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: res9: sulfonylureas
67 codes in list
| Code | Coding system | Description | Entity type | List name | multilexcode | bnfcode | bnfchapter |
|---|---|---|---|---|---|---|---|
| 11284 | CPRD_product_code | AMARYL tablets 4mg [AVENTIS] | drug | res9: sulfonylureas | 11665001 | 6010201 | Sulphonylureas |
| 11695 | CPRD_product_code | DIAMICRON MR tablets 30mg [SERVIER] | drug | res9: sulfonylureas | 8592001 | 6010201 | Sulphonylureas |
| 12455 | CPRD_product_code | RASTINON tablets 500mg [HOECHSTMAR] | drug | res9: sulfonylureas | 804001 | 6010201 | Sulphonylureas |
| 12513 | CPRD_product_code | GLIBENESE tablets 5mg [PFIZER] | drug | res9: sulfonylureas | 408001 | 6010201 | Sulphonylureas |
| 1254 | CPRD_product_code | glibenclamide tablets 5mg | drug | res9: sulfonylureas | 2872002 | 6010201 | Sulphonylureas |
| 13331 | CPRD_product_code | EUGLUCON tablets 5mg [AVENTIS] | drug | res9: sulfonylureas | 331002 | 6010201 | Sulphonylureas |
| 15374 | CPRD_product_code | gliclazide oral suspension 40mg/5ml | drug | res9: sulfonylureas | 13981001 | 6010201 | Sulphonylureas |
| 16602 | CPRD_product_code | CALABREN tablets 2.5mg [BERK] | drug | res9: sulfonylureas | 2942002 | 6010201 | Sulphonylureas |
| 17343 | CPRD_product_code | GLICLAZIDE tablets 80mg [HILLCROSS] | drug | res9: sulfonylureas | 1866009 | 6010201 | Sulphonylureas |
| 17698 | CPRD_product_code | MINODIAB tablets 5mg [PHARMACIA] | drug | res9: sulfonylureas | 580001 | 6010201 | Sulphonylureas |
| 17706 | CPRD_product_code | MINODIAB tablets 2.5mg [PHARMACIA] | drug | res9: sulfonylureas | 3718001 | 6010201 | Sulphonylureas |
| 1964 | CPRD_product_code | DIAMICRON tablets 80mg [SERVIER] | drug | res9: sulfonylureas | 2696001 | 6010201 | Sulphonylureas |
| 1965 | CPRD_product_code | tolbutamide tablets 500mg | drug | res9: sulfonylureas | 2890001 | 6010201 | Sulphonylureas |
| 21424 | CPRD_product_code | glibenclamide oral suspension 5mg/5ml | drug | res9: sulfonylureas | 14098001 | 6010201 | Sulphonylureas |
| 21564 | CPRD_product_code | GLICLAZIDE tablets 80mg [WOCKHARDT] | drug | res9: sulfonylureas | 3504009 | 6010201 | Sulphonylureas |
| 21832 | CPRD_product_code | DIABETAMIDE tablets 5mg [ASHBOURNE] | drug | res9: sulfonylureas | 2462002 | 6010201 | Sulphonylureas |
| 21892 | CPRD_product_code | DIAGLYK tablets 80mg [ASHBOURNE] | drug | res9: sulfonylureas | 11864001 | 6010201 | Sulphonylureas |
| 2219 | CPRD_product_code | glibenclamide tablets 2.5mg | drug | res9: sulfonylureas | 2872001 | 6010201 | Sulphonylureas |
| 25636 | CPRD_product_code | LIBANIL tablets 2.5mg [APS] | drug | res9: sulfonylureas | 2416001 | 6010201 | Sulphonylureas |
| 26218 | CPRD_product_code | CALABREN tablets 5mg [BERK] | drug | res9: sulfonylureas | 2942001 | 6010201 | Sulphonylureas |
| 28708 | CPRD_product_code | MALIX tablets 2.5mg [LAGAP] | drug | res9: sulfonylureas | 2902001 | 6010201 | Sulphonylureas |
| 29326 | CPRD_product_code | GLIPIZIDE tablets 5mg [GEN (UK)] | drug | res9: sulfonylureas | 2165009 | 6010201 | Sulphonylureas |
