Background
Methods
Data sources
Definition of type 2 diabetes
Definition of cardiovascular complications
Statistical analysis
Results
Diabetes rates
Rates of cardiovascular complications according to the status of diabetes
Variables | Year | Change | P value | ||||
---|---|---|---|---|---|---|---|
2006–2007 | 2008–2009 | 2010–2011 | 2012–2013 | Absolute change | Percent change | Linear trend | |
Ischemic heart disease | |||||||
Overall population | |||||||
No. of events/10,000 in diabetes | 368.02 | 338.28 | 289.65 | 259.57 | −108.45 | −29.47 | <.0001 |
95% CI | 360.53–375.51 | 331.81–344.75 | 284.36–294.95 | 254.74–264.41 | |||
No. of events/10,000 in non-diabetes | 117.44 | 115.74 | 106.79 | 100.23 | −17.21 | −14.65 | <.0001 |
95% CI | 117.34–117.54 | 115.65–115.83 | 106.72–106.87 | 100.16–100.30 | |||
RR (95% CI) | 3.13 (3.10–3.17) | 2.92 (2.89–2.95) | 2.71 (2.68–2.74) | 2.59 (2.56–2.62) | <.0001 | ||
Men | |||||||
No. of events/10,000 in diabetes | 376.91 | 351.86 | 307.31 | 276.17 | −100.74 | −26.73 | <.0001 |
95% CI | 364.49–389.33 | 340.89–362.82 | 298.38–316.23 | 268.04–284.31 | |||
No. of events/10,000 in non-diabetes | 120.53 | 119.2 | 111.25 | 104.91 | −15.62 | −12.96 | <.0001 |
95% CI | 120.31–120.74 | 119.01–119.39 | 111.08–111.41 | 104.77–105.06 | |||
RR (95% CI) | 3.13 (3.09–3.16) | 2.95 (2.92–2.98) | 2.76 (2.73–2.79) | 2.63 (2.61–2.66) | <.0001 | ||
Women | |||||||
No. of events/10,000 in diabetes | 359.75 | 325.64 | 273.22 | 244.12 | −115.63 | −32.14 | <.0001 |
95% CI | 342.59–376.90 | 311.01–340.27 | 261.22–285.21 | 233.15–255.10 | |||
No. of events/10,000 in non-diabetes | 114.57 | 112.51 | 102.65 | 95.87 | −18.7 | −16.32 | <.0001 |
95% CI | 114.38–114.76 | 112.34–112.68 | 102.50–102.80 | 95.74–95.99 | |||
RR (95% CI) | 3.14 (3.11–3.17) | 2.89 (2.86–2.93) | 2.66 (2.63–2.69) | 2.55 (2.52–2.57) | <.0001 | ||
Aged < 65 years | |||||||
No. of events/10,000 in diabetes | 280.04 | 262.22 | 226.39 | 205.71 | −74.33 | −26.54 | <.0001 |
95% CI | 268.84–291.24 | 252.26–272.19 | 218.48–234.30 | 198.49–212.92 | |||
No. of events/10,000 in non-diabetes | 65.41 | 65.27 | 61.08 | 58.66 | −6.75 | −10.32 | <.0001 |
95% CI | 65.35–65.48 | 65.22–65.33 | 61.03–61.13 | 58.62–58.71 | |||
RR (95% CI) | 4.28 (4.23–4.33) | 4.02 (3.97–4.06) | 3.71 (3.67–3.75) | 3.51 (3.47–3.55) | <.0001 | ||
Aged ≥ 65 years | |||||||
No. of events/10,000 in diabetes | 820.52 | 732.68 | 617.92 | 534.07 | −286.45 | −34.91 | <.0001 |
95% CI | 755.38–885.67 | 690.16–775.2 | 590.45–645.4 | 515.73–552.41 | |||
