• The number of diabetic/non-diabetic patients with disease or risk [ Time Frame: 10 months after enrollment ]
  The number of diabetic patients with established cardiovascular disease, chronic kidney disease, or at high cardiovascular risk among all patients with diabetes;
• The proportion of diabetic/non-diabetic patients with disease or risk [ Time Frame: 10 months after enrollment ]
  The proportion of diabetic/non-diabetic patients with established cardiovascular disease, chronic kidney disease, or at high cardiovascular risk among patients without diabetes
• The demographic characteristics of the last visit for all patients of the studied population [ Time Frame: 10 months after enrollment ]
  1. age at admission;
  2. gender;
  3. ethnic;
  4. insurance payment;
• The diagnosis of patients [ Time Frame: 10 months after enrollment ]
  The number of patients with diagnosis at the last visit
• The proportion of death [ Time Frame: 10 months after enrollment ]
  The proportion of death at the last visit; the proportion of death at admission of the last visit for inpatients in 2008, 2013 and 2018.
• Random blood glucose (mmol/L) [ Time Frame: 12 months after enrollment ]
  The most recent value of random blood glucose (mmol/L) within the previous year for outpatients; the value of random blood glucose (mmol/L) at admission of the last visit for inpatients in 2008, 2013, 2018.
• HbA1C (%) [ Time Frame: 12 months after enrollment ]
  The most recent value of HbA1C (%) within the previous year for outpatients; the value of HbA1C (%) at admission of the last visit for inpatients in 2008, 2013, 2018.
• Department of discharge for hospitalized patients [ Time Frame: 12 months after enrollment ]
  Department of discharge of the last visit for hospitalized patients; and summarize the number of patients of different department of discharge in 2008, 2013, 2018.
• serum creatinine (μmol/L) [ Time Frame: 12 months after enrollment ]
  The most recent value of serum creatinine (μmol/L) within the previous year for outpatients; the value of serum creatinine (μmol/L) at admission of the last visit for inpatients in 2008, 2013, 2018.
• eGFR (mL/min/1.73m2) [ Time Frame: 12 months after enrollment ]
  The most recent value of eGFR (mL/min/1.73m2) within the previous year for outpatients; the value of eGFR (mL/min/1.73m2) at admission of the last visit for inpatients in 2008, 2013, 2018.
• Microalbuminuria (MALB) (mg/24h) [ Time Frame: 12 months after enrollment ]
  The most recent value of microalbuminuria (MALB, mg/24h) within the previous year for outpatients; the value of microalbuminuria (MALB, mg/24h) at admission of the last visit for inpatients in 2008, 2013, 2018.
• High density lipoprotein (HDL) (mmol/L) [ Time Frame: 12 months after enrollment ]
  The lasted examination of high density lipoprotein (HDL) (mmol/L) within the last year for outpatients; the value of high density lipoprotein (HDL) (mmol/L) at admission of the last visit for inpatients in 2008, 2013, 2018.
• Low density lipoprotein (LDL) (mmol/L) [ Time Frame: 12 months after enrollment ]
  The lasted examination of low density lipoprotein (HDL) (mmol/L) within the last year for outpatients; the value of low density lipoprotein (HDL) (mmol/L) at admission of the last visit for inpatients in 2008, 2013, 2018.
• Total cholesterol (TC) (mmol/L) [ Time Frame: 12 months after enrollment ]
  The lasted examination of total cholesterol (TC) (mmol/L) within the last year for outpatients; the value of total cholesterol (TC) (mmol/L) at admission of the last visit for inpatients in 2008, 2013, 2018.
• Triglyceride (TG) (mmol/L) [ Time Frame: 12 months after enrollment ]
  The lasted examination of triglyceride (TG) (mmol/L) within the last year for outpatients; the value of triglyceride (TG) (mmol/L) at admission of the last visit for inpatients in 2008, 2013, 2018.

• The number of patients with different treatment pattern [ Time Frame: 10 months after enrollment ]
  1. number of patients with the treatment of antiplatelet drug,statin,vasodilators.
  2. number of patients with the treatment of different insulin and OHA prescription;
  3. number of patients with the treatment of anti-hypertensive drugs (CCB, ACEI/ARB, beta-blocker and diuretic)
  4. number of patients with the treatment of statin and fibrates;
  5. number of patients with the treatment of the dialysis, ACEI/ARB and the kindney transplantation.