| 29939 | CPRD_product_code | GLICLAZIDE tablets 80mg [GEN (UK)] | drug | res9: sulfonylureas | 2461009 | 6010201 | Sulphonylureas |
| 30460 | CPRD_product_code | MALIX tablets 5mg [LAGAP] | drug | res9: sulfonylureas | 2902002 | 6010201 | Sulphonylureas |
| 31212 | CPRD_product_code | GLICLAZIDE tablets 80mg [ACTAVIS] | drug | res9: sulfonylureas | 2110009 | 6010201 | Sulphonylureas |
| 31474 | CPRD_product_code | LIBANIL tablets 5mg [APS] | drug | res9: sulfonylureas | 2416002 | 6010201 | Sulphonylureas |
| 32 | CPRD_product_code | gliclazide tablets 80mg | drug | res9: sulfonylureas | 3716001 | 6010201 | Sulphonylureas |
| 33562 | CPRD_product_code | DUCLAZIDE tablets 80mg [DUMEX] | drug | res9: sulfonylureas | 8752001 | 6010201 | Sulphonylureas |
| 33673 | CPRD_product_code | TOLBUTAMIDE tablets 500mg [ACTAVIS] | drug | res9: sulfonylureas | 650009 | 6010201 | Sulphonylureas |
| 34399 | CPRD_product_code | GLICLAZIDE tablets 80mg [IVAX] | drug | res9: sulfonylureas | 2061009 | 6010201 | Sulphonylureas |
| 34507 | CPRD_product_code | GLIBENCLAMIDE tablets 2.5mg [WOCKHARDT] | drug | res9: sulfonylureas | 417010 | 6010201 | Sulphonylureas |
| 34563 | CPRD_product_code | GLIBENCLAMIDE tablets 5mg [WOCKHARDT] | drug | res9: sulfonylureas | 417009 | 6010201 | Sulphonylureas |
| 34676 | CPRD_product_code | GLIBENCLAMIDE tablets 2.5mg [HILLCROSS] | drug | res9: sulfonylureas | 419010 | 6010201 | Sulphonylureas |
| 34706 | CPRD_product_code | GLIBENCLAMIDE tablets 2.5mg [IVAX] | drug | res9: sulfonylureas | 2447009 | 6010201 | Sulphonylureas |
| 34802 | CPRD_product_code | GLIPIZIDE tablets 5mg [IVAX] | drug | res9: sulfonylureas | 2797009 | 6010201 | Sulphonylureas |
| 34932 | CPRD_product_code | GLICLAZIDE tablets 80mg [GENUS] | drug | res9: sulfonylureas | 2973009 | 6010201 | Sulphonylureas |
| 34957 | CPRD_product_code | TOLBUTAMIDE tablets 500mg [HILLCROSS] | drug | res9: sulfonylureas | 652009 | 6010201 | Sulphonylureas |
| 36856 | CPRD_product_code | GLICLAZIDE tablets 80mg [SANDOZ] | drug | res9: sulfonylureas | 2833009 | 6010201 | Sulphonylureas |
| 40365 | CPRD_product_code | GLIMEPIRIDE tablets 1mg [ACTAVIS] | drug | res9: sulfonylureas | 6435009 | 6010201 | Sulphonylureas |
| 40425 | CPRD_product_code | NAZDOL MR tablets 30mg [TEVA] | drug | res9: sulfonylureas | 16050001 | 6010201 | Sulphonylureas |
| 41558 | CPRD_product_code | GLIBENCLAMIDE tablets 5mg [TEVA] | drug | res9: sulfonylureas | 1335009 | 6010201 | Sulphonylureas |
| 41559 | CPRD_product_code | GLIBENCLAMIDE tablets 5mg [HILLCROSS] | drug | res9: sulfonylureas | 419009 | 6010201 | Sulphonylureas |
| 41593 | CPRD_product_code | GLIBENCLAMIDE tablets 2.5mg [TEVA] | drug | res9: sulfonylureas | 1335010 | 6010201 | Sulphonylureas |
| 42790 | CPRD_product_code | GLICLAZIDE tablets 80mg [MERCK-GEN] | drug | res9: sulfonylureas | 2409009 | 6010201 | Sulphonylureas |
| 43065 | CPRD_product_code | gliclazide tablets 40mg | drug | res9: sulfonylureas | 17862001 | 6010201 | Sulphonylureas |
