CVDs, all-cause death more likely in recently diagnosed T2D patients, insulin users

Patients recently diagnosed with type 2 diabetes (T2D) are at higher risk of developing cardiovascular diseases (CVDs) and premature death, finds a new Korea study. Treatment with insulin aggravates these risks, pointing to a greater need for stronger cardioprotective measures in this population.

Drawing from the 2002–2015 National Sample Cohort database of the Korean National Health Insurance Service, the researchers identified 363,919 individuals eligible for inclusion, of whom 15,767 were recently diagnosed with T2D and 348,152 did not have the disease. Among diabetics, only 1,370 were insulin users. Outcomes included incident myocardial infarction (MI), stroke, and all-cause mortality.

Over a mean follow-up of 7.79±1.05 years, 5,275 MI cases were recorded, while 7,220 stroke episodes were recorded over 7.77±1.09 years of follow-up. Overall, 15,834 deaths occurred. Kaplan-Meier curves showed that MI, stroke, and death all occurred more frequently among those with T2D, regardless of insulin use.

Multivariable-adjusted Cox regression analysis confirmed that T2D patients with (hazard ratio [HR], 3.037, 95 percent confidence interval [CI], 2.706–3.407) and without (HR, 1.135, 95 percent CI, 1.067–1.206) insulin use were significantly more likely to die of any cause than non-diabetics. A similar trend was reported for MI and stroke.

Further stratification showed that insulin use was also a significant risk factor for poor CVD and survival outcomes among T2D patients.

MI, for example, was nearly twice as likely to develop among insulin users (HR, 1.914, 95 percent CI, 1.502–2.441), while stroke risk was elevated by more than 60-percent (HR, 1.676, 95 percent CI, 1.363–2.060). All-cause death was also strongly affected, increasing by more than twice among patients on insulin (HR, 2.535, 95 percent CI, 2.232–2.880).