No. of events/10,000 in non-diabetes | 404.83 | 402.36 | 372.02 | 340.52 | −64.31 | −15.89 | <.0001 |
95% CI | 401.01–408.65 | 398.89–405.82 | 369.09–374.96 | 338.15–342.89 | |||
RR (95% CI) | 2.03 (2.01–2.05) | 1.82 (1.8–1.84) | 1.66 (1.64–1.68) | 1.57 (1.55–1.58) | <.0001 |
Variables | Year | Change | P value | ||||
---|---|---|---|---|---|---|---|
2006–2007 | 2008–2009 | 2010–2011 | 2012–2013 | Absolute change | Percent change | Linear trend | |
AMI | |||||||
Overall population | |||||||
No. of events/10,000 in diabetes | 87.09 | 81.36 | 61.67 | 54.62 | −32.47 | −37.28 | <.0001 |
95% CI | 85.27–88.91 | 79.82–82.89 | 60.64–62.69 | 53.71–55.54 | |||
No. of events/10,000 in non-diabetes | 26.31 | 26.15 | 21.43 | 19.59 | −17.21 | −25.50 | <.0001 |
95% CI | 26.29–26.33 | 26.13–26.17 | 21.42–21.45 | 19.57–19.60 | |||
RR (95% CI) | 3.31 (3.24–3.38) | 3.11 (3.05–3.18) | 2.88 (2.82–2.94) | 2.79 (2.73–2.85) | <.0001 | ||
Men | |||||||
No. of events/10,000 in diabetes | 100.97 | 92.90 | 73.55 | 66.12 | −34.85 | −34.52 | <.0001 |
95% CI | 97.37–104.58 | 89.84–95.95 | 71.34–75.77 | 64.16–68.08 | |||
No. of events/10,000 in non-diabetes | 30.34 | 29.51 | 24.13 | 22.27 | −8.07 | −26.60 | <.0001 |
95% CI | 30.29–30.39 | 29.46–29.56 | 24.09–24.16 | 22.24–22.30 | |||
RR (95% CI) | 3.33 (3.26–3.4) | 3.15 (3.08–3.21) | 3.05 (2.98–3.11) | 2.97 (2.91–3.03) | <.0001 | ||
Women | |||||||
No. of events/10,000 in diabetes | 74.17 | 70.61 | 50.60 | 43.92 | −30.25 | −40.78 | <.0001 |
95% CI | 70.52–77.81 | 67.52–73.69 | 48.69–52.51 | 42.21–45.62 | |||
No. of events/10,000 in non-diabetes | 22.55 | 23.01 | 18.92 | 17.09 | −5.46 | −24.21 | <.0001 |
95% CI | 22.52–22.59 | 22.98–23.05 | 18.89–18.95 | 17.07–17.11 | |||
RR (95% CI) | 3.29 (3.21–3.37) | 3.07 (3.00–3.14) | 2.67 (2.61–2.74) | 2.57 (2.51–2.63) | <.0001 | ||
Aged < 65 years | |||||||
No. of events/10,000 in diabetes | 66.35 | 63.53 | 47.05 | 42.57 | −23.78 | −35.84 | <.0001 |
95% CI | 63.62–69.08 | 61.09–65.98 | 45.57–48.52 | 41.20–43.93 | |||
No. of events/10,000 in non-diabetes | 14.12 | 14.25 | 11.63 | 10.70 | −3.42 | −24.22 | <.0001 |
95% CI | 14.11–14.13 | 14.24–14.27 | 11.62–11.64 | 10.69–10.71 | |||
RR (95% CI) | 4.70 (4.59–4.81) | 4.46 (4.36–4.56) | 4.05 (3.95–4.15) | 3.98 (3.88–4.08) | <.0001 | ||
Aged ≥ 65 years | |||||||
No. of events/10,000 in diabetes | 202.04 | 186.77 | 145.69 | 122.44 | −79.60 | −39.40 | <.0001 |
95% CI | 185.21–218.87 | 175.20–198.33 | 138.61–152.77 | 118.07–126.81 | |||
