Dataset Information

White cell count trajectory and type 2 diabetes in health management population: a retrospective cohort study.

ABSTRACT:

Objective

The purposes of current research were to investigate the time-dependent dynamic alteration of white cell count (WCC) in health management populations and to analyse its association with the type 2 diabetes mellitus (T2DM).

Design

Retrospective cohort research.

Setting

Shengjing Hospital of China Medical University in China's Shenyang.

Participants

The number of non-diabetic subjects (median age: 40 years) totaled 7924 in the present work.

Primary and secondary outcome measures

Assessment and grouping of changes in WCC between 2016 and 2019 were accomplished through group-based trajectory modelling. Newly diagnosed incidence associated with T2DM was estimated based on varying trajectories of WCC by the Kaplan-Meier method. Statistical differences in the incidences of new-onset T2DM among various WCC trajectory groups were examined through log-rank test. The influence of WCC trajectory alterations on the new-onset T2DM was evaluated with a multiparameter Cox (proportional-hazards) model.

Results

During a 3-year (2016-2019) period, the T2DM development was noted in 3.14% (249) of the subjects. The trajectory model of WCC change was divided into four groups. For participants with low stability (trajectory 1), medium stability (trajectory 2), medium stability (trajectory 3) and high stability (trajectory 4), the incidence of T2DM was separately 2.2%, 2.62%, 4.82% and 7.4%, respectively. After adjusting for the underlying confounders, new-onset T2DM HRs (95% CIs) for trajectories 3 and 4 were separately 1.94 (1.32 to 2.83) and 3.08 (1.82 to 5.21) compared with the trajectory 1, implying that the T2DM risks were statistically significantly high.

Conclusion

The 3-year T2DM incidence was impacted independently by the WCC trajectory fluctuations. The grouping trajectory can reflect the dynamic change of WCC over time, which is more representative than the measured WCC at a single time point.

SUBMITTER: Yang T

PROVIDER: S-EPMC9490632 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Publications

White cell count trajectory and type 2 diabetes in health management population: a retrospective cohort study.

Yang Tengfei T Zhao Bo B Guan Xuelai X Pei Dongmei D

BMJ open 20220920 9

<h4>Objective</h4>The purposes of current research were to investigate the time-dependent dynamic alteration of white cell count (WCC) in health management populations and to analyse its association with the type 2 diabetes mellitus (T2DM).<h4>Design</h4>Retrospective cohort research.<h4>Setting</h4>Shengjing Hospital of China Medical University in China's Shenyang.<h4>Participants</h4>The number of non-diabetic subjects (median age: 40 years) totaled 7924 in the present work.<h4>Primary and sec ...[more]

PMID: 36127085

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Project description:BackgroundClinical inertia can lead to poor glycemic control among type 2 diabetes patients. However, there is paucity of information on clinical inertia in low- and middle-income countries including Malaysia. This study aimed to determine the time to treatment intensification among T2D patients with HbA1c of ≥7% (≥53 mmol/mol) in Malaysian public health clinics. The proportion of patients with treatment intensification and its associated factors were also determined.Material and methodsThis was a five-year retrospective open cohort study using secondary data from the National Diabetes Registry. The study setting was all public health clinics (n = 47) in the state of Negeri Sembilan, Malaysia. Time to treatment intensification was defined as the number of years from the index year until the addition of another oral antidiabetic drug or initiation of insulin. Life table survival analysis based on best-worst case scenarios was used to determine the time to treatment intensification. Discrete-time proportional hazards model was fitted for the factors associated with treatment intensification.ResultsThe mean follow-up duration was 2.6 (SD 1.1) years. Of 7,646 patients, the median time to treatment intensification was 1.29 years (15.5 months), 1.58 years (19.0 months) and 2.32 years (27.8 months) under the best-, average- and worst-case scenarios respectively. The proportion of patients with treatment intensification was 45.4% (95% CI: 44.2-46.5), of which 34.6% occurred only after one year. Younger adults, overweight, obesity, use of antiplatelet medications and poorer HbA1c were positively associated with treatment intensification. Patients treated with more oral antidiabetics were less likely to have treatment intensification.ConclusionClinical inertia is present in the management of T2D patients in Malaysian public health clinics. We recommend further studies in lower- and middle-income countries to explore its causes so that targeted strategies can be developed to address this issue.

Dataset Information

White cell count trajectory and type 2 diabetes in health management population: a retrospective cohort study.

Objective

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusion

Publications

White cell count trajectory and type 2 diabetes in health management population: a retrospective cohort study.

Similar Datasets

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