For people newly diagnosed with type 2 diabetes, the combined risk of developing chronic kidney disease or heart failure, or dying, rose from 33% within five years to 55% within 10 years in an analysis of more than 1.6 million U.S. patients. The findings also show that kidney disease often appears before heart failure, while either complication can be followed by the other.
Researchers analyzed real-world health data from 1,617,508 people who were newly diagnosed with type 2 diabetes between Jan. 1, 2010, and March 31, 2024. The patients came from across the United States.
Their average age at enrollment was 59, and 51% were female. Among the 13% of patients with a recorded body mass index, the median was 30.9 kg/m².
Other health conditions were common in the group. About 72% had dyslipidemia, meaning high levels of cholesterol or other fats in the blood, and 68% had high blood pressure.
The analysis focused on how often chronic kidney disease and heart failure developed after a new type 2 diabetes diagnosis, including whether one condition tended to come before the other.
The combined risk of developing either chronic kidney disease or heart failure, or dying, was 33% during the first five years after diagnosis. Over 10 years, that figure rose to 55%.
Kidney disease was more often the first complication
Within five years of a type 2 diabetes diagnosis, 19.0% of patients developed chronic kidney disease first, compared with 8.3% who developed heart failure first.
The order mattered when researchers looked at what happened next.
Among patients who developed heart failure first, 42% went on to develop chronic kidney disease within the following five years. Among those who developed chronic kidney disease first, 23% developed heart failure during the following five years.
The findings provide information about both the overall risk of serious complications and the sequence in which the two conditions can occur after type 2 diabetes is diagnosed.
The study has important limits
The researchers described the work as an observational analysis, so it cannot establish that type 2 diabetes or the other health conditions caused the outcomes observed.
The analysis also cannot rule out selection bias, which can affect studies based on real-world health data. Differences in the risk of chronic kidney disease or heart failure across racial and ethnic groups, for example, may have influenced the results.
The findings are being presented at the annual meeting of the European Association for the Study of Diabetes in Milan, Italy, Sept. 28–Oct. 2.
