Incidence and prognosis of heart failure in persons with type 2 diabetes compared with individuals without diabetes – a nation-wide study from Finland in 1996–2012

Aims To quantify the incidence and prevalence of heart failure (HF) in persons with type 2 diabetes (T2DM) and to examine the 1-year survival after the diagnosis of HF.Materials and methods All cases of HF (n = 295,990) and T2DM in Finland were identified from national electronic health care registers for the period 1996–2012. The annual incidence and prevalence rates of HF and 1-year survival after the first diagnosis of HF were calculated for persons with T2DM and without diabetes using Poisson regression for the event rates.Results The age-adjusted rate ratio for incident HF among men with T2DM in the age group 35–74 years declined from 3.73 (95% CI, 3.46–4.02) in 1996 to 2.17 (2.04–2.31) in 2012 and among women from 3.90 (3.61–4.22) to 2.36 (2.16–2.58). The multivariate-adjusted hazard ratio of 1-year death after the diagnosis of HF declined from 1.15 (1.11–1.21) to 1.07 (1.05–1.10) from the first to the second half of the study period.Conclusions Individuals aged <75 years with T2DM had a considerably higher incidence of HF than individuals without diabetes. The prognosis of HF was worse in individuals with T2DM than in individuals without diabetes. However, the gap between the groups had narrowed over time.Key messagesThe incidence of heart failure is 2–3 times higher among patients under 75 years of age with type 2 diabetes than among individuals without diabetes.The prognosis of heart failure patients is worse among patients with type 2 diabetes than it is among patients without diabetes although it is improving.