Trial Outcomes & Findings for Clinical Characteristics and Disease Burden of Diabetic Patients Based on Tianjin Regional Database (NCT NCT04903496)

Results Overview

Number of participants with established cardiovascular disease (CVD), chronic kidney disease (CKD), and/or high cardiovascular (CV) risk was calculated as (100%\* Number of patients with labels of interested diseases from 2015 to the given year)/ (Number of diabetic or non-diabetic patients from 2015 to the given year). To compare diabetic with non-diabetic patients within a year and across years * the arms with diabetic in- and outpatients \[Arm A and B together\] were combined * the arms with non-diabetic in- and outpatients \[Arm C and D together\] were combined by year. Patients with risk factors were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Recruitment status

COMPLETED

Target enrollment

1233162 participants

Primary outcome timeframe

up to 5 years (2015 up to 2019)

Results posted on

2024-11-12

Participant Flow

This observational, cross-sectional study, based on routinely collected data captured in the regional, electronic, data-linking Tianjin medical database between 01/01/2015 and 31/12/2019 aimed to investigate the clinical characteristics, treatment, and economic burden of disease of Chinese diabetic/non-diabetic patients with/without established cardiovascular disease, chronic kidney disease, or high cardiovascular risk.

Only participants that met all inclusion and none of the exclusion criteria were included. Participants with at least 1 diagnosis record and baseline information (birth date and sex) were identified in the Tianjin regional medical database between 01/01/2015 to 31/12/2019 and allocated in 4 (A,B,C, and D) arms. The 4 arms were mutually exclusive in each year (2015, 2017, and 2019) but not across years.

Participant milestones

Participant milestones
Measure	In- and Outpatients: Diabetic With Risk Factors (RF) [Arm A] In- and outpatients with diagnosis of diabetes, and with diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD) or at high cardiovascular (CV) risk identified in the Tianjin regional medical database.	In- and Outpatients: Diabetic Without RF [Arm B] In- and outpatients with diagnosis of diabetes, but not with diagnosis of risk factors CVD, HF, CKD or at high CV risk identified in the Tianjin regional medical database.	In- and Outpatients: Non-diabetic With RF [Arm C] In- and outpatients without diabetes but with diagnosis of risk factors CVD, HF, CKD or at high CV risk identified in the Tianjin regional medical database.	In- and Outpatients: Non-diabetic Without RF [Arm D] In- and outpatients without diabetes and without diagnosis of risk factors CVD, HF, CKD or at high CV risk identified in the Tianjin regional medical database.
Study Period 2015 STARTED	166056	113787	66525	51640
Study Period 2015 COMPLETED	166056	113787	66525	51640
Study Period 2015 NOT COMPLETED	0	0	0	0
Study Period 2017 STARTED	379826	188681	144484	123839
Study Period 2017 COMPLETED	379826	188681	144484	123839
Study Period 2017 NOT COMPLETED	0	0	0	0
Study Period 2019 STARTED	576973	253012	198099	205078
Study Period 2019 COMPLETED	576973	253012	198099	205078
Study Period 2019 NOT COMPLETED	0	0	0	0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

As per protocol baseline characteristics were calculated by year over all individual participants considering only participants with available data at their last visit.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	All in- and Outpatients [Arm A, B, C, D Together] in 2015, 2017, and 2019 n=1233162 Participants All in- and outpatients with and without diagnosis of diabetes and with and without established risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or at high cardiovascular (CV) risk.
Age, Continuous All in- and outpatients in 2015	60.1 Years STANDARD_DEVIATION 12.9 • n=398008 Participants • As per protocol baseline characteristics were calculated by year over all individual participants considering only participants with available data at their last visit.
Age, Continuous All in- and outpatients in 2017	59.3 Years STANDARD_DEVIATION 13.1 • n=580958 Participants • As per protocol baseline characteristics were calculated by year over all individual participants considering only participants with available data at their last visit.
Age, Continuous All in- and outpatients in 2019	58.9 Years STANDARD_DEVIATION 12.9 • n=680438 Participants • As per protocol baseline characteristics were calculated by year over all individual participants considering only participants with available data at their last visit.
Sex: Female, Male All in- and outpatients in 2015 · Female	195654 Participants n=398008 Participants • As per protocol baseline characteristics were calculated by year over all individual participants considering only participants with available data at their last visit.
Sex: Female, Male All in- and outpatients in 2015 · Male	202354 Participants n=398008 Participants • As per protocol baseline characteristics were calculated by year over all individual participants considering only participants with available data at their last visit.
Sex: Female, Male All in- and outpatients in 2017 · Female	287609 Participants n=580958 Participants • As per protocol baseline characteristics were calculated by year over all individual participants considering only participants with available data at their last visit.
Sex: Female, Male All in- and outpatients in 2017 · Male	293349 Participants n=580958 Participants • As per protocol baseline characteristics were calculated by year over all individual participants considering only participants with available data at their last visit.
Sex: Female, Male All in- and outpatients in 2019 · Female	335474 Participants n=680438 Participants • As per protocol baseline characteristics were calculated by year over all individual participants considering only participants with available data at their last visit.
Sex: Female, Male All in- and outpatients in 2019 · Male	344964 Participants n=680438 Participants • As per protocol baseline characteristics were calculated by year over all individual participants considering only participants with available data at their last visit.

