The impact of type 2 diabetes mellitus on longevity using the United Kingdom primary care electronic health records

Ncube, Njabulo (2022) The impact of type 2 diabetes mellitus on longevity using the United Kingdom primary care electronic health records. Doctoral thesis, University of East Anglia.

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Previous researchers have mainly focused on pharmacosurveillance outcomes on type 2 diabetes mellitus (T2DM) patients and there is limited literature on studies that the impact of T2DM on longevity compared to non-diabetics in the United Kingdom (UK). Several of these pharmacosurveillance studies were clinical trials which with fewer selected recruited patients. Data collected from routine electronic health records (EHR) could provide insights in longevity in the general population as opposed to selected people.

The primary aims of this study were to investigate how incidence of T2DM affects longevity in the residents of the UK adjusting for several risk factors at entry into the study. This was followed by translating the resultant model into a life expectancy model for comparisons of survival prospect between people with and without T2DM.

Medical records from 2000 to 2016, inclusive, from general practice (GP) contributing to The Health Improvement Network (THIN) database were used to develop three specific models: two performed to estimate the hazard of all-cause mortality associated with T2DM taking into account age at diagnosis (grouped and continuous age) using time-to-event as time-scale and the third to calculate the life expectancy with age as time-scale. The models were multilevel Gompertz-double-Cox with frailty regressions adjusting for socio-demographics, comorbidities and lifestyle factors. Accurately estimated life expectancies could inform future medical management by clinicians and financial planning by individuals, actuaries, insurance stakeholders and government on social security, such as retirement and life insurance.

The research found that the hazards associated with T2DM were reduced than findings in previous studies. The years of life lost to a person in medium deprived area due to T2DM after adjusted for birth cohort and age at diagnosis was between 0.1 and 6 years.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Science > School of Computing Sciences
Depositing User: Chris White
Date Deposited: 22 Mar 2023 14:08
Last Modified: 22 Mar 2023 14:08


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