| 43465 | CPRD_product_code | ZICRON tablets 40mg [BRISTOL LB] | drug | res9: sulfonylureas | 17863001 | 6010201 | Sulphonylureas |
| 44304 | CPRD_product_code | GLYCONON tablets 500mg [DDSA] | drug | res9: sulfonylureas | 2910001 | 6010201 | Sulphonylureas |
| 44473 | CPRD_product_code | EDICIL MR tablets 30mg [RATIOPHARM] | drug | res9: sulfonylureas | 17010001 | 6010201 | Sulphonylureas |
| 44738 | CPRD_product_code | NIDDARYL tablets 1mg [DEE] | drug | res9: sulfonylureas | 16160001 | 6010201 | Sulphonylureas |
| 45215 | CPRD_product_code | GLICLAZIDE tablets 80mg [NEOLAB] | drug | res9: sulfonylureas | 4101009 | 6010201 | Sulphonylureas |
| 45831 | CPRD_product_code | DACADIS modified release tablet 30mg [GEN (UK)] | drug | res9: sulfonylureas | 17695001 | 6010201 | Sulphonylureas |
| 46927 | CPRD_product_code | TOLBUTAMIDE tablets 500mg [TEVA] | drug | res9: sulfonylureas | 1946009 | 6010201 | Sulphonylureas |
| 47074 | CPRD_product_code | gliclazide oral suspension 80mg/5ml | drug | res9: sulfonylureas | 18739001 | 6010201 | Sulphonylureas |
| 4862 | CPRD_product_code | DIABETAMIDE tablets 2.5mg [ASHBOURNE] | drug | res9: sulfonylureas | 2462001 | 6010201 | Sulphonylureas |
| 5276 | CPRD_product_code | glimepiride tablets 1mg | drug | res9: sulfonylureas | 11550002 | 6010201 | Sulphonylureas |
| 5316 | CPRD_product_code | glimepiride tablets 4mg | drug | res9: sulfonylureas | 11644001 | 6010201 | Sulphonylureas |
| 5353 | CPRD_product_code | glimepiride tablets 2mg | drug | res9: sulfonylureas | 11550001 | 6010201 | Sulphonylureas |
| 547 | CPRD_product_code | glipizide tablets 2.5mg | drug | res9: sulfonylureas | 3717001 | 6010201 | Sulphonylureas |
| 5627 | CPRD_product_code | gliclazide modified release tablet 30mg | drug | res9: sulfonylureas | 3716002 | 6010201 | Sulphonylureas |
| 5636 | CPRD_product_code | glipizide tablets 5mg | drug | res9: sulfonylureas | 3717002 | 6010201 | Sulphonylureas |
| 6337 | CPRD_product_code | glimepiride tablets 3mg | drug | res9: sulfonylureas | 11550003 | 6010201 | Sulphonylureas |
| 7284 | CPRD_product_code | AMARYL tablets 2mg [AVENTIS] | drug | res9: sulfonylureas | 11552001 | 6010201 | Sulphonylureas |
| 7332 | CPRD_product_code | AMARYL tablets 1mg [AVENTIS] | drug | res9: sulfonylureas | 11552002 | 6010201 | Sulphonylureas |
| 7409 | CPRD_product_code | AMARYL tablets 3mg [AVENTIS] | drug | res9: sulfonylureas | 11552003 | 6010201 | Sulphonylureas |
| 7744 | CPRD_product_code | DAONIL tablets 5mg [AVENTIS] | drug | res9: sulfonylureas | 212001 | 6010201 | Sulphonylureas |
| 7912 | CPRD_product_code | SEMI-DAONIL tablets 2.5mg [AVENTIS] | drug | res9: sulfonylureas | 854001 | 6010201 | Sulphonylureas |
| 8976 | CPRD_product_code | EUGLUCON tablets 2.5mg [AVENTIS] | drug | res9: sulfonylureas | 331001 | 6010201 | Sulphonylureas |
Please log in to leave a comment.
Code list links:
ClinicalCodes is a project at the University of Manchester Institute of Population Health
The ClinicalCodes project is funded by the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR)