Prevalence of comorbidities associated with type 2 diabetes and prediabetes and a case-control analysis of the emergence of new comorbidities in 2007 - 2019

• There are more people with prediabetes than with T2DM. • Almost half of patients with type 2 diabetes (T2DM) have at least one comorbidity. • Kidney disease was more common than ischemic heart disease in women with T2DM. • Ischaemic heart disease was also highly prevalent in prediabetes. • Appropriate drug selection may reduce the development of comorbidities. Diabetes and its comorbidities substantially contribute to morbidity. This study aimed to investigate the prevalence of cardiovascular diseases and diabetic kidney disease (CKD) among patients with type 2 diabetes (T2DM) and prediabetes, and the association of variables related to the treatment of T2DM with the risk of comorbidities. We collected the data by extracting laboratory test results from real-world data of the catchment area of Turku University Hospital between 2005 and 2019 (fP-Gluk, 2-h glucose stress test, B-HbA1c). Cardiovascular diseases were ascertained using ICD10 codes from 1999 onward. CKD was diagnosed based on the measurement of estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (U-AlbKre). The prevalence of comorbidities was studied in a cohort 1 in 2019 that included 37,209 patients with type 2 diabetes and 42,554 with prediabetes. The risk of comorbidities was studied in a cohort 2 of 41664 T2DM patients during the years 2007-2019. We analyzed the emergence of type 2 diabetes comorbidities by logistic regression. Patients with T2DM exhibited a higher prevalence of all comorbidities compared with individuals with prediabetes. Hyperglycemia was associated with a higher risk of complications in all disease groups. Highest risk ratio in glycemic burden was in CKD (OR 1.006, 95 % CI 1.005–1.006). Use of cholesterol-lowering drugs, GLP-1 receptor agonists and SGLT2 inhibitors was associated with a lower risk in comorbidities (p<0.0001). Early risk factor modification, optimal glycaemic control, and appropriate drug selection may substantially reduce the development of comorbidities.