No. of events/10,000 in non-diabetes | 100.86 | 101.48 | 84.69 | 75.72 | −25.14 | −24.93 | <.0001 |
95% CI | 99.83–101.88 | 100.54–102.41 | 83.98–85.41 | 75.17–76.28 | |||
RR (95% CI) | 2.00 (1.96–2.05) | 1.84 (1.8–1.88) | 1.72 (1.68–1.76) | 1.62 (1.58–1.65) | <.0001 |
Variables | Year | Change | P value | ||||
---|---|---|---|---|---|---|---|
2006–2007 | 2008–2009 | 2010–2011 | 2012–2013 | Absolute change | Percent change | Linear trend | |
Ischemic stroke | |||||||
Overall population | |||||||
No. of events/10,000 in diabetes | 188.94 | 157.29 | 135.46 | 119.07 | −69.87 | −36.98 | <.0001 |
95% CI | 186.41–191.46 | 155.28–159.29 | 133.75–137.18 | 117.51–120.63 | |||
No. of events/10,000 in non-diabetes | 64.72 | 58.25 | 51.29 | 46.00 | −18.72 | −28.92 | <.0001 |
95% CI | 64.66–64.78 | 58.21–58.30 | 51.25–51.33 | 45.96–46.03 | |||
RR (95% CI) | 2.92 (2.88–2.96) | 2.70 (2.66–2.74) | 2.64 (2.60–2.68) | 2.59 (2.55–2.63) | <.0001 | ||
Men | |||||||
No. of events/10,000 in diabetes | 188.65 | 159.79 | 141.53 | 125.13 | −63.52 | −33.67 | <.0001 |
95% CI | 184.30–193.00 | 156.42–163.16 | 138.67–144.39 | 122.68–127.58 | |||
No. of events/10,000 in non-diabetes | 63.64 | 57.35 | 51.63 | 46.93 | −16.71 | −26.26 | <.0001 |
95% CI | 63.52–63.75 | 57.25–57.44 | 51.55–51.70 | 46.86–46.99 | |||
RR (95% CI) | 2.96 (2.92–3.01) | 2.79 (2.75–2.83) | 2.74 (2.7–2.78) | 2.67 (2.63–2.7) | <.0001 | ||
Women | |||||||
No. of events/10,000 in diabetes | 189.2 | 154.96 | 129.82 | 113.43 | −75.77 | −40.05 | <.0001 |
95% CI | 183.56–194.84 | 150.39–159.52 | 125.90–133.73 | 109.74–117.12 | |||
No. of events/10,000 in non-diabetes | 65.73 | 59.1 | 50.98 | 45.13 | −20.60 | −31.34 | <.0001 |
95% CI | 65.62–65.85 | 59.01–59.19 | 50.91–51.05 | 45.07–45.19 | |||
RR (95% CI) | 2.88 (2.84–2.92) | 2.62 (2.59–2.66) | 2.55 (2.51–2.58) | 2.51 (2.48–2.55) | <.0001 | ||
Aged < 65 years | |||||||
No. of events/10,000 in diabetes | 104.76 | 91.84 | 82.45 | 75 | −29.76 | −28.41 | <.0001 |
95% CI | 101.91–107.61 | 89.24–94.43 | 80.20–84.71 | 72.91–77.09 | |||
No. of events/10,000 in non-diabetes | 22.98 | 21.07 | 19.66 | 18.12 | −4.86 | −21.15 | <.0001 |
95% CI | 22.96–23.00 | 21.05–21.09 | 19.64–19.67 | 18.10–18.13 | |||
RR (95% CI) | 4.56 (4.48–4.64) | 4.36 (4.28–4.44) | 4.19 (4.12–4.27) | 4.14 (4.07–4.21) | <.0001 | ||
Aged ≥ 65 years | |||||||
No. of events/10,000 in diabetes | 653.11 | 523.37 | 433.24 | 368.51 | −284.6 | −43.58 | <.0001 |
95% CI | 595.24–710.98 | 490.38–556.36 | 412.47–454.00 | 354.72–382.30 | |||
