Kamlesh Khunti

Medication burden in the first 5 years following diagnosis of type 2 diabetes: findings from the ADDITION-UK trial cohort.

Introduction Individuals with screen-detected diabetes are likely to receive intensified pharmacotherapy to improve glycaemic control and general cardiometabolic health. Individuals are often asymptomatic, and little is known about the degree to which polypharmacy is present both before, and after diagnosis. We aimed to describe and characterize the pharmacotherapy burden of individuals with screen-detected diabetes at diagnosis, 1 and 5u2005years post-diagnosis. Methods The prescription histories of 1026 individuals with screen-detected diabetes enrolled in the ADDITION-UK trial of the promotion of intensive treatment were coded into general medication types at diagnosis, 1 and 5u2005years post-diagnosis. The association between change in the count of several medication types and age, baseline 10-year UK Prospective Diabetes Study (UKPDS) cardiovascular disease (CVD risk), sex, intensive treatment group and number of medications was explored. Results Just under half of individuals were on drugs unrelated to cardioprotection before diagnosis (42%), and this increased along with a rise in the number of prescribed diabetes-related and cardioprotective drugs. The medication profile over the first 5u2005years suggests multimorbidity and polypharmacy is present in individuals with screen-detected diabetes. Higher modeled CVD risk at baseline was associated with a greater increase in cardioprotective and diabetes-related medication, but not an increase in other medications. Conclusion As recommended in national guidelines, our results suggest that treatment of diabetes was influenced by the underlying risk of CVD. While many individuals did not start glucose lowering and cardioprotective therapies in the first 5u2005years after diagnosis, more information is required to understand whether this represents unmet need, or patient-centered care. Trial registration number CNT00237549.

Does early intensive multifactorial treatment reduce total cardiovascular burden in individuals with screen-detected diabetes? Findings from the ADDITION-Europe cluster-randomized trial: Total cardiovascular burden in the ADDITION-Europe trial

Aimsu2002 To describe the total cardiovascular burden (cardiovascular morbidity or mortality, revascularization or non‐traumatic amputation) in individuals with screen‐detected diabetes in the ADDITION‐Europe trial and to quantify the impact of the intervention on multiple cardiovascular events over 5u2003years.

Biomedical, lifestyle and psychosocial characteristics of the DESMOND collaborative: Baseline data from the DESMOND randomised controlled trial.

Aimsu2003 To describe the characteristics of newly diagnosed people with Type 2 diabetes (T2DM) and compare these with published studies.