Evaluating Excess Risk for Heart Failure Hospitalization in Type 2 Diabetes

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Investigators observed that patients younger than 55 with good glycemic control had a 2-fold excess risk vs patients with poor glycemic control who had a 4.6-fold excess risk for hospitalization.
Investigators observed that patients younger than 55 with good glycemic control had a 2-fold excess risk vs patients with poor glycemic control who had a 4.6-fold excess risk for hospitalization.

According to a study published in Diabetologia, men and women younger than 55 who were diagnosed with type 2 diabetes (T2D) are at significantly higher excess risk for heart failure than people of the same age who do not have diabetes.

To determine excess risk for heart failure in individuals with T2D, researchers followed 266,305 patients with T2D and 1,323,504 age- and sex-matched control individuals without diabetes for a median of 5.6 years. Of the total population, 45%  was women and average age was 62.

Over the study period, 18,715 (7%) people with diabetes were hospitalized with any diagnosis of heart failure compared with 50,157 (3.8%) controls. After adjusting for several factors, people with diabetes younger than 55 were found to have markedly higher excess risk for heart failure. Young people who had good glycemic control experienced a 2-fold excess risk for hospitalization for heart failure compared with a 4.6-fold excess risk for individuals with poor glycemic control.

The researchers also noticed a successive tempering of risk with increased age; individuals with diabetes 75 or older experienced no or only slight excess risk for hospitalization. If an individual in this group did not have albuminuria they experienced no excess risk at all.

In general, compared with the control group, younger age, poorer glycemic control, and deteriorating renal function were associated with increased excess risk for heart failure in people with T2D.

There were a few study limitations, including that the researchers only assessed heart failure resulting in hospital admission, which might have caused them to overlook milder cases managed in an outpatient setting.

In spite of the limitations, researchers said their study results demonstrate that “diabetes confers a near-ubiquitous but varying excess risk of heart failure in all age groups and at all levels of glycemic control; however, not in older people in the absence of albuminuria, or whose blood glucose is well controlled.”

Reference

Rosengren A, Edqvist J, Rawshani A et al. Excess risk of hospitalisation for heart failure among people with type 2 diabetes [published online August 9, 2018] Diabetologia. doi:10.1007/s00125-018-4700-5

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