Patients with type 2 diabetes mellitus (T2D) are at risk of various comorbidities. We investigated the timing of incident T2D complications over the course of 15 years and clinical characteristics associated with those complications in a large U.S. integrated healthcare system.

We identified incident T2D between 2003-2014 with a validated algorithm using electronic health records. T2D complications included micro- and macro-vascular diseases, depression, and all-cause mortality. We calculated incidence rates per 1000 person-years and median time to developing each complication through 2018. Multivariable Poisson regression models were used to investigate factors associated with early T2D complications defined as shorter than the median time to incidence.

We identified 135,199 patients with newly diagnosed T2D and followed them for a median six years [mean age 58 years, 48% female, 36% White, 35% Hispanic, 12% Black, 13% Asian]. Median times to incidence of depression, peripheral vascular disease, stable angina, and chronic kidney disease (CKD) were shorter than median times to incidence of lower extremity amputation, stroke, and heart failure (Table). Having hypertension and lower eGFR were associated with shorter time to CKD whereas male was associated with shorter time to composite cardiovascular events. Older age and a higher comorbidity score were associated with shorter time to both.


J. An: Research Support; Self; Merck & Co., Inc., Novartis AG. G.A. Nichols: Research Support; Self; Boehringer Ingelheim International GmbH, Bristol-Myers Squibb, Merck & Co., Inc. L. Qian: None. Z. Li: None. M.A. Munis: None. R. Wei: None. T. Harrison: None. T. Weiss: Employee; Self; Merck & Co., Inc. S. Rajpathak: Employee; Self; Menarini Group. K. Reynolds: Research Support; Self; CSL Behring, Merck & Co., Inc., National Institutes of Health, Novartis Pharmaceuticals Corporation.

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