No. of events/10,000 in non-diabetes | 315.28 | 291.7 | 253.99 | 228.35 | −86.93 | −27.57 | <.0001 |
95% CI | 312.09–318.47 | 288.99–294.41 | 251.83–256.15 | 226.62–230.08 | |||
RR (95% CI) | 2.07 (2.05–2.1) | 1.79 (1.77–1.82) | 1.71 (1.68–1.73) | 1.61 (1.59–1.63) | <.0001 |
Variables | Year | Change | P value | ||||
---|---|---|---|---|---|---|---|
2006–2007 | 2008–2009 | 2010–2011 | 2012–2013 | Absolute change | Percent change | Linear trend | |
Hemorrhagic stroke | |||||||
Overall population | |||||||
No. of events/10,000 in diabetes | 66.44 | 61.22 | 54.65 | 46.43 | −20.01 | −30.12 | <.0001 |
95% CI | 65.09–67.8 | 60– 62.45 | 53.57–55.72 | 45.5–47.36 | |||
No. of events/10,000 in non-diabetes | 35.94 | 32.85 | 29.23 | 25.35 | −10.59 | −29.47 | <.0001 |
95% CI | 35.91–35.97 | 32.83–32.88 | 29.21–29.25 | 25.33–25.37 | |||
RR (95% CI) | 1.85 (1.80–1.89) | 1.86 (1.82–1.91) | 1.87 (1.83–1.91) | 1.83 (1.79–1.87) | <.0001 | ||
Men | |||||||
No. of events/10,000 in diabetes | 69.60 | 64.00 | 58.65 | 47.92 | −21.68 | −31.15 | <.0001 |
95% CI | 67.48–71.73 | 62.04–65.96 | 56.96–60.33 | 46.57–49.27 | |||
No. of events/10,000 in non-diabetes | 37.65 | 34.6 | 31.14 | 26.83 | −10.82 | −28.74 | <.0001 |
95% CI | 37.59–37.72 | 34.55–34.66 | 31.10–31.19 | 26.8 –26.87 | |||
RR (95% CI) | 1.85 (1.8–1.89) | 1.85 (1.81–1.89) | 1.88 (1.84–1.93) | 1.79 (1.75–1.83) | <.0001 | ||
Women | |||||||
No. of events/10,000 in diabetes | 63.5 | 58.64 | 50.93 | 45.04 | −18.46 | −29.07 | <.0001 |
95% CI | 60.28–66.71 | 55.78–61.51 | 48.38–53.47 | 42.73–47.35 | |||
No. of events/10,000 in non-diabetes | 34.35 | 31.22 | 27.45 | 23.97 | −10.38 | −30.22 | <.0001 |
95% CI | 34.30–34.41 | 31.18–31.27 | 27.41–27.49 | 23.94–24.00 | |||
RR (95% CI) | 1.85 (1.80–1.90) | 1.88 (1.83–1.93) | 1.86 (1.81–1.90) | 1.88 (1.83–1.93) | <.0001 | ||
Aged < 65 years | |||||||
No. of events/10,000 in diabetes | 51.91 | 48.43 | 42.66 | 37.41 | −14.5 | −27.93 | <.0001 |
95% CI | 50.05–53.78 | 46.69–50.17 | 41.10–44.22 | 35.96–38.86 | |||
No. of events/10,000 in non-diabetes | 23.34 | 20.79 | 18.48 | 16.18 | −7.16 | −30.68 | <.0001 |
95% CI | 23.32–23.36 | 20.77–20.81 | 18.46–18.49 | 16.16–16.19 | |||
RR (95% CI) | 2.22 (2.17–2.28) | 2.33 (2.27–2.39) | 2.31 (2.25–2.37) | 2.31 (2.25–2.37) | <.0001 | ||
Aged ≥ 65 years | |||||||
No. of events/10,000 in diabetes | 145.8 | 132.03 | 122.85 | 101.88 | −43.92 | −30.12 | <.0001 |
95% CI | 133.07–158.54 | 123.83–140.22 | 116.69–129.00 | 98.04–105.72 | |||
No. of events/10,000 in non-diabetes | 106.26 | 103.24 | 94.47 | 82.17 | −24.09 | −22.67 | <.0001 |
