DOI: 10.2337/db23-188-lb ISSN: 0012-1797

188-LB: Association between Age at Diagnosis of Type 2 Diabetes and Hospitalization for Heart Failure (HHF)

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Background: The relation between age at T2D diagnosis and HHF is unclear. We conducted a population-based cohort study to examine the association between age at diagnosis of T2D and incident HHF in Ontario, Canada.

Methods: Using administrative health databases, we identified people with new-onset T2D between April 1, 2005 and March 31, 2015. We matched each person to 3 other people without diabetes according to birth year and sex. We excluded any people with prior HHF. We used Cox proportional hazards models to estimate adjusted hazard ratios (HR) for the association between age at T2D diagnosis and incident HHF (followed up until March 31, 2020).

Results: Among 743,053 individuals with T2D and 2,199,539 matches, 126,241 incident HHF events occurred (median follow-up 8.9 years). T2D was associated with a greater adjusted hazard of HHF at younger ages (e.g., HR at age 30 years: 5.71, 95% CI: 5.46-5.96; Figure: Model 1) than at older ages (e.g., HR at age 60 years: 2.51, 2.46-2.55). Additional adjustment for recognized mediators (hypertension, coronary artery disease, chronic kidney disease) marginally attenuated this relation (Figure: Model 2).

Conclusion: Younger age at T2D diagnosis is independently associated with a disproportionately elevated risk of HHF relative to age-matched individuals without T2D. This relation may be substantially mediated by novel mechanisms that are inadequately understood.


C. Ke: Advisory Panel; Sanofi, Speaker's Bureau; AstraZeneca, Abbott. B. R. Shah: None. J. Echouffo tcheugui: None.


National Heart, Lung, and Blood Institute (K23HL153774 to J.E.T.); University of Toronto (to B.R.S.)

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