Three-year incidence and predictors of mortality and microvascular and macrovascular complications after newly diagnosed type 2 diabetes: A population-based cohort study.

Aims

To assess the incidence of microvascular and macrovascular complications and mortality within three years after clinical diagnosis of type 2 diabetes mellitus (T2DM), and to identify associated risk factors.

Methods

In this retrospective population based study, 5773 individuals aged 40-90 years diagnosed with T2DM in Region Halland, Sweden between 2015 and 2020 were included. Data were obtained from a regional healthcare database, and individuals were followed individually from the date of diabetes diagnosis for three years or until death, whichever occurred first. The primary outcome was a composite of microvascular complications, macrovascular complications, and all-cause mortality. Associations between clinical factors and outcomes were analyzed using Cox regression.

Results

Within three years, 36% of individuals developed complications and 4% died. Microvascular complications were more common than macrovascular events. In analyses of the composite outcome, impaired kidney function was associated with increased risk (hazard ratio [HR] 2.70, 95% confidence interval [CI] 2.08-3.52), as was poor glycemic control (HR 1.38, CI 1.19-1.59). Higher age increased risk, while female sex was associated with a lower risk.

Conclusions

A substantial proportion of individuals developed complications shortly after clinical diagnosis of T2DM. These findings highlight the importance of early assessment of glycemic control and kidney function for risk stratification and identification of individuals at increased risk of adverse outcomes.