{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T08:24:58Z","timestamp":1776414298156,"version":"3.51.2"},"reference-count":18,"publisher":"BMJ","issue":"10","funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,8,30]]},"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This is a retrospective cohort study using observational data from anonymised primary care records. We identify and extract all patients with type 2 diabetes and associated clinical data from the Clinical Practice Research Datalink (CPRD) to inform models of disease progression and stratification of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Data were extracted from CPRD on 8 August 2016. The initial data set contained all patients (n=313\u2009485) in the database who had received a type 2 diabetes medication. Criteria were applied to identify and exclude those with type 1 diabetes, polycystic ovarian syndrome or other forms of diabetes (n=40\u2009204), and for data quality control (n=12). We identified 251\u2009338 patients for inclusion in future analyses of diabetes progression and treatment response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings to date<\/jats:title>\n                    <jats:p>For 6-month response to treatment, measured by change in glycated haemoglobin (HbA1c), we have 91\u2009765 patients with 119\u2009785 treatment response episodes. The greatest impact on reduction of HbA1c occurs with first-line and second-line treatments, metformin and sulfonylurea. Patients moving to third-line treatments tend to have greater weights and higher body mass index. We have investigated the impact of non-adherence to commonly used glucose-lowering medications on HbA1c. For baseline-adjusted HbA1c change over 1\u2009year, non-adherent patients had lower HbA1c reductions than adherent patients, with mean and 95% CI of \u22124.4 (\u22124.7 to \u22124.0) mmol\/mol (\u22120.40 (\u22120.43 to \u22120.37) %).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Future plans<\/jats:title>\n                    <jats:p>Findings from studies using these data will help inform future treatment plans and guidelines. Additional data are added with updates from CPRD. This will increase the numbers of patients on newer medications and add more data on those already receiving treatment. There are several ongoing studies investigating different hypotheses regarding differential response to treatment and progression of diabetes. For side effects, links to Hospital Episode Statistics data, where severe events such as hypoglycaemia will be recorded, will also be explored.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-017989","type":"journal-article","created":{"date-parts":[[2017,10,12]],"date-time":"2017-10-12T10:00:51Z","timestamp":1507802451000},"page":"e017989","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Cohort profile for the MASTERMIND study: using the Clinical Practice Research Datalink (CPRD) to investigate stratification of response to treatment in patients with type 2 diabetes"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5040-3073","authenticated-orcid":false,"given":"Lauren R","family":"Rodgers","sequence":"first","affiliation":[{"name":"Institute of Health Research, University of Exeter Medical School, Exeter, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael N","family":"Weedon","sequence":"additional","affiliation":[{"name":"Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William E","family":"Henley","sequence":"additional","affiliation":[{"name":"Institute of Health Research, University of Exeter Medical School, Exeter, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew T","family":"Hattersley","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beverley M","family":"Shields","sequence":"additional","affiliation":[{"name":"NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,10,12]]},"reference":[{"key":"2025121512520208000_7.10.e017989.1","unstructured":"National Institute for Health and Care Excellence. Type 2 diabetes in adults: management. NICE guideline 2015."},{"key":"2025121512520208000_7.10.e017989.2","doi-asserted-by":"crossref","DOI":"10.2337\/dc15-0258","article-title":"Markers of \u03b2-cell failure predict poor glycemic response to GLP-1 receptor agonist therapy in type 2 diabetes","volume":"39","author":"Jones","year":"2016","journal-title":"Diabetes Care"},{"key":"2025121512520208000_7.10.e017989.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1326.2010.01248.x"},{"key":"2025121512520208000_7.10.e017989.4","doi-asserted-by":"publisher","DOI":"10.1177\/2042098611435911"},{"key":"2025121512520208000_7.10.e017989.5","unstructured":"MHRA. Release Notes \u2013 CPRD GOLD, 2017."},{"key":"2025121512520208000_7.10.e017989.6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001711"},{"key":"2025121512520208000_7.10.e017989.7","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2011-000681"},{"key":"2025121512520208000_7.10.e017989.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0099825","article-title":"ClinicalCodes: an online clinical codes repository to improve the validity and reproducibility of research using electronic medical records","volume":"9","author":"Springate","year":"2014","journal-title":"PLoS One"},{"key":"2025121512520208000_7.10.e017989.9","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1770"},{"key":"2025121512520208000_7.10.e017989.10","doi-asserted-by":"publisher","DOI":"10.1002\/sim.5925"},{"key":"2025121512520208000_7.10.e017989.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g5511"},{"key":"2025121512520208000_7.10.e017989.12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"2025121512520208000_7.10.e017989.13","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2013-132068"},{"key":"2025121512520208000_7.10.e017989.14","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s13104-016-2365-z","article-title":"Longitudinal multiple imputation approaches for body mass index or other variables with very low individual-level variability: the mibmi command in Stata","volume":"10","author":"Kontopantelis","year":"2017","journal-title":"BMC Res Notes"},{"key":"2025121512520208000_7.10.e017989.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2009.02898.x"},{"key":"2025121512520208000_7.10.e017989.16","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-1194"},{"key":"2025121512520208000_7.10.e017989.17","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jclinepi.2017.04.022","article-title":"Adjusting for unmeasured confounding in nonrandomized longitudinal studies: a methodological review","volume":"87","author":"Streeter","year":"2017","journal-title":"J Clin Epidemiol"},{"key":"2025121512520208000_7.10.e017989.18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b81"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-017989","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:52:08Z","timestamp":1765831928000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-017989"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10]]},"references-count":18,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2017,10,12]]},"published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.1136\/bmjopen-2017-017989"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-017989","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10]]}}}