Type 2 Diabetes Linked to Higher Mortality After Ischemic and Nonischemic Heart Failure: Study

The study examined data on adults recently diagnosed with type 2 diabetes in the period 2000 to 2021. They were matched to between zero and four individuals without diabetes by sex, year of birth, and general practice, to form a well-matched comparative cohort. Incident heart failure (HF) was categorized into two groups: ischaemic (after an earlier ischaemic heart disease event) and non-ischaemic (without such an event). The aim was to investigate all-cause mortality in these populations after an HF diagnosis, employing hazard ratios (HRs) that were adjusted for different socio demographic as well as clinical variables.

Results

• Of a total of 73,344 individuals with heart failure, 18,296 (24.9%) had ischaemic HF.

• During the study period, 9,584 deaths were in individuals with ischaemic HF and 31,800 deaths in individuals with non-ischaemic HF.

• Age-standardised rates of mortality were consistently elevated in individuals with type 2 diabetes, independent of HF type or sex.

In ischaemic HF:

• Women with diabetes: 19.2 deaths per 100 person-years (95% CI: 18.1–20.3)

• Men with diabetes: 20.4 per 100 person-years (95% CI: 19.5–21.4)

• Women without diabetes: 15.1 per 100 person-years (95% CI: 14.4–15.8)

• Men without diabetes: 16.5 per 100 person-years (95% CI: 15.9–17.1)

For non-ischaemic HF:

• Women with diabetes: 19.5 per 100 person-years (95% CI: 19.0–20.1)

• Men with diabetes: 22.0 per 100 person-years (95% CI: 21.4–22.6)

• Women without diabetes: 16.6 per 100 person-years (95% CI: 16.2–17.0)

• Men without diabetes: 19.4 per 100 person-years (95% CI: 18.9–19.8)

• Hazard ratios (HRs) for death were similarly distributed over sex and HF types:

• Ischaemic HF: HR = 1.26 (95% CI: 1.17–1.36) in women; 1.23 (1.15–1.31) in men

• Non-ischaemic HF: HR = 1.24 (95% CI: 1.19–1.29) in women; 1.20 (1.15–1.25) in men

This research offers robust evidence that type 2 diabetes in patients with heart failure of both ischaemic or non-ischaemic origin increases all-cause mortality significantly. The increased risk was equally present in women and men, pointing to a need to manage diabetes aggressively and comprehensively in all those with heart failure to enhance long-term survival.

Reference:

Panchal, K., Lawson, C. A., Shabnam, S., Khunti, K., & Zaccardi, F. (2025). Mortality risk following ischaemic and non-ischaemic heart failure in people with type 2 diabetes: Observational study in England, 2000-2021. Diabetes, Obesity & Metabolism, 27(7), 3848–3857. https://doi.org/10.1111/dom.16413