Chiou SJ, Kung PT, Naessens JM, Huang KH, Chang YC, Wang YH, Tsai WC. Do physicians with diabetes have differences in dialysis use and survival than other patients with diabetes.
Diabetes Res Clin Pract 2014;
105:382-90. [PMID:
25088403 DOI:
10.1016/j.diabres.2014.07.004]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/10/2014] [Accepted: 07/05/2014] [Indexed: 11/24/2022]
Abstract
AIMS
To assess whether the increased knowledge and resources available to physicians led to differences in dialysis and survival rates between physicians and non-physician patients with diabetes.
METHODS
All newly diagnosed (1997-2009) type 2 diabetes patients aged ≥35 years from the National Health Insurance Program of Taiwan database were included. After propensity score matching (1:10), we estimated the relative risk of dialysis and death using Cox proportional hazards model adjusted for demographic characteristics and comorbidities.
RESULTS
Physicians with diabetes were more likely to start dialysis than general patients, with a 48% increased hazard risk (HR) (P=0.006). Physicians with diabetes had significantly lower risk of death (HR: 0.88; P=0.025). However, those requiring dialysis had a non-significant increased risk of death (HR: 1.19). There was an increased HR for death in older physicians (HR: 1.81; P<0.001) and those with cancer or catastrophic illness. The HR of dialysis (7.89; P<0.0001) increased dramatically with increasing Charlson Comorbidity Index scores.
CONCLUSIONS
Physicians with DM survived longer than other patients with diabetes, likely benefiting from their professional resources in disease control and prevention. Nonetheless, they displayed no advantage from their medical backgrounds compared with the general patients if they developed end stage renal disease.
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