title: Cardiovascular complications and drug prescriptions in subjects with and without diabetes in a Northern region of Italy, in 2002 and 2012.
abstract: In contrast to the well-documented global prevalence of diabetes, much less is known about the epidemiology of cardiovascular (CV) complications in recent years. We describe the incidence of major CV events, deaths and drug prescribing patterns from 2002 to 2012 in subjects with (DM) or without diabetes mellitus (No DM).
  
  
  
  Subjects and outcomes were identified using linkable health administrative databases of Lombardy, a region in Northern Italy. A logistic regression model was used to compare myocardial infarction (MI), stroke, major amputation and death between DM and No DM in 2002 and 2012 and between the two index years in each population. The interaction between years and diabetes was introduced in the model. From 2002 to 2012 the incidence of major CV complications and death fell in both groups with a larger reduction among DM only for CV events: OR (95% CI) for the interaction 0.86 (0.79-0.93) for MI, 0.89 (0.82-0.96) for stroke, 0.78 (0.57-1.06) for major amputations. CV prevention drugs rose considerably from 2002 to 2012 particularly in DM and a switch towards safer antihyperglycemic drugs was also observed.
  
  
  
  Major CV complications and death declined from 2002 to 2012 in both DM and No DM. This might be due to a larger increase in prescriptions of CV drugs in DM and a relevant change toward recommended antihyperglycemic drugs.
authors.affiliation: Laboratory of Cardiovascular Prevention, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. Electronic address: marta.baviera@marionegri.it.
authors.forename: M
authors.initials: M
authors.lastname: Baviera
authors.affiliation: Laboratory of Cardiovascular Prevention, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Avanzini
authors.affiliation: Laboratory of Cardiovascular Prevention, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Marzona
authors.affiliation: Laboratory of Geriatric Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Tettamanti
authors.affiliation: Laboratory of Cardiovascular Prevention, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Vannini
authors.affiliation: Laboratory of Quality Assessment of Geriatric Therapies and Services, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Cortesi
authors.affiliation: Regional Health Ministry, Lombardy Region, Milan, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Fortino
authors.affiliation: Regional Health Ministry, Lombardy Region, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bortolotti
authors.affiliation: Regional Health Ministry, Lombardy Region, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Merlino
authors.affiliation: Diabetology Unit, Department of Internal Medicine, Ospedali Riuniti di Bergamo, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Trevisan
authors.affiliation: Laboratory of Cardiovascular Prevention, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Roncaglioni
mesh_terms: D000067575:Administrative Claims, Healthcare; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*; D016208:Databases, Factual; D048909:Diabetes Complications / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D011307:Drug Prescriptions; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010818:Practice Patterns, Physicians'; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents
keywords: Antidiabetic drugs; Databases research; Death; Diabetes complications