In people with type 2 diabetes (T2D), the body does not make enough of a hormone called insulin or does not use insulin well. This results in high blood sugar levels. People with T2D are at a higher risk of having a condition called chronic kidney disease (CKD). In people with CKD, the kidneys become damaged and do not work as they should. People with CKD can have trouble breathing and often have swelling in their arms and legs, and high blood pressure. People who have CKD and T2D are more likely to have other medical problems, such as heart disease. There are many treatments available to patients who have CKD and T2D. But, researchers need more information about how doctors in Canada are deciding which treatment to give these patients. In this study, the researchers will review health information from men and women with T2D who visited a doctor in 2019 and had check-ups for at least 6 months. The health information will be taken from a Canadian registry (or database) owned by LMC Diabetes \& Endocrinology. The registry contains information from people that went to an LMC clinic. In this study, the researchers will learn how many of these people had T2D and CKD. They will learn the treatments these people received, and if they had other related medical problems. The researchers will also use surveys to ask the doctors about why they chose certain treatments.
Study Type
OBSERVATIONAL
Enrollment
14,873
This is an Observational study that will not involve prescription of the drugs.
A Database
A Database, Canada
Proportion of patients with CKD in a large T2D population
The data will be retrieved from the LMC Diabetes Registry, a Pan-Canadian registry of diabetes community-based specialist practices and used to develop a renal registry to investigate the primary objectives of the study
Time frame: Retrospectively analysis between January 1, 2019 and December 31, 2019
Proportion of patients using the different therapies
The therapies are: ACEi, ARBs, ACEi/ARBs, MRAs, GLP-1 RA and SGLT2i
Time frame: Retrospectively analysis between January 1, 2019 and December 31, 2019
Proportion of patients with stage 1 CKD with moderate or greater albuminuria, stage 2 CKD with moderate or greater albuminuria, stage 3a CKD, stage 3b CKD, stage 4 CKD and stage 5 CKD in accordance with Canadian clinical practice guidelines
Stage 1 CKD: eGFR (estimated glomerular filtration rate) ≥ 90 ml/min/1.73 m\^2 Stage 2 CKD: eGFR between 60-89 ml/min/1.73 m\^2 Stage 3a CKD: eGFR between 45-59 ml/min/1.73 m\^2 Stage 3b CKD: eGFR between 30-44 ml/min/1.73 m\^2 Stage 4 CKD: eGFR between 15-29 ml/min/1.73 m\^2 Stage 5 CKD: eGFR \<15 ml/min/1.73 m\^2
Time frame: Retrospectively analysis between January 1, 2019 and December 31, 2019
Proportion of patients with microalbuminuria and macroalbuminuria, in accordance with Canadian clinical practice guidelines
Microalbuminuria: uACR (urine albumin-to-creatinine ratio) 2-20 mg/mmol Macroalbuminuria: uACR \> 20 mg/mmol
Time frame: Retrospectively analysis between January 1, 2019 and December 31, 2019
Proportion of patients within each albuminuria category (A1, A2 or A3), in accordance with KDIGO clinical practice guidelines
KDIGO = Kidney Disease: Improving Global Outcomes
Time frame: Retrospectively analysis between January 1, 2019 and December 31, 2019
Laboratory values for patients using either no therapy or using a therapy for ≥ 6 months
Laboratory values including glucose, glycated hemoglobin (HbA1c), lipids, creatinine, electrolytes, eGFR, and uACR
Time frame: Retrospectively analysis between January 1, 2019 and December 31, 2019
Proportion of patients with different comorbidities
Comorbidities like hypertension, dyslipidemia, microvascular disease, macrovascular disease
Time frame: Retrospectively analysis between January 1, 2019 and December 31, 2019
Proportion of healthcare provider prescriptions of RAS therapies (ACEi/ARB) used to treat hypertension, heart failure, coronary artery disease, CKD, or other condition
RAS: renin angiotensin system ACEi: angiotensin converting enzyme inhibitors ARB: angiotensin receptor blocker Healthcare providers will complete a questionnaire to determine their rationale for use of common therapies for CKD in T2D
Time frame: On the day of healthcare provider completes a questionnaire
Proportion of healthcare provider prescriptions of GLP-1 RA used to treat glycemia management, hypertension, heart failure, coronary artery disease, CKD or other condition
GLP-1 RA: glucagon-like peptide-1 receptor agonist Healthcare providers will complete a questionnaire to determine their rationale for use of common therapies for CKD in T2D
Time frame: On the day of healthcare provider completes a questionnaire
Proportion of healthcare provider prescriptions of MRAs used to treat hypertension, heart failure, coronary artery disease, CKD or other condition
MRAs: mineralocorticoid receptor antagonists Healthcare providers will complete a questionnaire to determine their rationale for use of common therapies for CKD in T2D
Time frame: On the day of healthcare provider completes a questionnaire
Proportion of healthcare provider prescriptions of SGLT2i used to treat glycemia management, hypertension, heart failure, coronary artery disease, CKD or other condition
SGLT2i: sodium-glucose co-transporter-2 inhibitors Healthcare providers will complete a questionnaire to determine their rationale for use of common therapies for CKD in T2D
Time frame: On the day of healthcare provider completes a questionnaire
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.