There was a significant decrease in the rates of cardiovascular complications and mortality in adults with diabetes in South Korea, but other conditions increased.
While the prevalence of diabetes is increasing, the incidence of cardiovascular disease (CVD) and CVD-related mortality among patients with diabetes has decreased over the past 2 decades. A recent study, published in Diabetes & Metabolism, sought to determine the rates of cardiovascular complications and mortality in adults 30 years of age or more with diabetes in South Korea.
The study authors analyzed data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) which enrolled 1,021,208 individuals, which equated to nearly 2.2% of the eligible population in 2006. Investigators identified patients who were hospitalized for diabetes-related cardiovascular complications: ischemic heart disease, myocardial infarction, heart failure, hemorrhagic stroke, ischemic stroke, and peripheral artery disease (PAD). The rates of hospitalization were calculated separately for each year by dividing the number of patients hospitalized for cardiovascular complications by the corresponding number of patients with diabetes for that year.
Hospitalization rates were expressed as age-standardized rates per 10,000 people while mortality rates were per 100,000 people, separated by men and women.
Investigators found that from 2006 to 2015, hospitalization rates due to major cardiovascular complication such as ischemic heart disease, ischemic stroke, and myocardial infarction all went down. In fact, there was a declining trend observed in ischemic heart disease rates (from 438 to 461 in men and 419 to 397 women), ischemic stroke rates (from 257 to 205 men and 257 to 204 women), and myocardial infarction rates (from 111 to 81 men and 97 to 60 women). However, rates of heart failure did increase (from 72 to 146 in men and 124 to 161 in women), as well as and PAD (from 39 to 55 in men and 19 to 35 in women).
In terms of mortality rates, authorized analyzed data from 2007 to 2015 and discovered that it had decreased in both men and women from 2599 to 2010 and 1939 to 1662 per 100,000 adults with diabetes, respectively. In 2015, there were 6 leading causes of death that accounted for 66.7% of all deaths in Korean adults with diabetes (cancer, 30.3%; diabetes, 10.5%; heart disease, 10.5%; cerebrovascular disease, 8.9%; pneumonia, 5.0%; and hypertensive disease, 1.5%).
Overall, the authors found that there was a significant decrease in the rates of cardiovascular complications and mortality in Korean adults with diabetes, which may be due to advancements in diabetes care. However, increases were seen in the hospitalization rates for heart failure and PAD, as well as the mortality rates for pneumonia. The investigators concluded that, “more efforts are needed to prevent diabetes complications.”
Hwan Park J, Hwa Ha K, Yeon Kim B, Hyuk Lee J, Jung Kim D. Trends in cardiovascular complications and mortality among patients with diabetes. Diabetes Metab J. Published online December 9, 2020. doi: 10.4093/dmj.2020.0175