Background: Type 2 diabetes (T2D) has been rising in Europe, leading to increased morbidity and mortality among affected patients, which may reflect differences in patient management practices too. Identifying diseases in large databases from different countries presents challenges, since definitions vary due to unique practices.
Objectives: This study aims to estimate the prevalence of people with T2D (PwT2D), to identify clinical outcomes following the diagnosis of T2D, and to describe the treatment management landscape from a large database in France compared to published data from the UK using the Clinical Practice Research Datalink (CPRD).
Methods: A representative sample of the Système National des Données de Santé (SNDS), the échantillon général des bénéficiaires (EGB) was used to evaluate T2D prevalence in France. PwT2D were identified between 2012-2018 with ICD-10 codes or at least 3 antidiabetic medication reimbursements in 12 months, and followed until December 31, 2019. Patients were excluded if they had a type 1 diabetes code combined with insulin monotherapy. Definitions were based on literature and clinical experts in France. Point prevalence of T2D was calculated on December 31, 2018, among the adult population. Descriptive statistics were used to depict patient characteristics and management practices, such as the use of antidiabetic treatments and glucose monitoring devices, frequency of lab tests and outpatient visits, in addition to clinical outcomes, such as cardiovascular disease (CVD), cerebrovascular disease, and mortality.
Results: In the EGB, 45,331 PwT2D were identified, and T2D point-prevalence in France was 64.6 per 1000 on December 31, 2018. The mean age was 61.0 years, and 45.7% were female. Overall, 95.2% were treated with antidiabetic medications, where biguanides (78.0%) and sulfonylureas (44.0%) were common. The mean frequency of blood/urine glucose lab tests was 3.9 per patient per year, and 54.4% of the cohort had records of using glucose monitoring devices. The mean frequency of outpatient visits was 18.3 per patient per year. During follow-up, 34.0% were diagnosed with a CVD, 10.5% were diagnosed with cerebrovascular disease, and 18.0% died. The assessments of published data from the UK CPRD database suggest similarities in treatment management. While broadly comparable, T2D prevalence and frequency of clinical outcomes varied depending on study and definitions used.
Conclusions: Results suggest there may be comparable prevalence, as well as similarities and differences in patient management and clinical outcomes of PwT2D in France and the UK. Further research should be performed to continue evaluating T2D at a global scale.
