Temporal trends on the prevalence of renal disease and outcomes among patients with diabetes mellitus hospitalized by heart failure: findings from INCAex

Expert Rev Endocrinol Metab. 2024 Sep;19(5):447-457. doi: 10.1080/17446651.2024.2365769. Epub 2024 Jun 12.

Abstract

Background: To assess 20-year time trends in the prevalence of diabetes mellitus (DM) among inpatients with heart failure (HF) and the influence of coexisting DM and kidney disease (KD) on outcomes.

Research design and methods: A retrospective study of patients was admitted due to HF, during the period 2000/2019. The period of follow-up was divided into three intervals according to the European Medical Agency approval of newer hypoglycemic drugs. We analyzed in-hospital mortality and outcomes during the follow-up period.

Results: A total of 4959 patients were included. Over time, prevalence of DM was significantly raising among women with HF (50 to 53.2%) and descending among men (50% to 46.8%, p = 0.02). Total mortality and readmissions were higher in patients with DM during the and second periods. However, no significant differences were found in the third-one (HR 1.14, 95% CI 0.94-1.39, p = 0.181). A protector role of oral hypoglycemic medications was observed in this last period. According to the presence of KD, the patients with both DM and KD were who presented most of the events.

Conclusions: Over the time analyzed, the prevalence of DM raised among women and decreased among men. DM influenced the prognosis of HF except in the third period when more protective hypoglycemic drugs started to be used.

Keywords: Chronic kidney disease; diabetes complications; diabetes mellitus; epidemiology; heart failure.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Diabetes Mellitus* / drug therapy
  • Diabetes Mellitus* / epidemiology
  • Female
  • Heart Failure* / epidemiology
  • Hospital Mortality
  • Hospitalization* / statistics & numerical data
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Kidney Diseases / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies

Substances

  • Hypoglycemic Agents