Heart failure among people with Type 2 diabetes mellitus: real-world data of 289 954 people from a diabetes database

Diabet Med. 2020 Aug;37(8):1291-1298. doi: 10.1111/dme.13915. Epub 2019 Feb 27.

Abstract

Aim: Comparing people with Type 2 diabetes mellitus with and without heart failure in terms of metabolic control, therapeutic regimen and comorbidities.

Methods: The Prospective Diabetes Registry (DPV) is a longitudinal documentation system for demographics, medical care and outcome in people with diabetes mellitus. It consists of follow-up data from people with diabetes mellitus who have agreed to be recorded in the registry. Clinical data are submitted by general practitioners, specialists and clinics throughout Germany and Austria. Some 289 954 people with Type 2 diabetes mellitus (years 2000 to 2015) were analysed using demographic statistics and adjustment for confounders based on linear and logistic regression analysis.

Results: People with Type 2 diabetes mellitus (ICD code: E11) and heart failure (ICD code: I50) (N = 14 723) were older, more often women and presented with longer diabetes duration compared with those without heart failure. After adjustment for age, gender and diabetes duration, people with heart failure showed lower HbA1c , higher BMI and more intense insulin therapy. Analysis revealed that people with heart failure were more often treated with insulin, and more frequently received anti-hypertensives and lipid-lowering medication. They presented with lower systolic and diastolic BP. People with heart failure more frequently showed a history of comorbidities.

Conclusion: Heart failure is common in diabetes mellitus, but the prevalence in the DPV is lower frequent than expected. The reason for improved metabolic control in heart failure may be intensified therapy with insulin, lipid-lowering medication and anti-hypertensives in this cohort.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Comorbidity
  • Diabetes Complications / epidemiology*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / metabolism
  • Female
  • Glucagon-Like Peptide-1 Receptor Agonists
  • Glycated Hemoglobin / metabolism
  • Heart Failure / drug therapy
  • Heart Failure / epidemiology*
  • Heart Failure / metabolism
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Hypolipidemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Registries
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Hypolipidemic Agents
  • Insulin
  • hemoglobin A1c protein, human
  • Glucagon-Like Peptide-1 Receptor Agonists