The proposed EHR-based approach will quantify the T2DM severity for primary care performance management and inform the methodology for measuring severity of other primary care-managed chronic conditions .
INTRODUCTION The increasing prevalence of type 2 diabetes mellitus ( T2DM ) presents a significant burden on affected individuals and healthcare systems internationally .
There is , however , no agreed vali date d measure to infer diabetes severity from electronic health records ( EHRs ) .
We aim to quantify T2DM severity and vali date it using clinical adverse outcomes .
Prevalence, incidence, predictors and outcome of type 2 diabetes in Turkey.
OBJECTIVES To investigate prospect ively the incidence , certain predictors and outcomes of type 2 diabetes ( DM ) , as well as to determine its prevalence cross-sectionally , in a representative sample of Turkish men and women . METHODS Prospect i ve evaluation of 3401 male and female participants ( aged 48.2 + /-12 years ) . Follow-up constituted 19,050 person-years . Individuals with DM were diagnosed with criteria of the American Diabetes Association .  Fatal and nonfatal coronary heart disease ( CHD ) was identified by clinical findings and Minnesota coding of resting electrocardiograms . Cut-points of > or = 95 cm in males and > or = 91 cm in females were selected for abdominal obesity . For prospect i ve evaluations , cases with DM or CHD were excluded . RESULTS Prevalence of  DM in Turkish adults was estimated as 2.89 million ( 11.0 % of the population aged > or = 35 years ) . Over a mean follow-up of 5.9 years , incident DM developed in 223 subjects , yielding an incidence per 1000 person-years of 11.0 in women and 12.4 in men . This corresponded to a 300,000 annual incidence . Following risk parameter levels but not HDL-cholesterol were significantly elevated at baseline in subjects developing DM compared to those without : age ( 5 years ) , waist girth ( 7 cm ) , blood pressure ( 12/6 mmHg ) , apolipoprotein B ( 7 mg/dl ) , total cholesterol ( 14 mg/dl ) , and fasting triglycerides ( only in women , 52 mg/dl ) . Abdominal obesity ( RR 2.61 [ 95%CI 1.87 ; 3.63 ] ) and age in both genders , hypertension ( RR 1.81 [ 95%CI 1.10 ; 2.98 ] ) and low HDL-cholesterol in men alone were significant independent predictors of DM . Diabetes mellitus was a significant and independent predictor of fatal and nonfatal CHD , with a RR of 1.81 ( 95%CI 1.19 ; 2.75 ) , after adjustment for sex , age , hypertension , waist circumference , serum total cholesterol and smoking status . CONCLUSIONS The annual incidence of DM in Turkey rises very rapidly , currently st and s at 300,000 , and , hence , its prevalence also rises correspondingly . Insulin resistance appears to be a weak determinant of DM in Turkish women while abdominal obesity is the main determinant . Multivariately adjusted DM is a significant independent predictor of fatal and nonfatal CHD . These observations emphasize that measures to reverse or stop the " epidemic " of abdominal obesity are severely required
The proposed EHR-based approach will quantify the T2DM severity for primary care performance management and inform the methodology for measuring severity of other primary care-managed chronic conditions .
INTRODUCTION The increasing prevalence of type 2 diabetes mellitus ( T2DM ) presents a significant burden on affected individuals and healthcare systems internationally .
There is , however , no agreed vali date d measure to infer diabetes severity from electronic health records ( EHRs ) .
We aim to quantify T2DM severity and vali date it using clinical adverse outcomes .