TY - JOUR
T1 - Association between hyperglycaemia, diabetes complications and development of fibrotic conditions among people living with type 1 and type 2 diabetes in England
T2 - a retrospective cohort study using UK Clinical Resource Datalink Aurum and Hospital Episode Statistics
AU - DEMISTIFI Consortium
AU - Massen, Georgie May
AU - Cook, Sarah
AU - Moss, Samuel T.
AU - Chambers, Rachel
AU - Jenkins, Gisli
AU - Allen, Richard J.
AU - Wain, Louise V.
AU - Stewart, Iain
AU - Oliver, Nick
AU - Morganstein, Daniel L.
AU - Quint, Jennifer K.
AU - Thorley, Andrew
AU - Duckworth, Anna
AU - Mohammadi-Nejad, Ali Reza
AU - Aravinthan, Aloysious
AU - Harbottle, Anthony
AU - Villalon, Armando Mendez
AU - Scotton, Chris
AU - Denton, Christopher
AU - Lea, Daniel
AU - Auer, Dorothee
AU - Joof, Ebrima
AU - Cox, Eleanor
AU - Eves, Elizabeth
AU - Robertson, Elizabeth
AU - Blamont, Emma
AU - Khan, Fasihul
AU - Parcesepe, Gina
AU - Moran, Gordon
AU - Aithal, Guruprasad
AU - Longhurst, Hilary
AU - Paxton, Jane
AU - Hanley, Karen Piper
AU - Frost, Kate
AU - Casmino, Leo
AU - Chakrabarti, Lisa
AU - Roeth, Margot
AU - Kaisar, Maria
AU - Craig, Martin
AU - Nation, Michael
AU - Kisomi, Mohammad Alireza
AU - Zeybel, Mujdat
AU - Guha, Neil
AU - Selby, Nicholas
AU - Selby, Nick
AU - Leavy, Olivia C.
AU - Gowland, Penny
AU - Quinlan, Philip
AU - Hubbard, Richard
AU - Slack, Rob
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.
PY - 2025/10/27
Y1 - 2025/10/27
N2 - Objective Fibrosis is a pathological feature that can occur in a wide range of diseases including diabetes mellitus. We investigated whether in people with type 1 (T1DM) or type 2 diabetes mellitus (T2DM), glycaemia or diabetes-related complications are associated with fibrotic diseases. Design and setting Retrospective cohort study using UK Clinical Resource Datalink (CPRD) Aurum and Hospital Episode Statistics. Participants We included people with prevalent T1DM or T2DM as of 31 December 2015 (recorded in CPRD Aurum), eligible for linkage with Hospital Episode Statistics and followed up for 3 years. Outcome measures We defined diabetes status using blood/urine biomarkers and complications. In the T2DM cohort, we also investigated exposures of hyperglycaemia, insulin resistance and metformin prescription. Fibrotic condition diagnoses were determined from both primary and secondary care records. Logistic regression analyses were undertaken to understand the strength of association between diabetes status/diabetic complications and fibrotic conditions, respectively. Results The T1DM cohort consisted of 9669 people while the T2DM cohort included 504 066 people. In T1DM, we found that albuminuria was associated with lung fibrosis (ORadj: 2.07, 99% CI 1.35 to 2.17), and microvascular complications were associated with atherosclerosis (ORadj: 1.81, 99% CI 1.18 to 2.77) and cardiomyopathy (ORadj 1.53, 99% CI:1.15 to 2.04). In the T2DM cohort, both glycaemia above target and diabetes complications were associated with most fibrotic conditions. Conclusions Within the T1DM population, no consistent association between diabetes status and all fibrotic diseases was observed. More research is required to understand whether the association between diabetes complications and fibrotic diseases is due to shared risk factors or whether glycaemia in T2DM may be influenced by fibrotic pathology.
AB - Objective Fibrosis is a pathological feature that can occur in a wide range of diseases including diabetes mellitus. We investigated whether in people with type 1 (T1DM) or type 2 diabetes mellitus (T2DM), glycaemia or diabetes-related complications are associated with fibrotic diseases. Design and setting Retrospective cohort study using UK Clinical Resource Datalink (CPRD) Aurum and Hospital Episode Statistics. Participants We included people with prevalent T1DM or T2DM as of 31 December 2015 (recorded in CPRD Aurum), eligible for linkage with Hospital Episode Statistics and followed up for 3 years. Outcome measures We defined diabetes status using blood/urine biomarkers and complications. In the T2DM cohort, we also investigated exposures of hyperglycaemia, insulin resistance and metformin prescription. Fibrotic condition diagnoses were determined from both primary and secondary care records. Logistic regression analyses were undertaken to understand the strength of association between diabetes status/diabetic complications and fibrotic conditions, respectively. Results The T1DM cohort consisted of 9669 people while the T2DM cohort included 504 066 people. In T1DM, we found that albuminuria was associated with lung fibrosis (ORadj: 2.07, 99% CI 1.35 to 2.17), and microvascular complications were associated with atherosclerosis (ORadj: 1.81, 99% CI 1.18 to 2.77) and cardiomyopathy (ORadj 1.53, 99% CI:1.15 to 2.04). In the T2DM cohort, both glycaemia above target and diabetes complications were associated with most fibrotic conditions. Conclusions Within the T1DM population, no consistent association between diabetes status and all fibrotic diseases was observed. More research is required to understand whether the association between diabetes complications and fibrotic diseases is due to shared risk factors or whether glycaemia in T2DM may be influenced by fibrotic pathology.
KW - DIABETES & ENDOCRINOLOGY
KW - EPIDEMIOLOGY
KW - Fibrosis
UR - https://www.scopus.com/pages/publications/105020181627
U2 - 10.1136/bmjopen-2025-103426
DO - 10.1136/bmjopen-2025-103426
M3 - Article
C2 - 41145255
AN - SCOPUS:105020181627
SN - 2044-6055
VL - 15
JO - BMJ Open
JF - BMJ Open
IS - 10
M1 - e103426
ER -
