Heart Failure Risk in Patients With Type 1 Diabetes Mellitus

Absolute and relative risk for heart failure (HF) among patients with type 1 diabetes mellitus (T1DM) is significantly higher compared with patients without diabetes, according to study results presented at the American College of Cardiology (ACC) 2023 conference, held from March 4 to 6, 2023, in New Orleans, Louisiana.

Investigators sought to assess the association between T1DM and risk for incident HF.

A review and meta-analysis of electronic literature was conducted that included 4 studies reporting on T1DM and risk for incident HF. The researchers used random-effects meta-analysis to pool incident rates of HF and risk ratios (RRs) for patients with T1DM (n=61,885), T2DM (n=248,021), and control individuals without DM (n=4,599,213).

Overall 56% of patients in the T1DM group, 54% of patients in the T2DM group, and 55% of patients in the control group were men. Patients with T1DM were 25 years younger on average than patients with T2DM. Average follow-up range was 1 to 12 years across studies, and investigators noted HF events occurred in 1378 patients with T1DM, 3993 patients with T2DM, and 18,945 control patients. Pooled HF incidence rates were 5.8 per 1000 person-years for patients with T1DM, 10.0 per 1000 person-years for patients with T2DM, and 1.3 per 1000 person-years for control patients.

Patients with T1DM had a significantly higher risk for HF (adjusted RR [aRR], 3.4; 95% CI, 2.71-4.26) vs control patients. The investigators noted that women had a stronger RR for HF (aRR, 4.89; 95% CI, 4.09-5.85) vs men (aRR, 2.95; 95% CI, 2.17-4.01).

 “Our study shows substantial higher absolute and relative risks of HF among patients with T1DM compared to those without diabetes,” the study authors wrote “Given the younger age of onset, absolute risk of HF in T1DM is likely higher than that observed in T2DM.”