  We descirbe the treatment pattern based on treatment prescribed during the most recent visit for all inpatients, and based on at least 2 prescription within the previous year for outpatients
• The length of stay in the hospital [ Time Frame: 12 months after enrollment ]
  describe the length of stay in the hospital of the last hospitalization, the length stay in the hospital for inpatients from 2008 to 2018.
• The economic burden [ Time Frame: 12 months after enrollment ]
  hospitalization cost of the studied population for the last visit; total cost and hospitalization cost of the studied population from 2008 to 2018.
• Numbers of admissions [ Time Frame: 12 months after enrollment ]
  The total number of admissions for inpatients from 2008 to 2018
• The proportion of re-hospitalization [ Time Frame: 12 months after enrollment ]
  The last visiting and previous one within 30 days and 90 days

The study 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 at high cardiovascular risk, including:

1. estimate the proportion of Chinese diabetic/non-diabetic patients with established cardiovascular disease, CKD, or at high cardiovascular risk including hypertension and hyperlipidaemia;
2. describe the demographic and clinical characteristics of Chinese diabetic/non-diabetic patients with/without established cardiovascular disease, CKD, or at high cardiovascular risk;
3. investigate the treatment patterns of Chinese diabetic/non-diabetic patients with/without established cardiovascular disease, CKD, or at high cardiovascular risk;
4. examine economic burden of disease of Chinese diabetic/non-diabetic patients with/without established cardiovascular disease, CKD, or at high cardiovascular risk;
5. explore the trends of clinical characteristics, treatment pattern, economic burden of inpatients over time (2008, 2013, and 2018 separately);

• Cardiovascular Abnormalities
• Chronic Kidney Diseases
• Diabetes

• Diabetic patients with CVD, CKD or at risk
  The group A include all diabetic patients with established cardiovascular disease, chronic kidney disease, or at high cardiovascular risk.
• Diabetic patients without CVD, CKD or at risk
  The group B include all diabetic patients without established cardiovascular disease, chronic kidney disease, or at high cardiovascular risk.
• Non-diabetic patients with CVD, CKD or at risk
  The group C included all non-diabetic patients with established cardiovascular disease, chronic kidney disease, or at high cardiovascular risk.
• Health controls
  The group D included non-diabetic patients without established cardiovascular disease, chronic kidney disease, and not at high cardiovascular risk.

Inclusion Criteria:

• Patients in the TianJin regional database from 2015 to 2018.
• patients with at least 1 discharged diagnosis or 2 outpatient diagnosis of ischemic heart diseases (ICD-10 I20~I25);
• patients with at least 1 discharged diagnosis or 2 outpatient diagnosis of cerebrovascular diseases (ICD-10 I60~I69);
• patients with at least 1 discharged diagnosis or 2 outpatient diagnosis of ischemic peripheral artery disease (ICD-10 E10.501, E11.603, E14.501, E14.606, E14.503, I73.9, I99.03, I99.04);
• patients with at least 1 discharged diagnosis or 2 outpatient diagnosis of heart failure (ICD-10 I50);
• inpatients with at least once 1 discharged diagnosis CKD (ICD-10 N18), or inpatients with the last estimated glomerular filtration rate (eGFR, calculated by CKD-EPI equation) <60 mL/min/1.73 m2 or prescription of dialysis, but not with the diagnosis of acute kidney injury (ICD-10 N17)
• Outpatients with at least 2 diagnosis of CKD or with two consecutive eGFR(calculated by CKD-EPI equation) <60 mL/min/1.73 m2 by 90 days or more.
• patients with at least 1 discharged diagnosis or 2 outpatient diagnosis of hypertension (ICD-10 I10~I15);
• at least 1 discharged diagnosis or 2 outpatient diagnosis of hyperlipidaemia (ICD-10 E78.001-E78.003, E78.101, E78.203, E78.301-E78.304, E78.306, E78.401, E78.501, E78.902)
• patients with at least 1 discharged diagnosis or 2 outpatient diagnosis of diabetes (ICD-10 E10-E14)
• In addition, we will randomly select a group of non-diabetic patients without any of the above diseases by matching on age and gender.

Exclusion Criteria:

• Patients with non-Chinese nationalities;
• Patients with abnormal bill (planning to define abnormal bill as the top 1-2.5% of total medical costs in three groups, respectively, but the final standard will be defined based on the real extracted data);
• Duplicated storage (records with same inpatient code).