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Adults with congenital heart disease at elevated risk for type 2 diabetes
Patients older than 30 years with congenital heart disease, particularly cyanotic congenital heart disease, have increased risk for developing type 2 diabetes, researchers reported.
The researchers analyzed 5,149 individuals born from 1963 to 1980 with congenital heart disease in Denmark and who were alive at age 30 years.
Nicolas Madsen, MD, MPH, and colleagues matched each individual with congenital heart disease with 10 people of the same sex and birth year in the Danish Civil Registration System.
Nicolas Madsen
“Given the [CV] health burden of type 2 diabetes, attention to its development in [congenital heart disease] survivors is warranted,” Madsen, cardiologist at Cincinnati Children’s Hospital Medical Center, said in a press release. “Unfortunately, promoting [CV] health isn’t always prioritized with the aging [congenital heart disease] population.”
The outcome of interest was development of type 2 diabetes by age 45 years. Participants with congenital heart disease were stratified by cyanotic or acyanotic congenital heart disease.
After adjustment for severity of congenital heart disease, age, sex, preterm birth and extracardiac defects, Madsen and colleagues determined that the cumulative incidence of type 2 diabetes in the adult congenital heart disease cohort after age 30 years was 4%, and those in the cohort were at higher risk for diabetes compared with the general population (HR = 1.4; 95% CI, 1.1-1.6).
Compared with those with acyanotic congenital heart disease, individuals with cyanotic congenital heart disease were at elevated risk for development of diabetes (HR = 1.9; 95% CI, 1.1-3.3), according to the researchers.
Traditional risk factors for type 2 diabetes such as obesity and sedentary lifestyle are common in the adult congenital heart disease population, and the elevated risk in those with acyanotic congenital heart disease could be related to chronic hypoxia, which is associated with abnormal glucose metabolism, or to genetic or environmental risk factors in common with diabetes, Madsen and colleagues wrote. – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.