Diabetes Duration, Glycaemic Control Predict Risk of CVD and Mortality

Sarfaroj Khan 

Disclosures

March 03, 2021

Takeaway

  • Longer diabetes duration and poor glycaemic control (high glycated haemoglobin [HbA1c] levels) were associated with increased risks of cardiovascular disease (CVD) and all-cause mortality.

  • Combination of longer diabetes duration and poor glycaemic control conferred the greatest risks.

Why this matters

  • Physicians should consider these 2 conditions together as part of CVD risk assessments for patients with diabetes.

Study details

  • Prospective cohort analysis of 435,679 participants without CVD (with diabetes, n=21,109; without diabetes, n=414,570) from the UK Biobank.

  • Funding: supported by the Open Project of Guangdong Provincial Key Laboratory of Tropical Disease Research.

Key results

  • Longer diabetes duration was associated with higher risks of CVD and all-cause mortality.

    • Compared with diabetes duration of <5 year, the adjusted HRs (aHRs, 95% CIs) for diabetes durations of 5 to <10 years, 10 to <15 years and ≥15 years were 1.15 (0.99-1.34), 1.50 (1.26-1.79) and 2.22 (1.90-2.58), respectively, for fatal/non-fatal CVD.

    • The corresponding aHRs (95% CIs) were 0.86 (0.65-1.12), 1.56 (1.18-2.08) and 2.05 (1.58-2.66), respectively, for fatal CVD and 1.15 (1.04-1.27), 1.35 (1.19-1.53) and 1.71 (1.53-1.92), respectively, for all-cause mortality.

  • HbA1c ≥8% vs <7% was associated with an increased risk of (aHR; 95% CI):

    • fatal/non-fatal CVD (1.67; 1.45-1.92);

    • fatal CVD (1.68; 1.32-2.13); and

    • all-cause mortality (1.40; 1.26-1.55) (Ptrend for all <.001).

  • Patients with diabetes duration of ≥15 years and HbA1c ≥8% vs those with diabetes duration of <5 years and HbA1c <8% had the highest risks of (aHR; 95% CI):

    • fatal/non-fatal CVD: 3.12; 2.52-3.86;

    • fatal CVD: 3.24; 2.29-4.57; and

    • all-cause mortality: 2.48; 2.12-2.90.

Limitations

  • Limited generalisability.

  • Risk of inaccuracy in calculating diabetes duration.

 

Li FR, Yang HL, Zhou R, Zheng JZ, Chen GC, Zou MC, Wu XX, Wu XB. Diabetes Duration and Glycemic Control as Predictors of Cardiovascular Disease and Mortality. Diabetes Obes Metab. 2021 Feb 23 [Epub ahead of print]. doi: 10.1111/dom.14348. PMID: 33620747. View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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