILLY] drug res9: insulin 2947001 06010102 Intermediate- and long-acting insulins
42395 CPRD_product_code HUMALOG MIX 25 VIAL injection suspension 100 units/ml [LILLY] drug res9: insulin 17542001 06010102 Intermediate- and long-acting insulins
4247 CPRD_product_code insulin isophane porcine injection 100 units/ml drug res9: insulin 3944001 06010102 Intermediate- and long-acting insulins
42954 CPRD_product_code insulin biphasic isophane human vial injection suspension 25:75; 100 units/ml drug res9: insulin 13716001 06010102 Intermediate- and long-acting insulins
43950 CPRD_product_code HUMULIN I KWIKPEN injection suspension 100 units/ml [LILLY] drug res9: insulin 18037001 06010102 Intermediate- and long-acting insulins
43953 CPRD_product_code insulin biphasic lispro vial injection suspension 25:75; 100 units/ml drug res9: insulin 17541001 06010102 Intermediate- and long-acting insulins
43991 CPRD_product_code HUMULIN M3 KWIKPEN injection suspension 100 units/ml [LILLY] drug res9: insulin 18036001 06010102 Intermediate- and long-acting insulins
44251 CPRD_product_code insulin zinc suspension mixed porcine injection 100 units/ml drug res9: insulin 8839001 06010102 Intermediate- and long-acting insulins
44378 CPRD_product_code insulin biphasic isophane human disposable pen injection suspension 25:75; 100 units/ml drug res9: insulin 13718001 06010102 Intermediate- and long-acting insulins
44480 CPRD_product_code INSUMAN COMB 25 SOLOSTAR injection suspension 100 units/ml [AVENTIS] drug res9: insulin 18209001 06010102 Intermediate- and long-acting insulins
45158 CPRD_product_code INSUMAN COMB 15 CARTRIDGE injection suspension 100 units/ml [AVENTIS] drug res9: insulin 18312001 06010102 Intermediate- and long-acting insulins
46001 CPRD_product_code INSUMAN BASAL SOLOSTAR injection suspension 100 units/ml [AVENTIS] drug res9: insulin 18573001 06010102 Intermediate- and long-acting insulins
46666 CPRD_product_code NOVORAPID FLEXTOUCH injection solution 100 units/ml [NOVO] drug res9: insulin 18835001 06010101 Short-acting insulins
4706 CPRD_product_code VELOSULIN VIAL injection solution 100 units/ml [NOVO] drug res9: insulin 1772001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
4715 CPRD_product_code HUMALOG MIX 25 injection 25:75; 100 units/ml [LILLY] drug res9: insulin 1104001 06010102 Intermediate- and long-acting insulins
47360 CPRD_product_code NEUTRAL INSULIN injection 100 units/ml [CELLTECH] drug res9: insulin 1525009 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
4760 CPRD_product_code HUMULIN I injection 100 units/ml [LILLY] drug res9: insulin 445001 06010102 Intermediate- and long-acting insulins
4784 CPRD_product_code LENTARD MC injection 100 units/ml [NOVO] drug res9: insulin 519001 06010102 Intermediate- and long-acting insulins
4790 CPRD_product_code MIXTARD 50 PENFILL 100 iu/ml [NOVO] drug res9: insulin 8709001 06010102 Intermediate- and long-acting insulins
5021 CPRD_product_code NOVORAPID PENFILL injection solution 100 units/ml [NOVO] drug res9: insulin 1801001 06010101 Short-acting insulins
5214 CPRD_product_code insulin lispro human prb injection 100 iu/ml drug res9: insulin 9987001 06010101 Short-acting insulins
5250 CPRD_product_code insulin biphasic lispro human prb injection 25:75; 100 units/ml drug res9: insulin 10009001 06010102 Intermediate- and long-acting insulins
5255 CPRD_product_code MIXTARD 10 PENFILL 100 iu/ml [NOVO] drug res9: insulin 8705001 06010102 Intermediate- and long-acting insulins
5501 CPRD_product_code INSUMAN BASAL injection 100 iu/ml [AVENTIS] drug res9: insulin 2145001 06010102 Intermediate- and long-acting insulins
5845 CPRD_product_code MIXTARD 30 INNOLET injection suspension 30:70; 100 units/ml [NOVO] drug res9: insulin 9830001 06010102 Intermediate- and long-acting insulins
5891 CPRD_product_code INSULATARD FLEXPEN injection 100 iu/ml [NOVO] drug res9: insulin 8494001 06010102 Intermediate- and long-acting insulins
5892 CPRD_product_code NOVORAPID FLEXPEN injection solution 100 units/ml [NOVO] drug res9: insulin 8490001 06010101 Short-acting insulins
5933 CPRD_product_code MIXTARD 50 NOVOLET 100 iu/ml [NOVO] drug res9: insulin 8709002 06010102 Intermediate- and long-acting insulins
5953 CPRD_product_code insulin glargine injection 100 iu/ml drug res9: insulin 8241001 06010102 Intermediate- and long-acting insulins
6057 CPRD_product_code LANTUS injection 100 iu/ml [AVENTIS] drug res9: insulin 7444001 06010102 Intermediate- and long-acting insulins
6061 CPRD_product_code NOVOMIX 30 injection 30:70; 100 units/ml [NOVO] drug res9: insulin 10445001 06010102 Intermediate- and long-acting insulins
6209 CPRD_product_code NOVORAPID VIAL injection solution 100 units/ml [NOVO] drug res9: insulin 597001 06010101 Short-acting insulins
6447 CPRD_product_code insulin aspart human pyr injection 100 iu/ml drug res9: insulin 9620001 06010101 Short-acting insulins
