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Incidence of heart failure in patients with type 1 diabetes: a systematic review of observational studies

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Abstract

Background

Heart failure (HF) is considered an important contributor to cardiovascular morbidity and mortality in diabetes mellitus. However, a precise identification of hyperglycemia as contributor for HF is missing.

Objectives

We performed a review and a meta-regression of the available observational studies on the incidence of HF in type 1 diabetes (T1D).

Data source and analysis

We conducted a systematic search of the literature on the incidence of HF in patients with T1D identifying suitable studies published between January 1970 and June 2018 using the following search string: “type 1 diabetes” AND, “heart failure” OR “cardiac failure” OR “congestive heart failure” AND “incidence” NOT “type 2 diabetes” OR “diabetes type 2”. Six observational studies were included. A random effect meta-regression model has been estimated to evaluate the incidence rate ratio (IRR) of HF in T1D compared to healthy controls.

Results

The mean ± SD age of patients with T1D was 42 ± 11 years, the mean HbA1c was 8.4 ± 0.3%, and average follow-up was 11 ± 3 years. The age-adjusted model shows an incidence rate ratio (IRR) effect of 3.18 (p < 0.001), in correspondence of the mean age at enrollment of studies involved in the analysis. A negative correlation was observed between IRR and average age.

Conclusions

This review shows that the incidence rate of HF is three times higher in patients with T1D than in controls. A careful surveillance of the risk factors for this condition should be included, since the onset of T1D may be important to reduce HF risk in these patients.

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Authors and Affiliations

  1. Unit of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padua, Italy

    A. Avogaro & G. P. Fadini

  2. Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128, Padua, Italy

    D. Azzolina & I. Baldi

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  1. A. Avogaro
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  2. D. Azzolina
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  3. G. P. Fadini
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  4. I. Baldi
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Avogaro, A., Azzolina, D., Fadini, G.P. et al. Incidence of heart failure in patients with type 1 diabetes: a systematic review of observational studies. J Endocrinol Invest 44, 745–753 (2021). https://doi.org/10.1007/s40618-020-01368-5

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  • DOI: https://doi.org/10.1007/s40618-020-01368-5

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