Diabetes is not only a major health problem in itself, but it also increases the risk of cardiovascular and kidney disease. Researchers have used national healthcare records to identify the likelihood of developing these serious conditions over the lifetime of a person with type 2 diabetes. This could help to increase efforts to detect and prevent cases of heart and kidney disease in these people.

The challenge

There are over 450 million individuals living with type 2 diabetes worldwide and this is expected to grow significantly. These people are much more likely to develop cardiovascular and kidney problems, which not only has severe impact on quality of life but can shorten their life expectancy. Despite this link being well-established, these conditions are not typically studied together.

While doctors may be able to explain to a patient the likelihood of developing these comorbidities over the next ten years, we do not know what the risk is over the rest of their lifetime. The risk of heart failure, for instance, is likely to be low over the next ten years for someone who is 45 years old, but this may not be the case in the long term.

The solution

A team of researchers supported by HDR UK studied the health records of almost half a million adults in England with type 2 diabetes between 2007 and 2018. This included data from primary care, hospital admissions and death registry.

They examined the records for details relating to diagnoses of cardiovascular and renal diseases, such as heart failure, chronic kidney disease, heart attack and stroke. By looking at the rate of diagnoses over this period, they were able to calculate the lifetime risk of these conditions. This is the first nationally representative, population-based study of lifetime risk in individuals with type 2 diabetes.

Impact and outcomes

The study found that 45-year-olds with type 2 diabetes had an 80 per cent risk of having some form of major cardiovascular or renal event in their life time if they were free from heart or kidney problems. For those people with diagnoses of heart failure or a heart attack, the risk of having a second cardiovascular or renal issue rose to over 97 per cent.

The team hopes that shifting focus to the lifetime risk of these diseases, rather than the 10-year risk, will motivate people with type 2 diabetes to improve how they look after their health. These results could also prompt healthcare systems to prioritise this group for early preventative measures and increase the use of interventions that are known to lower the risk of these conditions.

Dr Rachel Zhang, the first author of the paper published in the journal BMC Medicine, said:

“People don’t think type 2 diabetes is a big risk factor for other diseases especially when they are young, so they don’t make lifestyle changes. But our calculations show that even if you’re in your 40s and have type 2 diabetes, your lifetime risk of getting cardiovascular or renal disease is really high.”

Impact committee

The Impact committee noted that this research made good use of large-scale data thanks to strong interdisciplinary collaboration.