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Article History

Received: 4 October 2024

Accepted: 26 February 2025

First Online: 31 May 2025

Acknowledgements

: We thank other members of the PERMIT team (A. Basu (University of Washington, Seattle), P. Charlton (public contributor), I. Douglas (LSHTM) and L. Smeeth (LSHTM) for their helpful advice. We acknowledge and appreciate the support of the PERMIT study advisory team (K. Paterson, J. Lewsey (University of Glasgow), E. Pearson (University of Dundee), S. Finer (Queen Mary’s University of London), S. Evans (LSHTM), B. Huston (public contributor) and R. Mohan) and the management and administrative support provided by E. Silver (Women and Children First), A. Carnegie (King’s College London), P. Fry (LSHTM) and D. Mongiardi (LSHTM). This study is based in part on data from the Clinical Practice Research Datalink obtained under licence from the UK Medicines and Healthcare products Regulatory Agency. The data are provided by patients and entered by primary care practitioners as part of their care and support. The interpretation and conclusions contained in this study are those of the author/s alone. The study was approved by the Independent Scientific Advisory Committee (approval no. 20_064).

: CPRD data of the form used in this paper are available by application to the CPRD Independent Scientific Advisory Committee ().

: This work was funded by the National Institute for Health and Care Research (NIHR) grant number NIHR128490. KK is supported by the NIHR Applied Research Collaboration East Midlands (ARC EM), NIHR Global Research Centre for Multiple Long Term Conditions, Multiple Long-Term Conditions Cross-NIHR Collaboration and the NIHR Leicester Biomedical Research Centre (BRC). AIA is supported by the NIHR Oxford BRC. The funder had no role in considering the study design or in the collection, analysis, interpretation of data, writing of the report or decision to submit the article for publication.

: KK has acted as a consultant for, has been a speaker for, or has received grants for investigator-initiated studies from Astra Zeneca, Bayer, Novo Nordisk, Sanofi-Aventis, Servier, Lilly, Merck Sharp & Dohme, Boehringer Ingelheim, Oramed Pharmaceuticals, Pfizer, Roche, Daiichi-Sankyo, Applied Therapeutics, Embecta and Nestle Health Science. AIA has received research income from Novo Nordisk. The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work.

: PB, SON, OC, DGLP, KK, AIA and RG were responsible for the conception and design of the study. All authors critically appraised and contributed to the study design and analysis plan. PB requested and extracted the data. PB, SON, DGLP and OC performed the data management and analysis. PB and ILE developed code lists for the identification of morbidities for the cohort with type 2 diabetes mellitus. SON, PB and RG wrote the manuscript with contributions from all authors. All authors critically revised and approved the manuscript. SON, PB and RG are guarantors and as such had full access to the data in the study, and take responsibility for the integrity of the data and the accuracy of the data analysis. SON and PB share first authorship. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.