Cardiovascular Disease, Chronic Kidney Disease Affect Mortality in Patients With Diabetes

Heart disease, stroke, and chronic kidney disease have an independent and cumulative effect on all-cause mortality and medical costs in patients with diabetes, according to a study published online in Diabetes Care.

“These findings support the importance of preventing both cardiovascular disease and chronic kidney disease in patients with diabetes,” researchers wrote.

The retrospective cohort study included 208,792 adults with diabetes. To evaluate associations between cardiovascular disease and chronic kidney disease with mortality risk, life expectancy, and direct medical costs in patients with diabetes, researchers stratified participants into 12 disease groups with varying combinations of heart disease, stroke, and chronic kidney disease. 

Those with a single condition among heart disease, stroke, and moderate chronic kidney disease in addition to diabetes had similar mortality risks, according to the study. Compared with patients without additional conditions, those with one additional condition had a 1.75 times  increased mortality risk. Those with two additional conditions had 2.63 times greater mortality risk, and patients with three additional conditions had 3.58 times greater mortality risk.  

Similarly, annual public healthcare costs increased 2.91-fold with one additional condition, 3.90-fold with two additional conditions, and 3.88-fold with three additional conditions, researchers reported.  

Life expectancy in patients with diabetes decreased as the number of additional conditions increased, especially in younger patients.

“Reduction in life expectancy for a 40-year-old with one, two, and three conditions was 20, 25, and 30 years for men and 25, 30, and 35 years, respectively, for women,” researchers wrote.  

Severe chronic kidney disease, researchers noted, had a particularly significant effect on life expectancy and direct medical costs in the study.  

—Jolynn Tumolo

Reference:

Wan EYF, Chin WY, Yu EYT, et al. The Impact of Cardiovascular Disease and Chronic Kidney Disease on Life Expectancy and Direct Medical Cost in a 10-year Diabetes Cohort Study [published online ahead of print, 2020 May 26]. Diabetes Care. 2020;dc192137. doi:10.2337/dc19-2137