PRIMARY outcome

Timeframe: up to 5 years (2015 up to 2019)

Population: In- and outpatients in 2015, 2017, and 2019 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, groups were combined as per protocol to 'Diabetic Patients \[Arm A and B\]' and 'Non-Diabetic Patients \[Arm C and D\]'. Arms were not mutually exclusive. Only patients with available data were included in this analysis.

Number of participants with established cardiovascular disease (CVD), chronic kidney disease (CKD), and/or high cardiovascular (CV) risk was calculated as (100%\* Number of patients with labels of interested diseases from 2015 to the given year)/ (Number of diabetic or non-diabetic patients from 2015 to the given year). To compare diabetic with non-diabetic patients within a year and across years * the arms with diabetic in- and outpatients \[Arm A and B together\] were combined * the arms with non-diabetic in- and outpatients \[Arm C and D together\] were combined by year. Patients with risk factors were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=279843 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=118165 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=568507 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=268323 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=829985 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] n=403177 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Participants With Established Cardiovascular Disease, or Chronic Kidney Disease, or High Cardiovascular Risk High cardiovascular risk	113261 Participants	52628 Participants	293826 Participants	115692 Participants	473348 Participants	159502 Participants
Number of Participants With Established Cardiovascular Disease, or Chronic Kidney Disease, or High Cardiovascular Risk With cardiovascular disease	127726 Participants	43819 Participants	295882 Participants	99128 Participants	448063 Participants	138069 Participants
Number of Participants With Established Cardiovascular Disease, or Chronic Kidney Disease, or High Cardiovascular Risk With chronic kidney disease	16143 Participants	2465 Participants	47900 Participants	7059 Participants	89826 Participants	13012 Participants

SECONDARY outcome

Timeframe: Last visit in 2015, up to 1 day

Population: In- and outpatients in 2015 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2015. Only patients with available data for this outcome were included in this analysis.

The mean age was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2015. The Arms A, B, C, D - inpatients only were mutually exclusive in 2015. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=84600 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=14322 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=21682 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=6573 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=398008 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Mean Age of Inpatients and All Participants (In-and Outpatients) at Their Last Visit in 2015	64.1 Years Standard Deviation 12.0	49.7 Years Standard Deviation 16.0	64.8 Years Standard Deviation 13.3	61.9 Years Standard Deviation 12.6	60.1 Years Standard Deviation 12.9	—

SECONDARY outcome

Timeframe: Last visit in 2017, up to 1 day

Population: In- and outpatients in 2017 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2017. Only patients with available data for this outcome were included in this analysis.

The mean age was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2017. The Arms A, B, C, D - inpatients only were mutually exclusive in 2017. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=116799 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=22212 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=26955 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=8908 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=580958 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Mean Age of Inpatients and All Participants (In-and Outpatients) at Their Last Visit in 2017	63.0 Years Standard Deviation 12.3	44.2 Years Standard Deviation 16.5	62.7 Years Standard Deviation 13.8	62.1 Years Standard Deviation 12.7	59.3 Years Standard Deviation 13.1	—

SECONDARY outcome

Timeframe: Last visit in 2019, up to 1 day

Population: In- and outpatients in 2019 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2019. Only patients with available data for this outcome were included in this analysis.

