Microvascular Burden and Incident Heart Failure Among Middle-Aged and Older Adults With Type 1 or Type 2 Diabetes

Abstract

OBJECTIVE To examine the association between microvascular disease (MVD) and risk of heart failure (HF) among individuals with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS We included 1,713 and 28,624 participants with T1DM and T2DM, respectively, from the UK Biobank who were free of HF during enrollment. MVD burden reflected by the presence of retinopathy, peripheral neuropathy, and chronic kidney disease (CKD) at baseline was prospectively evaluated for the association with incidence of HF. Hazard ratios (HRs) and 95% CIs of HF were estimated by Cox regression models adjusted for multiple traditional risk factors. RESULTS There were 145 and 2,515 incident cases of HF recorded among participants with T1DM and T2DM, respectively, during a median follow-up of 11.5 years. The association between the number of MVD and HF was stronger among participants with T1DM than among those with T2DM (P for interaction <0.001). Compared with participants with no MVD, those with all three MVD had an adjusted HR (95% CI) of 11.37 (5.62, 22.99) in T1DM and 3.66 (2.74, 4.88) in T2DM. In T1DM, HRs (CIs) were 2.69 (1.75, 4.14) for retinopathy, 2.11 (1.38, 3.23) for peripheral neuropathy, and 2.21 (1.53, 3.18) for CKD. The corresponding estimates in T2DM were 1.24 (1.13, 1.36), 1.63 (1.36, 1.96), and 1.73 (1.59, 1.89), respectively. CONCLUSIONS While a heavier burden of MVD was associated with excess risk of HF both in T1DM and T2DM, the association was evidently more pronounced in T1DM.

Serum 25-hydroxyvitamin D, type 2 diabetes, and liver-related outcomes: Secondary data analysis of a prospective recruited cohort

“…Individuals with T2DM were identified based on recognized criteria 16 , 17 : (1) diagnoses recorded in inpatient data [International Classification of Diseases (ICD), ICD-10 codes E11], primary care data (mapped read codes to ICD codes), or self-reported data; (2) random blood glucose level ≥11.1 mmol/L or fasting blood glucose ≥7.0 mmol/L; (3) blood glycated hemoglobin (HbA1c) level ≥48 mmol/mol; and (4) used antidiabetes drugs collected by a baseline touchscreen questionnaire and verified in the face-to-face interview. Details of the definition are presented in Supplemental Table S1, http://links.lww.com/HC9/A605 .…”

Coffee Consumption and Incidence of Cardiovascular and Microvascular Diseases in Never-Smoking Adults with Type 2 Diabetes Mellitus

“…The secondary outcomes were individual CVD and MVD as listed above. Consistent with prior studies on CVD or MVD [ 17 , 18 , 19 ], we determined the outcomes based on cumulative medical records of hospital diagnoses and identified the incident cases according to the International Classification of Disease (ICD), 10th version (ICD-10). The definitions of CVD and MVD in the UK biobank are provided in Supplementary Table S1 .…”

Clinical features of type 1 diabetes in older adults and the impact of intermittently scanned continuous glucose monitoring: An Association of British Clinical Diabetologists (ABCD) study

“…Type 1 diabetes (T1D) is a chronic autoimmune disease that affects individuals of all age groups, including older adults. [1][2][3][4] However, the clinical features and management of T1D in older adults can differ from those in younger age groups due to various physiological, cognitive, and psychosocial factors. 3,5 Older adults with T1D may experience unique challenges related to glycaemic control, hypoglycaemia awareness, diabetes distress, and functional limitations.…”

“…Type 1 diabetes (T1D) is a chronic autoimmune disease that affects individuals of all age groups, including older adults 1–4 . However, the clinical features and management of T1D in older adults can differ from those in younger age groups due to various physiological, cognitive, and psychosocial factors 3,5 .…”