6958 CPRD_product_code LEVEMIR FLEXPEN injection solution 100 units/ml [NOVO] drug res9: insulin 12528001 06010102 Intermediate- and long-acting insulins
6965 CPRD_product_code LEVEMIR PENFILL injection solution 100 units/ml [NOVO] drug res9: insulin 12527001 06010102 Intermediate- and long-acting insulins
7228 CPRD_product_code NOVOMIX 30 FLEXPEN injection suspension 100 units/ml [NOVO] drug res9: insulin 13740001 06010102 Intermediate- and long-acting insulins
7231 CPRD_product_code MIXTARD 30 PENFILL injection suspension 100 units/ml [NOVO] drug res9: insulin 13696001 06010102 Intermediate- and long-acting insulins
7237 CPRD_product_code LANTUS OPTISET injection solution 100 units/ml [AVENTIS] drug res9: insulin 13760001 06010102 Intermediate- and long-acting insulins
7266 CPRD_product_code LANTUS CARTRIDGE injection solution 100 units/ml [AVENTIS] drug res9: insulin 13761001 06010102 Intermediate- and long-acting insulins
7267 CPRD_product_code NOVOMIX 30 PENFILL injection suspension 100 units/ml [NOVO] drug res9: insulin 13739001 06010102 Intermediate- and long-acting insulins
7300 CPRD_product_code MIXTARD 30 VIAL injection suspension 100 units/ml [NOVO] drug res9: insulin 13921001 06010102 Intermediate- and long-acting insulins
7318 CPRD_product_code HUMALOG CARTRIDGE injection solution 100 units/ml [LILLY] drug res9: insulin 13747001 06010101 Short-acting insulins
7319 CPRD_product_code MIXTARD 20 PENFILL injection suspension 100 units/ml [NOVO] drug res9: insulin 13691001 06010102 Intermediate- and long-acting insulins
7349 CPRD_product_code ACTRAPID VIAL injection solution 100 units/ml [NOVO] drug res9: insulin 13687001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
7350 CPRD_product_code insulin isophane porcine vial injection suspension 100 units/ml drug res9: insulin 13805001 06010102 Intermediate- and long-acting insulins
7393 CPRD_product_code insulin glargine cartridge injection solution 100 units/ml drug res9: insulin 13758001 06010102 Intermediate- and long-acting insulins
7400 CPRD_product_code insulin glargine disposable pen injection solution 100 units/ml drug res9: insulin 13757001 06010102 Intermediate- and long-acting insulins
7402 CPRD_product_code LANTUS VIAL injection solution 100 units/ml [AVENTIS] drug res9: insulin 13759001 06010102 Intermediate- and long-acting insulins
7537 CPRD_product_code HUMULIN ZN injection 100 units/ml [LILLY] drug res9: insulin 1182001 06010102 Intermediate- and long-acting insulins
7771 CPRD_product_code HUMAN PROTAPHANE PENFILL 100 units/ml [NOVO] drug res9: insulin 1518002 06010102 Intermediate- and long-acting insulins
7772 CPRD_product_code HUMAN PROTAPHANE injection 100 units/ml [NOVO] drug res9: insulin 1518001 06010102 Intermediate- and long-acting insulins
7793 CPRD_product_code HUMAJECT M3 pen 100 iu/ml [LILLY] drug res9: insulin 8724003 06010102 Intermediate- and long-acting insulins
8118 CPRD_product_code HUMAJECT I pen 100 iu/ml [LILLY] drug res9: insulin 8723001 06010102 Intermediate- and long-acting insulins
8203 CPRD_product_code PENMIX 50/50 PENFILL injection 100 iu/ml [NOVO] drug res9: insulin 5563001 06010102 Intermediate- and long-acting insulins
8322 CPRD_product_code insulin zinc suspension mixed human pyr injection 100 units/ml drug res9: insulin 3939001 06010102 Intermediate- and long-acting insulins
8841 CPRD_product_code HUMULIN M5 injection 100 units/ml [LILLY] drug res9: insulin 2948002 06010102 Intermediate- and long-acting insulins
8895 CPRD_product_code INITARD 50/50 injection 100 units/ml [NOVO] drug res9: insulin 466001 06010102 Intermediate- and long-acting insulins
9341 CPRD_product_code insulin biphasic isophane human prb injection 30:70; 100 units/ml drug res9: insulin 9302003 06010102 Intermediate- and long-acting insulins
9376 CPRD_product_code insulin zinc suspension crystalline human pyr - long acting injection 100 units/ml drug res9: insulin 3941001 06010102 Intermediate- and long-acting insulins
9503 CPRD_product_code HYPURIN BOVINE PROTAMINE ZINC VIAL injection suspension 100 units/ml [WOCKHARDT] drug res9: insulin 2471001 06010102 Intermediate- and long-acting insulins
9521 CPRD_product_code PORK ACTRAPID VIAL injection solution 100 units/ml [NOVO] drug res9: insulin 11586001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
9565 CPRD_product_code HUMAJECT S DISPOSABLE PEN injection solution 100 units/ml [LILLY] drug res9: insulin 8725001 06010101/06010300 Short-acting insulins/Diabetic ketoacidosis
9618 CPRD_product_code HYPURIN PORCINE 30/70 MIX injection 100 iu/ml [WOCKHARDT] drug res9: insulin 11021001 06010102 Intermediate- and long-acting insulins
9737 CPRD_product_code INSULATARD INNOLET injection 100 iu/ml [NOVO] drug res9: insulin 9831001 06010102 Intermediate- and long-acting insulins

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