Key result
New-onset T2D in 2013-2018 linked to ~32% lower 5-year CHD risk versus 2001-2006.
Why the study?
Cardiovascular disease events remain a critical concern in patients with type 2 diabetes, prompting evaluation of time trends in 5-year cardiovascular event incidence over 17 years.
Does contemporary management (2013-2018) reduce the 5-year incidence of cardiovascular and cerebrovascular events in patients with new-onset Type 2 diabetes compared to historical management (2001-2006)?
Cohort (n=40,648)
Yes
Does contemporary management (2013-2018) reduce the 5-year incidence of cardiovascular and cerebrovascular events in patients with new-onset Type 2 diabetes compared to historical management (2001-2006)?
Effect estimate: HR 0.68 (95% CI 0.63-0.73)
Absolute Event Rate: 12.8% vs 16%
p-value: p=<0.001
While the incidence of CHD and TIA in new-onset Type 2 diabetes has declined over the past two decades, the stable rates of MI and ischemic stroke highlight persistent cardiovascular risk that likely accumulates during the prediabetic phase.
Associated with lower CHD in recent new-onset T2D; extends temporal trend data but leaves stroke/MI risk drivers open.
BACKGROUND: Events of cardiovascular disease (CVD) remain a critical concern in patients with Type 2 diabetes mellitus (T2D). Over 17 years, this study analyzed time changes in the 5-year incidence of myocardial infarction (MI), chronic coronary heart disease (CHD), transient ischemic attack (TIA), and ischemic stroke (IS). METHODS: This retrospective cohort study was conducted using the Disease Analyzer database, including patients aged ≥ 18 years with at least 12 months of no prior CVD with new-onset T2D in 2001-2006 (n = 10 162) and in 2013-2018 (n = 30 486), matched 1:3 by age and sex. Kaplan-Meier survival analysis estimated the 5-year cumulative incidence of the outcomes. Multivariable Cox regression models assessed temporal changes, adjusted for comorbidities. RESULTS: The incidence of CHD and TIA significantly declined in 2013-2018 compared to 2001-2006, with HRs of 0.68 (95% CI: 0.63-0.73; p < 0.001) and 0.63 (95% CI: 0.52-0.76; p < 0.001), respectively. Reductions were more pronounced in women and older patients. Surprisingly, MI incidence showed only a trend of reduction (HR: 0.82; 95% CI: 0.68-0.99; p = 0.045) and IS incidence was not different (HR: 0.97; 95% CI: 0.85-1.12; p = 0.722) between time periods. CONCLUSIONS: This study is the first to report time trends in CVD incidence in new-onset T2D in Germany. From 2001 to 2018, the 5-year incidence of CHD and TIA decreased in new-onset T2D, reflecting demographic-specific advancements in diabetes and cardiovascular care. However, the stable incidence of IS and MI underscores a persistent challenge in prevention strategies in patients with prediabetes and T2D.
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Sarabhai et al. (2025) conducted a cohort in New-onset Type 2 diabetes (n=40,648). Diagnosis in 2013-2018 vs. Diagnosis in 2001-2006 was evaluated on 5-year cumulative incidence of coronary heart disease (HR 0.68, 95% CI 0.63-0.73, p=<0.001). Patients diagnosed with new-onset type 2 diabetes in 2013-2018 had a significantly lower 5-year incidence of coronary heart disease compared to those diagnosed in 2001-2006 (HR 0.68).
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