The mean age was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2019. The Arms A, B, C, D - inpatients only were mutually exclusive in 2019. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=139535 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=21549 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=28868 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=9012 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=680438 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Mean Age of Inpatients and All Participants (In-and Outpatients) at Their Last Visit in 2019	61.8 Years Standard Deviation 11.4	46.3 Years Standard Deviation 16.2	63.0 Years Standard Deviation 12.8	62.5 Years Standard Deviation 12.1	58.9 Years Standard Deviation 12.9	—

SECONDARY outcome

Timeframe: Last visit in 2015, up to 1 day

Population: In- and outpatients in 2015 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2015. Only patients with available data for this outcome were included in this analysis.

The number of female and male was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2015. The Arms A, B, C, D - inpatients only were mutually exclusive in 2015. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=84600 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=14322 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=21682 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=6573 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=398008 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Female and Male Inpatients and All Participants (In-and Outpatients) at Their Last Visit in 2015 Female	42775 Participants	7683 Participants	11709 Participants	2761 Participants	195654 Participants	—
Number of Female and Male Inpatients and All Participants (In-and Outpatients) at Their Last Visit in 2015 Male	41825 Participants	6639 Participants	9973 Participants	3812 Participants	202354 Participants	—

SECONDARY outcome

Timeframe: Last visit in 2017, up to 1 day

Population: In- and outpatients in 2017 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2017. Only patients with available data for this outcome were included in this analysis.

The number of female and male was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2017. The Arms A, B, C, D - inpatients only were mutually exclusive in 2017. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=116799 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=22212 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=26955 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=8908 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=580958 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Female and Male Inpatients and All Participants (In-and Outpatients) at Their Last Visit in 2017 Female	54221 Participants	14543 Participants	13939 Participants	3789 Participants	287609 Participants	—
Number of Female and Male Inpatients and All Participants (In-and Outpatients) at Their Last Visit in 2017 Male	62578 Participants	7669 Participants	13016 Participants	5119 Participants	293349 Participants	—

SECONDARY outcome

Timeframe: Last visit in 2019, up to 1 day

Population: In- and outpatients in 2019 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2019. Only patients with available data for this outcome were included in this analysis.

The number of female and male was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2019. The Arms A, B, C, D - inpatients only were mutually exclusive in 2019. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=139535 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=21549 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=28868 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=9012 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=680438 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Female and Male Inpatients and All Participants (In-and Outpatients) at Their Last Visit in 2019 Female	63480 Participants	14309 Participants	14894 Participants	3865 Participants	335474 Participants	—
Number of Female and Male Inpatients and All Participants (In-and Outpatients) at Their Last Visit in 2019 Male	76055 Participants	7240 Participants	13974 Participants	5147 Participants	344964 Participants	—

SECONDARY outcome

Timeframe: Last visit in 2015, up to 1 day

Population: In- and outpatients in 2015 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2015. Only patients with available data for this outcome were included in this analysis.

The number of participants with insurance payment was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2015. The Arms A, B, C, D - inpatients only were mutually exclusive in 2015. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=84600 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=14322 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=21682 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=6573 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=398008 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Inpatients and All Participants (In-and Outpatients) With Insurance Payment at Their Last Visit in 2015	57950 Participants	8489 Participants	13797 Participants	3760 Participants	340909 Participants	—

SECONDARY outcome

Timeframe: Last visit in 2017, up to 1 day

Population: In- and outpatients in 2017 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2017. Only patients with available data for this outcome were included in this analysis.

The number of participants with insurance payment was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2017. The Arms A, B, C, D - inpatients only were mutually exclusive in 2017. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=116799 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=22212 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=26955 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=8908 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=580958 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Inpatients and All Participants (In-and Outpatients) With Insurance Payment at Their Last Visit in 2017	77385 Participants	12792 Participants	16484 Participants	4467 Participants	482628 Participants	—

SECONDARY outcome

Timeframe: Last visit in 2019, up to 1 day

Population: In- and outpatients in 2019 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2019. Only patients with available data for this outcome were included in this analysis.