95% CI | 105.23–107.29 | 102.33–104.15 | 93.7–95.24 | 81.58–82.77 | |||
RR (95% CI) | 1.37 (1.34–1.41) | 1.28 (1.25–1.31) | 1.3 (1.27–1.33) | 1.24 (1.21–1.27) | <.0001 |
Variables | Year | Change | P value | ||||
---|---|---|---|---|---|---|---|
2006–2007 | 2008–2009 | 2010–2011 | 2012–2013 | Absolute change | Percent change | Linear trend | |
PCI | |||||||
Overall population | |||||||
No. of events/10,000 in diabetes | 69.52 | 72.12 | 71.58 | 66.93 | −2.59 | −3.73 | <.0001 |
95% CI | 68.56–70.48 | 71.26–72.98 | 70.72–72.45 | 66.16–67.70 | |||
No. of events/10,000 in non-diabetes | 16.86 | 18.00 | 18.59 | 18.43 | 1.57 | 9.31 | <.0001 |
95% CI | 16.84–16.87 | 17.98–18.01 | 18.58–18.6 | 18.42–18.44 | |||
RR (95% CI) | 4.12 (4.03–4.22) | 4.01 (3.93–4.09) | 3.85 (3.78–3.92) | 3.63 (3.57–3.70) | <.0001 | ||
Men | |||||||
No. of events/10,000 in diabetes | 91.56 | 94.84 | 95.28 | 91.72 | .16 | .17 | .0343 |
95% CI | 88.89–94.22 | 92.49–97.18 | 93.03–97.52 | 89.54–93.9 | |||
No. of events/10,000 in non-diabetes | 23.5 | 25.13 | 26.39 | 26.64 | 3.14 | 13.36 | <.001 |
95% CI | 23.46–23.55 | 25.09–25.17 | 26.35–26.42 | 26.60–26.68 | |||
RR (95% CI) | 3.9 (3.81–3.98) | 3.77 (3.7–3.85) | 3.61 (3.54–3.68) | 3.44 (3.38–3.5) | <.001 | ||
Women | |||||||
No. of events/10,000 in diabetes | 49.00 | 50.98 | 49.53 | 43.85 | −5.15 | −10.51 | <.001 |
95% CI | 47.73–50.27 | 49.80–52.15 | 48.25–50.80 | 42.89–44.82 | |||
No. of events/10,000 in non-diabetes | 10.67 | 11.36 | 11.33 | 10.79 | .12 | 1.12 | .784 |
95% CI | 10.65–10.69 | 11.34–11.38 | 11.31–11.35 | 10.77–10.80 | |||
RR (95% CI) | 4.59 (4.46–4.73) | 4.49 (4.37–4.61) | 4.37 (4.26–4.49) | 4.06 (3.96–4.17) | <.001 | ||
Aged < 65 years | |||||||
No. of events/10,000 in diabetes | 52.51 | 53.43 | 53.2 | 50.13 | −2.38 | −4.53 | <.001 |
95% CI | 51.30–53.73 | 52.30–54.55 | 52.09–54.31 | 49.14–51.13 | |||
No. of events/10,000 in non-diabetes | 9.78 | 10.09 | 10.2 | 10.05 | .27 | 2.76 | .002 |
95% CI | 9.77–9.79 | 10.08–10.10 | 10.19–10.21 | 10.04–10.06 | |||
RR (95% CI) | 5.37 (5.23–5.51) | 5.3 (5.17–5.42) | 5.22 (5.10–5.33) | 4.99 (4.88–5.10) | <.001 | ||
Aged ≥ 65 years | |||||||
No. of events/10,000 in diabetes | 130.66 | 146.82 | 148.89 | 138.75 | 8.09 | 6.19 | .0019 |
95% CI | 122.64–138.69 | 139.54–154.11 | 143.04–154.74 | 134.53–142.97 | |||
No. of events/10,000 in non-diabetes | 49.31 | 56.65 | 62.66 | 63.47 | 14.16 | 28.72 | <.001 |
95% CI | 48.91–49.71 | 56.21–57.08 | 62.20–63.12 | 63.05–63.88 | |||
