Takeaway
- In patients with type 2 diabetes (T2D), level of multimorbidity, and in particular, cardiovascular disease (CVD) multimorbidity, was associated with an increased risk and early onset of a CVD event, mortality, and CV mortality.
- The risk difference was highest in the year following T2D diagnosis, and the increased risk remained up to 19 years.
Why this matters
- Physicians should identify and manage both T2D and comorbidities early on.
- An important finding for clinical decision-making is that CVD comorbidities are the primary driver of increased risk.
Study design
- This retrospective study included 120,409 adults newly diagnosed with T2D using data from the UK Clinical Practice Research Datalink (2000-2018).
- Primary outcome: first fatal or non-fatal CVD event; secondary outcomes: CV and all-cause mortality.
- Funding: Novo Nordisk.
Key results
- Overall, 66,977 (55.6%) patients had T2D only, 37,894 (31.5%) had 1 comorbidity, 11,357 (9.4%) had 2 comorbidities, 3186 (2.6%) had 3 comorbidities and 995 (0.8%) had ≥4 comorbidities.
- At 1 and 19 years after T2D diagnosis, the adjusted HR (aHR; 95% CI) for ≥4 comorbidities was:
- 4.62 (4.28-4.98) and 2.57 (2.45-2.69) for a CVD event;
- 4.44 (4.13-4.76) and 1.73 (1.68-1.78) for all-cause mortality; and
- 6.91 (6.08-7.84) and 2.68 (2.52-2.85) for CV mortality, respectively.
- Overall, 100,183 (83.2%) patients had no CVD comorbidities, 16,874 (14.0%) had 1 CVD comorbidity and 3352 (2.8%) had ≥2 comorbidities.
- At 1 and 19 years after T2D diagnosis, the aHR (95% CI) for ≥2 CVD comorbidities was:
- 4.01 (3.85-4.18) and 2.42 (2.35-2.49) for a CVD event;
- 2.57 (2.46-2.68) and 1.44 (1.42-1.47) for all-cause mortality; and
- 5.46 (5.10-5.85) and 2.44 (2.35-2.54) for CV mortality, respectively.
Limitations
- Retrospective design.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