The number of participants with insurance payment was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2019. The Arms A, B, C, D - inpatients only were mutually exclusive in 2019. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=139535 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=21549 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=28868 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=9012 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=680438 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Inpatients and All Participants (In-and Outpatients) With Insurance Payment at Their Last Visit in 2019	94453 Participants	13508 Participants	18762 Participants	5167 Participants	543328 Participants	—

SECONDARY outcome

Timeframe: Last visit in 2015, up to 1 day

Population: In- and outpatients in 2015 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. Inpatients results \[Arm A, B, C, D\] are reported separately per arm, in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2015. Only patients with available data were included in this analysis. Patients could have records in multiple departments or could not be classified to any given department.

The number of participants in a particular discharge department was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2015. The Arms A, B, C, D - inpatients only were mutually exclusive in 2015. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses and records in multiple discharge departments simultaneously. Thus, one participant could potentially occur more than once per arm. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=84515 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=14304 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=21619 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=6573 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=397835 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2015 Department of Pediatric	210 Participants	19 Participants	66 Participants	2 Participants	417 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2015 Department of Obstetrics and Gynecology	933 Participants	3296 Participants	420 Participants	248 Participants	6897 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2015 Emergency Department	0 Participants	0 Participants	0 Participants	0 Participants	7553 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2015 Department of Mental Health	11 Participants	5 Participants	1 Participants	0 Participants	876 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2015 Department of Stomatology	97 Participants	64 Participants	42 Participants	62 Participants	3719 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2015 Department of Internal Medicine	58775 Participants	4829 Participants	14031 Participants	1513 Participants	236691 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2015 Other departments	3209 Participants	1221 Participants	680 Participants	568 Participants	85650 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2015 Department of Surgery	13877 Participants	4686 Participants	4890 Participants	4116 Participants	39274 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2015 Medical Technical Departments	19 Participants	21 Participants	2 Participants	4 Participants	2185 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2015 Department of Integrated Traditional Chinese and Western Medicine	2769 Participants	250 Participants	461 Participants	21 Participants	19206 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2015 Department of Critical Care Medicine	2467 Participants	80 Participants	678 Participants	39 Participants	2331 Participants	—

SECONDARY outcome

Timeframe: Last visit in 2017, up to 1 day

Population: In- and outpatients in 2017 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. Inpatients results \[Arm A, B, C, D\] are reported separately per arm, in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2017. Only patients with available data were included in this analysis. Patients could have records in multiple departments or could not be classified to any given department.

The number of participants in a particular discharge department was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2017. The Arms A, B, C, D - inpatients only were mutually exclusive in 2017. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses and records in multiple discharge departments simultaneously. Thus, one participant could potentially occur more than once per arm. Thus, one participant could potentially occur more than once per arm. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=116675 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=22189 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=26915 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=8908 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=580764 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2017 Department of Internal Medicine	78467 Participants	5348 Participants	16959 Participants	2046 Participants	358282 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2017 Other departments	3197 Participants	1012 Participants	751 Participants	630 Participants	111242 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2017 Department of Surgery	21583 Participants	5542 Participants	6654 Participants	5571 Participants	57355 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2017 Medical Technical Departments	181 Participants	48 Participants	59 Participants	36 Participants	2180 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2017 Department of Integrated Traditional Chinese and Western Medicine	3996 Participants	310 Participants	571 Participants	91 Participants	24076 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2017 Department of Critical Care Medicine	2623 Participants	112 Participants	664 Participants	43 Participants	2595 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2017 Department of Pediatric	35 Participants	136 Participants	13 Participants	5 Participants	422 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2017 Department of Obstetrics and Gynecology	2071 Participants	9474 Participants	659 Participants	385 Participants	15681 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2017 Emergency Department	671 Participants	66 Participants	180 Participants	14 Participants	14294 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2017 Department of Mental Health	1 Participants	0 Participants	0 Participants	2 Participants	1523 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2017 Department of Stomatology	169 Participants	83 Participants	43 Participants	85 Participants	3285 Participants	—

SECONDARY outcome

Timeframe: Last visit in 2019, up to 1 day

Population: In- and outpatients in 2019 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. Inpatients results \[Arm A, B, C, D\] are reported separately per arm, in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2019. Only patients with available data were included in this analysis. Patients could have records in multiple departments or could not be classified to any given department.

