title: Elevated risk of death and major cardiovascular events in subjects with newly diagnosed diabetes: findings from an administrative database.
abstract: OBJECTIVE
  To investigate the incidence of major cardiovascular complications and mortality in the first years of follow-up in patients with newly diagnosed diabetes.
  
  
  RESULTS
  We examined incidence rates of hospitalization for cardiovascular reasons and death among new patients with diabetes using the administrative health database of the nine million inhabitants of Lombardy followed from 2002 to 2007. Age and sex-adjusted rates were calculated and hazard ratios (HR) were estimated with a matched population without diabetes of the same sex, age (± 1 year) and general practitioner. There were 158,426 patients with newly diagnosed diabetes and 314,115 subjects without diabetes. Mean follow-up was 33.0 months (SD ± 17.5). 9.7% of patients with diabetes were hospitalized for cardiovascular events vs. 5.4% of subjects without diabetes; mortality rate was higher in patients with diabetes (7.7% vs. 4.4%). The estimated probability of hospitalization during the follow up was higher in patients with diabetes than in subjects without for coronary heart disease (HR 1.4, 95% CI 1.3-1.4), cerebrovascular disease (HR 1.3.95% CI 1.2-1.3), heart failure (HR 1.4, 95% CI 1.3-1.4) as was mortality (HR 1.4, 95% CI 1.4-1.4). Younger patients with diabetes had a risk of death or hospital admission for cardio-cerebrovascular events similar to subjects without diabetes ten years older.
  
  
  CONCLUSIONS
  The elevated morbidity and mortality risks were clear since the onset of diabetes and rose over time. These data highlight the importance of prompt and comprehensive patients care in addition to anti-diabetic therapy in patients with newly diagnosed diabetes.
authors.affiliation: Laboratory of General Practice Research, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa, 19, 20156 Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Monesi
authors.affiliation: Laboratory of Geriatric Neuropsychiatry, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Tettamanti
authors.affiliation: Laboratory of General Practice Research, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa, 19, 20156 Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Cortesi
authors.affiliation: Laboratory of General Practice Research, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa, 19, 20156 Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Baviera
authors.affiliation: Laboratory of General Practice Research, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa, 19, 20156 Milan, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Marzona
authors.affiliation: Laboratory of General Practice Research, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa, 19, 20156 Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Avanzini
authors.affiliation: Diabetes Unit, "S. Maria della Misericordia" Hospital, Rovigo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Monesi
authors.affiliation: Laboratory for Quality Assessment of Geriatric Therapies and Services, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Nobili
authors.affiliation: Laboratory of Geriatric Neuropsychiatry, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Riva
authors.affiliation: Regional Health Ministry, Lombardy Region, Milan, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Fortino
authors.affiliation: Regional Health Ministry, Lombardy Region, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bortolotti
authors.affiliation: Regional Health Ministry, Lombardy Region, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Fontana
authors.affiliation: Regional Health Ministry, Lombardy Region, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Merlino
authors.affiliation: Diabetology Unit, Department of Internal Medicine, Ospedali Riuniti di Bergamo, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Trevisan
authors.affiliation: Laboratory of General Practice Research, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa, 19, 20156 Milan, Italy. Electronic address: carla.roncaglioni@marionegri.it.
authors.forename: M C
authors.initials: MC
authors.lastname: Roncaglioni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000453:epidemiology*; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015999:Multivariate Analysis; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016016:Proportional Hazards Models; D012307:Risk Factors
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D010975:Platelet Aggregation Inhibitors
keywords: Cardiovascular events; Death; Newly diagnosed diabetes