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Heart Failure Complication in Type 2 Diabetes Focus of Study

Risk of hospitalization, early death doubled in type 2 patients…

Cardiovascular complications have been linked to diabetes. However, according Dr. Timothy Davis from University of Western Australia, “there have been no detailed contemporary population-based studies of heart failure (HF) complicating type 2 diabetes.”

In an effort to investigate predictors and outcome of hospitalization or death from heart failure in type 2 diabetes, Dr. Davis and his team conducted a community-based longitudinal cohort study. In this study, 1,296 patients with mean age of 64 years old and median diabetes duration of 4 years were selected from 1993-1996 and their data was analyzed prospectively until the end of June 2012. In addition, control groups of 5159 non-diabetic representatives with similar demographics were also included for comparison.

According to the results of the study, 337 (31.8%) out of 1185 patients with no prior history of heart failure were hospitalized or died from heart failure during the follow-up period. Cox proportional hazards modelling was exploited to account for confounding factors such as: sedentary lifestyle, central obesity, lower systolic blood pressure, higher serum triglycerides and urinary albumin to creatinine ratio, eGFR ≥ 90 ml/min, known ischemic heart disease, retinopathy and schizophrenia (P ≤ 0.046). Furthermore, the age-adjusted hazard ratio (95% CI) for HF hospitalization/death in T2D vs non-diabetic subjects was 2.36 (2.09-2.66) (P<0.001).

The finding of this study suggests type 2 diabetes is an established risk factor for early development and deaths due to heart failure. Compared to the control groups, type 2 diabetes patients are twice as likely to suffer from this complication. As stated in the study, “type 2 diabetes patients were 4.8 years younger vs. non-diabetic controls at first heart failure event (P<0.001), and these patients were also 4.4 years younger at time of death (P<0.001).” In addition, Dr. Davis also mentioned in his abstract presented at American Diabetes Association (ADA) 2015 Scientific Sessions that hyperfiltration (eGFR ≥ 90 ml/min) might represent a novel risk factor for developing heart failure. However, further explanation of this suspicion was not detailed.

Since heart failure is common in 30% of type 2 diabetic patients, extra precautions and monitoring is recommended in managing these cardiovascular risk factors in these patients.

Practice Pearls:

  • The risk for early development of heart failure is doubled in type 2 diabetes patients.
  • Type 2 diabetes patients develop heart failure 4.8 years earlier and also 4.4 years younger at time of death when compared to non-diabetic patients.
  • Hyperfiltration may represent as one of the potential risk factors leading to heart failure

Davis T, Davis WA. Predictors and outcome of heart failure complicating type 2 diabetes: The Fremantle Diabetes Study. American Diabetes Association 2015 Scientific Sessions; June 7, 2015; Boston, MA. Abstract 1490-P.