RR (95% CI) | 2.65 (2.58–2.72) | 2.59 (2.54–2.65) | 2.38 (2.33–2.43) | 2.19 (2.14–2.23) | −2.59 | <.001 |
Variables | Year | Change | P value | ||||
---|---|---|---|---|---|---|---|
2006–2007 | 2008–2009 | 2010–2011 | 2012–2013 | Absolute change | Percent change | Linear trend | |
CABG | |||||||
Overall population | |||||||
No. of events/10,000 in diabetes | 8.19 | 7.46 | 6.46 | 5.63 | −2.56 | −31.25 | <.0001 |
95% CI | 8.10–8.28 | 7.40–7.53 | 6.38–6.54 | 5.56–5.70 | |||
No. of events/10,000 in non-diabetes | 1.33 | 1.29 | 1.13 | .976 | −.35 | −26.67 | <.0001 |
95% CI | 1.33–1.332 | 1.291–1.293 | 1.131–1.133 | .975–.976 | |||
RR (95% CI) | 6.15 (5.76–6.57) | 5.78 (5.43–6.15) | 5.71 (5.36–6.08) | 5.77 (5.41–6.15) | <.0001 | ||
Men | |||||||
No. of events/10,000 in diabetes | 11.40 | 10.28 | 8.94 | 8.01 | −3.39 | −29.74 | <.0001 |
95% CI | 11.16–11.64 | 10.09–10.48 | 8.75–9.12 | 7.86–8.17 | |||
No. of events/10,000 in non-diabetes | 2.02 | 1.94 | 1.67 | 1.462 | −.56 | −27.48 | <.0001 |
95% CI | 2.013–2.02 | 1.94–1.947 | 1.667–1.672 | 1.46–1.464 | |||
RR (95% CI) | 5.66 (5.3–6.04) | 5.29 (4.97–5.63) | 5.35 (5.02–5.7) | 5.48 (5.14–5.84) | <.0001 | ||
Women | |||||||
No. of events/10,000 in diabetes | 5.196 | 4.838 | 4.159 | 3.411 | −1.79 | −34.35 | <.0001 |
95% CI | 5.081–5.310 | 4.759–4.917 | 4.018–4.299 | 3.279–3.542 | |||
No. of events/10,000 in non-diabetes | .692 | .685 | .632 | .523 | −.17 | −24.42 | <.0001 |
95% CI | .691–.694 | .684–.686 | .631–.633 | .522–.523 | |||
RR (95% CI) | 7.51 (6.79–8.30) | 7.06 (6.42–7.77) | 6.58 (5.97–7.25) | 6.52 (5.88–7.23) | <.0001 | ||
Aged < 65 years | |||||||
No. of events/10,000 in diabetes | 5.807 | 5.157 | 4.567 | 3.91 | −1.90 | −32.67 | <.0001 |
95% CI | 5.709–5.906 | 5.079–5.235 | 4.467–4.667 | 3.825–3.995 | |||
No. of events/10,000 in non-diabetes | .727 | .686 | .572 | .505 | −.22 | −30.54 | <.0001 |
95% CI | .726–.727 | .685–.686 | .572–.573 | .505–.506 | |||
RR (95% CI) | 7.99 (7.37–8.66) | 7.52 (6.96–8.12) | 7.98 (7.37–8.65) | 7.74 (7.13–8.41) | <.0001 | ||
Aged ≥ 65 years | |||||||
No. of events/10,000 in diabetes | 15.749 | 14.518 | 12.417 | 10.875 | −4.87 | −30.95 | <.0001 |
95% CI | 14.895–16.603 | 14.01–15.026 | 12.055–12.779 | 10.641–11.109 | |||
No. of events/10,000 in non-diabetes | 3.645 | 3.77 | 3.552 | 3.101 | −.54 | −14.92 | <.0001 |
95% CI | 3.621–3.67 | 3.745–3.794 | 3.531–3.573 | 3.084–3.117 | |||
RR (95% CI) | 4.32 (4.01–4.66) | 3.85 (3.59–4.13) | 3.5 (3.26–3.75) | 3.51 (3.26–3.77) | <.0001 |