Does type 2 diabetes increase the risk of heart failure?

This study investigated the risk of heart failure in people with type 2 diabetes (T2D). It was determined that T2D was associated with a higher risk of heart failure in both men and women, of all ages, but especially in younger people.

Heart failure happens when the heart is not able to pump enough blood through the body. This causes fluid build-up in the lungs, which may cause shortness of breath. Conditions like coronary heart disease (CHD) and irregular heart rhythms increase the risk of developing heart failure. Evidence suggests that T2D also increases the risk of heart failure. However, the effects of age and sex on this risk are still under investigation.

This study used a Taiwanese insurance database to gather information on 34291 adults with T2D. They were compared to 34291 similar people without T2D (control group). The T2D group was followed for an average of 7.79 years for the development of heart failure. The control group was followed for an average of 8.02 years.

Overall, the T2D group was 47% more likely to develop heart failure than the control group. The risk was 44% higher in men with T2D, and 49% higher in women with T2D, than in men and women in the control group. The risk of developing heart failure was higher in patients with T2D than in those without, in all age groups. The most affected were people under 45 years. Men under 45 years with T2D had a 2.54 times higher risk of developing heart failure than men of the same age without T2D. The risk was 4.12 times higher for women under 45 with T2D than in women of the same age without T2D.

People with T2D who did not have CHD were 56% more likely to develop heart failure than those without T2D or CHD. The risk of developing heart failure was similar (58%) in patients without T2D who had CHD. People who had both T2D and CHD were 2.14 times more likely to develop heart failure than people with neither.

In the T2D group, certain drugs used to treat T2D were associated with an increased risk of heart failure. Metformin (Glucophage) was associated with the greatest risk. Participants with T2D who received metformin were 94% more likely to have heart failure than those who did not. Types of medications called sulfonylureas and insulin did not affect the risk of heart failure.

The study concluded that T2D increased the risk of developing heart failure in both men and women, of all ages, but particularly in people under 45. They also determined that people with T2D and no CHD have a similar risk of developing heart failure as people with CHD without T2D.

Information about the participants was gathered from an insurance database. The researchers did not interview or examine the patients. This means they could not check that all of the data was accurate. It also means that certain data was not available to them, such as duration of T2D, and alcohol consumption. This may have affected the results.

T2D is just one factor that may increase the risk of developing heart failure. Discuss your risks for heart failure with your physician.