Diabetes research and clinical practice · 2026
Predicted risk of death and frequency of outpatient follow-up visits in diabetes clinics. Insight from the large, real-life Italian AMD-Annals database.
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De Cosmo Salvatore A, Lucisano Giuseppe, Nicolucci Antonio, Copetti Massimiliano, Menzaghi Claudia, Cianni Graziano Di, Russo Giuseppina, Candido Riccardo, Trischitta Vincenzo, AMD-Annals Study Group
Аннотация
AIMS: To investigate, in Italian patients with type 2 diabetes, whether the frequency of outpatient visits was associated with the predicted individual risk of death (a measurable proxy of the need of care).
METHODS: Data on patients with type 2 diabetes who attended AMD-Annals, a network of Italian diabetes clinics, between 2017 and 2023 were analyzed in two three-year periods: 2021-2023 and 2017-2019 (the latter used as a validation sample). The predicted risk of death was estimated using ENFORCE and RECODe, two established all-cause mortality equations in type 2 diabetes.
RESULTS: Complete data on mortality risk scores were available for 45,676 individuals. In 2021-2023, the annual number of patient visits was not associated with the risk of death predicted by either ENFORCE or RECODe, in both univariate and multivariate models. Also, no association was observed with either algorithm in the 2017-2019 period.
CONCLUSIONS: The frequency of follow-up visits at diabetes clinics for people with diabetes (scheduled according to empirical practices) is not associated with the predicted risk of death, a measurable indicator of individual's need of care. This suggests that the available resources could have been allocated in a more targeted manner, likely benefiting the most vulnerable individuals.
METHODS: Data on patients with type 2 diabetes who attended AMD-Annals, a network of Italian diabetes clinics, between 2017 and 2023 were analyzed in two three-year periods: 2021-2023 and 2017-2019 (the latter used as a validation sample). The predicted risk of death was estimated using ENFORCE and RECODe, two established all-cause mortality equations in type 2 diabetes.
RESULTS: Complete data on mortality risk scores were available for 45,676 individuals. In 2021-2023, the annual number of patient visits was not associated with the risk of death predicted by either ENFORCE or RECODe, in both univariate and multivariate models. Also, no association was observed with either algorithm in the 2017-2019 period.
CONCLUSIONS: The frequency of follow-up visits at diabetes clinics for people with diabetes (scheduled according to empirical practices) is not associated with the predicted risk of death, a measurable indicator of individual's need of care. This suggests that the available resources could have been allocated in a more targeted manner, likely benefiting the most vulnerable individuals.