Disease management, outcomes, and healthcare resource utilization in real-life clinical practice of diabetes and diabetic kidney disease in Finland - UTU Research Portal

A1 Refereed original research article in a scientific journal

Disease management, outcomes, and healthcare resource utilization in real-life clinical practice of diabetes and diabetic kidney disease in Finland

Authors: Laine, Merja K.; Haapala, Mervi; Uusi-Rauva, Kristiina; Aakko, Juhani; Pentikäinen, Markku; Mikkola, Kirsi; Halonen, Nami; Pulkki, Kari; Säävuori, Niina; Groop, Per-Henrik; Metsärinne, Kaj

Publisher: Elsevier

Publication year: 2026

Journal: Diabetes Research and Clinical Practice

Article number: 113067

Volume: 231

ISSN: 0168-8227

eISSN: 1872-8227

DOI: https://doi.org/10.1016/j.diabres.2025.113067

Publication's open availability at the time of reporting: No Open Access

Publication channel's open availability : Partially Open Access publication channel

Web address : https://doi.org/10.1016/j.diabres.2025.113067

Abstract

Aims

A significant number of individuals with diabetes have chronic kidney disease (CKD). Delays in diagnosis and management of CKD hinder treatment initiation and worsen outcomes. The adherence to monitoring and pharmacological treatments is poorly characterized worldwide.

Methods

We determined the prevalence, outcomes, treatment adherence, and healthcare resource utilization in individuals with type 1 (T1D) or type 2 (T2D) diabetes managed since 2008 in Finland. The management of CKD, glucose monitoring, and outcomes by SGLT-2 inhibitor (SGLT-2i) discontinuation were determined in large subpopulations.

Results

The prevalence of diabetes was 9.9 % in 2021. Despite having averaged 40–50 healthcare contacts per year, only one-third completed the recommended annual urine albumin-creatinine ratio (UACR) test. Factors positively associated with UACR test adherence included older age, male sex, T2D, higher HbA_1c values, municipality, and calendar year. In T1D, 29 %, and in T2D, 75 % had HbA_1c ≤ 53 mmol/mol. SGLT-2i was prescribed to 19 % of individuals with diabetes but one-third discontinued within a year, accompanied by a trend towards increased occurrence of kidney complications and heart failure.

Conclusions

Individuals with diabetes remain neglected for albuminuria screening, pharmacological management of complications, and also glycemic control in T1D, underlining an urgent need for improved awareness and risk management.

Funding information in the publication:
This study was funded by Bayer Oy. The funding source participated in study concept/design, interpretation of results, writing of the manuscript and the decision to submit the article for publication.