@article{430680cc33ec46af9baf0b652c0a6b74,
title = "Projecting the Incidence of Type 2 Diabetes–Related End-Stage Kidney Disease Until 2040: A Comparison Between the Effects of Diabetes Prevention and the Effects of Diabetes Treatment",
abstract = "OBJECTIVE This study sought to examine the effects of two diabetes prevention approaches and of widespread use of sodium–glucose cotransporter 2 inhibitors (SGLT2is) among people with diabetes on the future incidence of diabetes-related end-stage kidney disease (ESKD-D). RESEARCH DESIGN AND METHODS We developed a life table model to project the incidence of ESKD-D for type 2 diabetes in Australia until 2040. We projected incident ESKD-D under three separate scenarios: a large-scale lifestyle modification program for diabetes prevention; a population-wide sugar-sweetened beverage tax for diabetes prevention; and widespread use of SGLT2is among people with diabetes. RESULTS Assuming current trends, we projected that the annual incidence of ESKD-D will increase from 3.7 per 100,000 of the general population in 2014 to 5.7 by 2040. Incorporating the diabetes prevention approaches, we projected that the annual incidence of ESKD-D will be between 5.2 and 5.5 per 100,000 by 2040. When we modeled scenarios in which 50\% and 70\% of eligible people with diabetes were prescribed an SGLT2i, the annual incidence of ESKD-D by 2040 was projected to be 4.7 and 4.3 per 100,000, respectively. SGLT2is were projected to reduce the total number of incident ESKD-D cases between 2020 and 2040 by 12–21\% compared with current trends, whereas diabetes prevention reduced cases by 1–3\%. CONCLUSIONS It is likely that the number of people developing ESKD-D will increase over the coming decades, although widespread SGLT2i use will be effective at limiting this increase. Diabetes prevention will be crucial to prevent an ever-increasing burden of diabetes complications.",
author = "Morton, \{Jedidiah I.\} and McDonald, \{Stephen P.\} and Agus Salim and Danny Liew and Shaw, \{Jonathan E.\} and Magliano, \{Dianna J.\}",
note = "Funding Information: The data here have been supplied by ANZDATA. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of ANZDATA. Funding Information: The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of ANZDATA. Funding. J.I.M. is supported by an Australian Government Research Training Program (RTP) Scholarship and Monash Graduate Excellence Scholarship from Monash University. J.E.S. is supported by a National Health and Medical Research Council Investigator Grant. D.J.M. is supported by a National Health and Medical Research Council Senior Research Fellowship. This work is partially supported by the Victorian Government{\textquoteright}s Operational Infrastructure Support Program. ANZDATA is funded by the Australian Organ and Tissue Authority, the New Zealand Ministry of Health, and Kidney Health Australia. Duality of Interest. J.E.S. has received honoraria for lectures and consultancies from As-traZeneca, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, Merck Sharp \& Dohme, and Pfizer. S.P.M. holds an Investigator Initiated Research grant from Baxter. ANZDATA has received untied grants from Astellas Pharmaceuticals. No other potential conflicts of interest relevant to this article were reported. Author Contributions. J.I.M. contributed to the design of the study and interpretation of data, performed the analysis and literature search, and wrote and revised the manuscript. S.P.M. contributed to the design of the study, acquisition and interpretation of data, and revision of the manuscript. A.S. contributed to the design of the study and revision of the manuscript. D.L. contributed to interpretation of data and revision of the manuscript. J.E.S. and D.J.M. are principal investigators and made contributions to the design of the study, acquisition and interpretation of the data, and revision of the manuscript. J.I.M. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Prior Presentation. Parts of this study were presented in abstract form at the Australasian Diabetes Congress 2020, virtual, 11–13 November 2020. Publisher Copyright: {\textcopyright} 2021 by the American Diabetes Association.",
year = "2021",
month = jul,
doi = "10.2337/DC21-0220",
language = "English",
volume = "44",
pages = "1515--1523",
journal = "Diabetes Care",
issn = "0149-5992",
publisher = "American Diabetes Association Inc.",
number = "7",
}