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Elevated risk of death and major cardiovascular events in subjects with newly diagnosed diabetes: Findings from an administrative database |
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| Institution: | 1. Laboratory of General Practice Research, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa, 19, 20156 Milan, Italy;2. Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy;3. Diabetes Unit, “S. Maria della Misericordia” Hospital, Rovigo, Italy;4. Laboratory for Quality Assessment of Geriatric Therapies and Services, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy;5. Regional Health Ministry, Lombardy Region, Milan, Italy;6. Diabetology Unit, Department of Internal Medicine, Ospedali Riuniti di Bergamo, Italy;1. Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women''s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA;2. Department of Endocrinology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago 8330074, Chile;3. Division of Dermatopathology, Department of Pathology, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA 02115, USA;4. Department of Medicine, University of Massachusetts, Worcester, MA 01605, USA;5. Department of Pathology and Medicine, University of Cincinnati, Cincinnati, OH 45219, USA;1. Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Milan, Italy;2. Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Italy;3. Department of Neurology, Medical University Innsbruck, Austria;4. Department of Inflammation and Immunology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy;5. Department of Translational Medicine, University of Milan, Milan, Italy;6. Laboratory of Autoimmunity, Biocenter, Innsbruck, Austria;7. IRCCS Multimedica, Milan, Italy;8. The Blizard Institute, Centre for Diabetes, Barts and The London School of Medicine & Dentistry, Queen Mary University, London, UK;1. National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain;2. Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain;3. CIBERESP, Madrid, Spain;1. Department of Pharmacology, School of Pharmacy, University of Seville, Seville, Spain;2. Departament de Farmacologia, Terapèutica i Toxicologia, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain;1. Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, Nuthetal 14558, Germany;2. Centre for Health Protection, National Institute for Public Health and The Environment, Bilthoven, The Netherlands;3. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany |
| Abstract: | AimsTo investigate the incidence of major cardiovascular complications and mortality in the first years of follow-up in patients with newly diagnosed diabetes.Methods and resultsWe examined incidence rates of hospitalization for cardiovascular reasons and death among new patients with diabetes using the administrative health database of the nine million inhabitants of Lombardy followed from 2002 to 2007. Age and sex-adjusted rates were calculated and hazard ratios (HR) were estimated with a matched population without diabetes of the same sex, age (±1 year) and general practitioner.There were 158,426 patients with newly diagnosed diabetes and 314,115 subjects without diabetes. Mean follow-up was 33.0 months (SD ± 17.5). 9.7% of patients with diabetes were hospitalized for cardiovascular events vs. 5.4% of subjects without diabetes; mortality rate was higher in patients with diabetes (7.7% vs. 4.4%). The estimated probability of hospitalization during the follow up was higher in patients with diabetes than in subjects without for coronary heart disease (HR 1.4, 95% CI 1.3–1.4), cerebrovascular disease (HR 1.3.95% CI 1.2–1.3), heart failure (HR 1.4, 95% CI 1.3–1.4) as was mortality (HR 1.4, 95% CI 1.4–1.4).Younger patients with diabetes had a risk of death or hospital admission for cardio-cerebrovascular events similar to subjects without diabetes ten years older.ConclusionsThe elevated morbidity and mortality risks were clear since the onset of diabetes and rose over time. These data highlight the importance of prompt and comprehensive patients care in addition to anti-diabetic therapy in patients with newly diagnosed diabetes. |
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