The number of participants in a particular discharge department was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2019. The Arms A, B, C, D - inpatients only were mutually exclusive in 2019. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses and records in multiple discharge departments simultaneously. Thus, one participant could potentially occur more than once per arm. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=138983 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=21549 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=28742 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=9012 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=679661 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2019 Department of Pediatric	50 Participants	229 Participants	13 Participants	8 Participants	704 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2019 Department of Obstetrics and Gynecology	2428 Participants	9362 Participants	686 Participants	319 Participants	16314 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2019 Emergency Department	723 Participants	92 Participants	130 Participants	13 Participants	18809 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2019 Department of Mental Health	9 Participants	0 Participants	1 Participants	0 Participants	1877 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2019 Department of Stomatology	183 Participants	70 Participants	54 Participants	73 Participants	3546 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2019 Department of Internal Medicine	90932 Participants	4638 Participants	17288 Participants	1916 Participants	408554 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2019 Other departments	4396 Participants	1072 Participants	879 Participants	688 Participants	131976 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2019 Department of Surgery	28099 Participants	5411 Participants	7790 Participants	5864 Participants	78429 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2019 Medical Technical Departments	189 Participants	49 Participants	72 Participants	35 Participants	3325 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2019 Department of Integrated Traditional Chinese and Western Medicine	4624 Participants	298 Participants	665 Participants	64 Participants	28303 Participants	—
Number of Inpatients and All Participants (In-and Outpatients) by Discharge Department at Their Last Visit in 2019 Department of Critical Care Medicine	3081 Participants	78 Participants	629 Participants	30 Participants	2938 Participants	—

SECONDARY outcome

Timeframe: On the last visit (1 day) in 2015 data was retrospectively assessed for the last 12 months in 2015.

Population: In- and outpatients in 2015 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2015. Only patients with available data for this outcome were included in this analysis.

The number of participants who were diagnosed as dead in 2015 was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2015. The Arms A, B, C, D - inpatients only were mutually exclusive in 2015. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=84600 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=14322 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=21682 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=6573 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=398008 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Deaths in Inpatients and All Participants (In-and Outpatients) at Their Last Visit in 2015	303 Participants	18 Participants	94 Participants	15 Participants	430 Participants	—

SECONDARY outcome

Timeframe: On the last visit (1 day) in 2017 data was retrospectively assessed for the last 12 months in 2017.

Population: In- and outpatients in 2017 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2017. Only patients with available data for this outcome were included in this analysis.

The number of participants who were diagnosed as dead in 2017 was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2017. The Arms A, B, C, D - inpatients only were mutually exclusive in 2017. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=116799 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=22121 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=26955 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=8908 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=580958 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Deaths in Inpatients and All Participants (In-and Outpatients) at Their Last Visit in 2017	504 Participants	29 Participants	141 Participants	30 Participants	704 Participants	—

SECONDARY outcome

Timeframe: On the last visit (1 day) in 2019 data was retrospectively assessed for the last 12 months in 2019.

Population: In- and outpatients in 2019 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2019. Only patients with available data for this outcome were included in this analysis.

The number of participants who were diagnosed as dead in 2019 was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2019. The Arms A, B, C, D - inpatients only were mutually exclusive in 2019. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=139535 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=21549 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=28868 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=9012 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=680438 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Number of Deaths in Inpatients and All Participants (In-and Outpatients) at Their Last Visit in 2019	225 Participants	8 Participants	41 Participants	20 Participants	294 Participants	—

SECONDARY outcome

Timeframe: Last visit in 2015, up to 1 day

Population: In- and outpatients in 2015 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2015. Only patients with available data for this outcome were included in this analysis.

The value of glycated hemoglobin (HbA1c) was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2015. The Arms A, B, C, D - inpatients only were mutually exclusive in 2015. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=9217 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=1517 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=738 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=2 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=11900 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
The Value of Glycated Hemoglobin (HbA1c) in Inpatients and in All Participants (in- and Outpatients) at Their Last Visit in 2015	7.8 Percentage of glycated hemoglobin Interval 6.9 to 9.3	9.2 Percentage of glycated hemoglobin Interval 7.4 to 11.0	5.7 Percentage of glycated hemoglobin Interval 5.4 to 6.0	5.4 Percentage of glycated hemoglobin Interval 5.3 to 5.4	6.9 Percentage of glycated hemoglobin Interval 6.1 to 8.1	—

SECONDARY outcome

Timeframe: Last visit in 2017, up to 1 day

Population: In- and outpatients in 2017 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2017. Only patients with available data for this outcome were included in this analysis.

