{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T22:25:18Z","timestamp":1791584718166,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T00:00:00Z","timestamp":1650326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014091","name":"AstraZeneca AB","doi-asserted-by":"publisher","award":["GPP3"],"award-info":[{"award-number":["GPP3"]}],"id":[{"id":"10.13039\/501100014091","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine how the development of cardiovascular and renal disease (CVRD) translates to hospital healthcare costs in individuals with type 2 diabetes (T2D) initially free from CVRD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were obtained from the digital healthcare systems of 12 nations using a prespecified protocol. A fixed country\u2010specific index date of 1 January was chosen to secure sufficient cohort disease history and maximal follow\u2010up, varying between each nation from 2006 to 2017. At index, all individuals were free from any diagnoses of CVRD (including heart failure [HF], chronic kidney disease [CKD], coronary ischaemic disease, stroke, myocardial infarction [MI], or peripheral artery disease [PAD]). Outcomes during follow\u2010up were hospital visits for CKD, HF, MI, stroke, and PAD. Hospital healthcare costs obtained from six countries, representing 68% of the total study population, were cumulatively summarized for CVRD events occurring during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 1.2 million CVRD\u2010free individuals with T2D were identified and followed for 4.5\u2009years (mean), that is, 4.9 million patient\u2010years. The proportion of individuals indexed before 2010 was 18% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0207\u2009137); 2010\u20102015, 31% (361\u2009175); and after 2015, 52% (609\u2009095). Overall, 184\u2009420 (15.7%) developed CVRD, of which cardiorenal disease was most frequently the first disease to develop (59.7%), consisting of 23.0% HF and 36.7% CKD, and more common than stroke (16.9%), MI (13.7%), and PAD (9.7%). The total cumulative cost for CVRD was US$1 billion, of which 59.0% was attributed to cardiorenal disease, 3\u2010, 5\u2010, and 6\u2010fold times greater than the costs for stroke, MI, and PAD, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Across all nations, HF or CKD was the most frequent CVRD manifestation to develop in a low\u2010risk population with T2D, accounting for the highest proportion of hospital healthcare costs. These novel findings highlight the importance of cardiorenal awareness when planning healthcare.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.14698","type":"journal-article","created":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T17:31:43Z","timestamp":1648143103000},"page":"1277-1287","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Cost of healthcare utilization associated with incident cardiovascular and renal disease in individuals with type 2 diabetes: A multinational, observational study across 12 countries"],"prefix":"10.1111","volume":"24","author":[{"given":"Anna","family":"Norhammar","sequence":"first","affiliation":[{"name":"Cardiology Unit, Department of Medicine Solna, Karolinska Institute  Stockholm Sweden"},{"name":"Capio St G\u00f6rans Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5423-3967","authenticated-orcid":false,"given":"Johan","family":"Bodegard","sequence":"additional","affiliation":[{"name":"AstraZeneca  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2639-9481","authenticated-orcid":false,"given":"Jan W.","family":"Eriksson","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Clinical Diabetes and Metabolism Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Haller","sequence":"additional","affiliation":[{"name":"Division of Nephrology Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard C. M.","family":"Linssen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital Group Twente  Almelo and Hengelo The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amitava","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics University College London  London UK"},{"name":"Department of Cardiology University College London Hospitals  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avraham","family":"Karasik","sequence":"additional","affiliation":[{"name":"Maccabi Institute for Research and Innovation Maccabi Healthcare Services  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavlos","family":"Mamouris","sequence":"additional","affiliation":[{"name":"Academic Center for General Practice KU Leuven  Leuven 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