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Diabetologia

Insulin resistance linked to heart failure after diabetes diagnosis

Over a median five-year follow-up, heart failure incidence was 4.8%, versus 3.0% for heart attacks, in a Swedish cohort with newly diagnosed diabetes.

Paper by Carl Lejonberg, Tomasz Czuba, Louise Bennet, +5 more authorsJ. Gustav Smith · Lund University

Our read

Populations
Studied:
Cohort study of adults with newly diagnosed diabetes, median five years
What changed:
Higher insulin resistance was linked to higher heart failure risk in low-risk participants (hazard ratio 1.89)
The catch:
Insulin resistance was assessed using a blood-based estimate rather than a direct measurement
Stake:
Novo Nordisk funded the study.
In the record:
The 96th paper on eGFR with results in people; 390 on record in all.
Why it’s aging research:
It bears on staying healthy in midlife and later life.

Editor of record: Boris Djordjevic · AgingResearch.News

Paper
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The prospective observational study included 19,892 adults with newly diagnosed diabetes in southern Sweden. Their median age was 62.5 years, and 58.6% were male. Researchers excluded 819 people with existing heart failure from analyses of new cases. Follow-up lasted up to 14 years, with a median of five years.

No participants with type 1 diabetes developed heart failure, so risk-factor analyses covered other diabetes types. In these participants, higher insulin resistance and lower kidney function were linked to heart failure after accounting for conventional risk factors. Insulin resistance means cells respond less well to insulin, a hormone that regulates blood sugar. High blood sugar was not independently associated with heart failure. A blood-based estimate of insulin resistance also added predictive information beyond an established cardiovascular risk score.

Why it matters

Heart failure is a common complication of diabetes and carries a high risk of death. For people diagnosed later in life, the study addressed how to recognize that risk beyond conventional measures.

Caveats

The observational design cannot show that insulin resistance or reduced kidney function caused heart failure. Risk-factor findings did not cover type 1 diabetes, and the cohort came from one Swedish region.

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