The value of glycated hemoglobin (HbA1c) was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2017. The Arms A, B, C, D - inpatients only were mutually exclusive in 2017. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=19404 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=3578 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=1596 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=22 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=26183 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
The Value of Glycated Hemoglobin (HbA1c) in Inpatients and in All Participants (in- and Outpatients) at Their Last Visit in 2017	7.6 Percentage of glycated hemoglobin Interval 6.6 to 9.0	7.8 Percentage of glycated hemoglobin Interval 6.2 to 10.0	5.8 Percentage of glycated hemoglobin Interval 5.6 to 6.2	5.8 Percentage of glycated hemoglobin Interval 5.4 to 6.1	7.2 Percentage of glycated hemoglobin Interval 6.6 to 8.4	—

SECONDARY outcome

Timeframe: Last visit in 2019, up to 1 day

Population: In- and outpatients in 2019 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2019. Only patients with available data for this outcome were included in this analysis.

The value of glycated hemoglobin (HbA1c) was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2019. The Arms A, B, C, D - inpatients only were mutually exclusive in 2019. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=50815 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=5093 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=2927 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=49 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=72815 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
The Value of Glycated Hemoglobin (HbA1c) in Inpatients and in All Participants (in- and Outpatients) at Their Last Visit in 2019	7.7 Percentage of glycated hemoglobin Interval 6.8 to 9.1	7.3 Percentage of glycated hemoglobin Interval 6.0 to 9.3	5.8 Percentage of glycated hemoglobin Interval 5.5 to 6.1	5.4 Percentage of glycated hemoglobin Interval 5.1 to 5.7	7.1 Percentage of glycated hemoglobin Interval 6.4 to 8.1	—

SECONDARY outcome

Timeframe: Last visit in 2015, up to 1 day

Population: In- and outpatients in 2015 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2015. Only patients with available data for this outcome were included in this analysis.

The concentration (Millimole per liter (mmol/L)) of random blood glucose was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2015. The Arms A, B, C, D - inpatients only were mutually exclusive in 2015. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=11534 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=2909 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=3153 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=21 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=19066 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Concentration of Random Blood Glucose in Inpatients and in All Participants (in- and Outpatients) at Their Last Visit in 2015	8.3 Millimole per liter (mmol/L) Interval 6.2 to 12.1	8.3 Millimole per liter (mmol/L) Interval 6.2 to 12.6	5.3 Millimole per liter (mmol/L) Interval 4.7 to 6.1	8.5 Millimole per liter (mmol/L) Interval 6.3 to 10.8	8.3 Millimole per liter (mmol/L) Interval 6.5 to 10.9	—

SECONDARY outcome

Timeframe: Last visit in 2017, up to 1 day

Population: In- and outpatients in 2017 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2017. Only patients with available data for this outcome were included in this analysis.

The concentration (Millimole per liter (mmol/L)) of random blood glucose was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2017. The Arms A, B, C, D - inpatients only were mutually exclusive in 2017. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=24077 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=6389 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=6065 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=13 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=41511 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Concentration of Random Blood Glucose in Inpatients and in All Participants (in- and Outpatients) at Their Last Visit in 2017	9.4 Millimole per liter (mmol/L) Interval 7.0 to 12.4	8.8 Millimole per liter (mmol/L) Interval 6.5 to 11.3	5.3 Millimole per liter (mmol/L) Interval 4.7 to 6.2	7.2 Millimole per liter (mmol/L) Interval 5.9 to 10.5	8.5 Millimole per liter (mmol/L) Interval 6.8 to 11.3	—

SECONDARY outcome

Timeframe: Last visit in 2019, up to 1 day

Population: In- and outpatients in 2019 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2019. Only patients with available data for this outcome were included in this analysis.

