Evidence map›Paper›PMID 40874385›Full record

ArticleDiabetes, obesity & metabolism2025

Disrupted specialist outpatient services and alternative modes of service for patients with diabetes mellitus: A population-based, retrospective cohort study in Hong Kong.

Yuk Kam Yau, Meijiao Li, Jianchao Quan, Karen Ann Grépin, Gary Kui Kai Lau, Ivy Lynn Mak, Chak Sing Lau, Ian Chi Kei Wong, David Vai Kiong Chao, Welchie Wai Kit Ko and 2 more

Abstract read
In one paragraph

Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Yuk Kam YauDepartment of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Meijiao LiDepartment of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Jianchao QuanSchool of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.ORCID 0000-0002-8386-8512
Karen Ann GrépinSchool of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Gary Kui Kai LauDepartment of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Ivy Lynn MakDepartment of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Chak Sing LauDepartment of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Ian Chi Kei WongDepartment of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
David Vai Kiong ChaoDepartment of Family Medicine and Primary Health Care, United Christian Hospital, Kowloon East Cluster, Hospital Authority, Hong Kong, China.
Welchie Wai Kit KoDepartment of Family Medicine and Primary Healthcare, Hong Kong West Cluster, Hospital Authority, Hong Kong, China.
Cindy Lo Kuen LamDepartment of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Eric Yuk Fai WanDepartment of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.ORCID 0000-0002-6275-1147

Funding

Health and Medical Research Fund, Health Bureau, Government of Hong Kong Special Administrative Region COVID19F08
6 · The paper itself

Abstract

introductionReduced specialist outpatient clinic (SOPC) services during COVID-19 waves may have increased the risk of mortality and complications in patients with diabetes mellitus (DM). Evidence on whether alternative modes of service have mitigated these risks is lacking.

methodsIn this population-based, retrospective cohort study in Hong Kong, we included patients with DM between 2010 and 2019 and had internal medicine SOPC visits in 2019. We identified modes of care (SOPC, primary care clinics and drug-refill service) of these patients in 2020 and followed them from January 2021 to June 2024. Cox proportional hazards models were used to estimate risks of all-cause mortality and complications.

resultsAmong 96 372 patients, SOPC follow-up disruptions in 2020 were associated with a higher risk of all-cause mortality (hazard ratio [HR] 1.20, 95% CI 1.12-1.29) and cardiovascular diseases (CVD) incidence (HR 1.12, 95% CI 1.05-1.20). Among those affected by SOPC follow-up disruptions in 2020, patients who had attended primary care clinics in 2020 had a lower risk of all-cause mortality (HR 0.72, 95% CI 0.60-0.87) and CVD (HR 0.84, 95% CI 0.72-0.99) than those without any primary care clinic attendance visits.

conclusionSOPC service disruption was associated with increased risk of mortality and CVD among patients with DM. Primary care clinic service could be a beneficial alternative mode of service to attenuate the excessive risk. These findings support a policy that follow-up at primary care clinics should be provided for patients with DM when SOPC service is disrupted in future public health crises.

Indexed as

Ambulatory CareAmbulatory Care FacilitiesCOVID-19Diabetes MellitusAdultAgedCardiovascular DiseasesDiabetes ComplicationsFemaleHong KongHumansMaleMiddle AgedPrimary Health CareRetrospective StudiesSARS-CoV-2cardiovascular diseasesdiabetes mellitusmortalityprimary care clinicspecialist outpatient clinics

Identifiers

PMID40874385
PMCPMC12515776

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.