The concentration (Millimole per liter (mmol/L)) of random blood glucose was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2019. The Arms A, B, C, D - inpatients only were mutually exclusive in 2019. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=60298 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=9690 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=12107 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=34 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=119972 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Concentration of Random Blood Glucose in Inpatients and in All Participants (in- and Outpatients) at Their Last Visit in 2019	9.0 Millimole per liter (mmol/L) Interval 6.8 to 12.1	7.7 Millimole per liter (mmol/L) Interval 5.7 to 11.1	5.3 Millimole per liter (mmol/L) Interval 4.8 to 6.2	5.1 Millimole per liter (mmol/L) Interval 4.5 to 7.0	8.3 Millimole per liter (mmol/L) Interval 6.5 to 11.1	—

SECONDARY outcome

Timeframe: Last visit in 2015, up to 1 day

Population: In- and outpatients in 2015 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2015. Only patients with available data for this outcome were included in this analysis.

Serum creatine concentration (μmol/L) was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2015. The Arms A, B, C, D - inpatients only were mutually exclusive in 2015. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=14240 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=3345 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=4142 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=2622 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=27863 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Serum Creatine Concentration in Inpatients and in All Participants (in- and Outpatients) at Their Last Visit in 2015	70.0 Micromole per liter (μmol/L) Interval 54.1 to 95.8	56.0 Micromole per liter (μmol/L) Interval 46.0 to 68.0	67.0 Micromole per liter (μmol/L) Interval 54.0 to 87.0	62.3 Micromole per liter (μmol/L) Interval 52.0 to 73.0	68.0 Micromole per liter (μmol/L) Interval 54.1 to 88.0	—

SECONDARY outcome

Timeframe: Last visit in 2017, up to 1 day

Population: In- and outpatients in 2017 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2017. Only patients with available data for this outcome were included in this analysis.

Serum creatine concentration (μmol/L) was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2017. The Arms A, B, C, D - inpatients only were mutually exclusive in 2017. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.

Outcome measures

Outcome measures
Measure	Diabetic In-and Outpatients in 2015 [Arm A and B] n=29249 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), or high cardiovascular (CV) risk recorded in the Tianjin regional database in 2015.	Non-diabetic In-and Outpatients in 2015 [Arm C and D] n=7090 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk recorded in the Tianjin regional database in 2015.	Diabetic In-and Outpatients in 2017 [Arm A and B] n=7533 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Non-diabetic In-and Outpatients in 2017 [Arm C and D] n=3737 Participants In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2017.	Diabetic In-and Outpatients in 2019 [Arm A and B] n=52078 Participants In-and outpatients with diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.	Non-diabetic In-and Outpatients in 2019 [Arm C and D] In-and outpatients without diabetes, and with or without diagnosis of risk factors CVD, HF, CKD, or high CV risk and were recorded in the Tianjin regional database in 2019.
Serum Creatine Concentration in Inpatients and in All Participants (in- and Outpatients) at Their Last Visit in 2017	69.2 Micromole per liter (μmol/L) Interval 55.0 to 95.0	54.0 Micromole per liter (μmol/L) Interval 45.0 to 65.0	68.0 Micromole per liter (μmol/L) Interval 55.0 to 87.0	61.0 Micromole per liter (μmol/L) Interval 51.0 to 71.6	67.0 Micromole per liter (μmol/L) Interval 54.0 to 87.0	—

SECONDARY outcome

Timeframe: Last visit in 2019, up to 1 day

Population: In- and outpatients in 2019 with and without diabetes and with and without diagnosis of risk factors CVD, HF, CKD, and high CV risk. For this outcome, inpatients results \[Arm A, B, C, D\] are reported separately per arm and in- and outpatients results \[All in-and outpatients\] are reported over all in- and outpatients and over all arms in 2019. Only patients with available data for this outcome were included in this analysis.

Serum creatine concentration (μmol/L) was calculated for inpatients grouped by their diagnoses category \[Arm A, B, C, D - inpatients only\] and for all participants \[All in- and outpatients\] at their last visit in 2019. The Arms A, B, C, D - inpatients only were mutually exclusive in 2019. Patients with risk factors (RF) were patients with diagnosis of CVD, HF, CKD or at high CV risk. Each participant could potentially have multiple diagnoses simultaneously. The data presented for this outcome is an retrospective analysis of electronic healthcare records of the Tianjin regional data base. Participants with diagnoses of interest were identified by International Classification of Disease (ICD) code.