Teenage girl injecting insulin, daily diabetes care during COVID-19
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Patients with diabetes, especially type 1, have higher rates of sudden cardiac death (SCD), according to a study that used a nationwide Danish database. The work was led by Jacob Tfelt-Hansen, MD, of the University of Copenhagen.

Tfelt-Hansen presented the findings at the European Society of Cardiology (ESC) Congress 2024. Medscape reported on his presentation.

The International Diabetes Federation estimates that one in ten people, globally, suffer from diabetes. 90 percent of those cases are type 2.

In this study, patients with type 1 diabetes carried an increased risk for SCD, relative to the general population, across all ages, up to 90 years. These patients showed a nearly 10-fold increased risk at ≤ 30 years and a 20-fold increased risk in ages 30–40 years. The risk then decreases with age up to 90 years, Tfelt-Hansen said, according to Medscape.

Those with type 2 diabetes had a nearly sixfold increased relative risk in the age group up to 30 years, a 5.6-fold increased relative risk in ages 30–40 years (95% CI, 2.7-14.0), and again, a decrease in relative risk of SCD up to age 90 years.

The researchers said that other links between diabetes and health threats should also be further investigated.

Previously, Tfelt-Hansen and his colleagues published a paper that showed a sevenfold increased risk for cardiac death in people younger than 50 years in Denmark who had diabetes compared with those who did not have the disease. The researchers, identified 1363 cases of SCD, 669 with diabetes mellitus (DM). Among the DM patients 118 suffered SCD (9% of all SCD), making SCD the leading cause of death among DM patients under 50 DM in this study.

In both studies, the researchers used data from the whole Danish population (approximately 5.5 million individuals). In the latest study, they identified 6851 cases of SCD which they matched to individuals with types 1 and 2 diabetes. Among the SCD cases, 155 had type 1 diabetes, 1055 had type 2 diabetes, and 5641 did not have diabetes at all.

They found the incidence of SCD was consistently elevated across all age groups (0–90 years) for individuals with diabetes compared to the general population.

“Cardiac disease was more common in the diabetes patients but so too were other diseases, compared with the general population. So chronic kidney disease, for example, is found in 0.6%, 12.0%, and 5.9% in the general, type 1, and type 2 diabetes populations, respectively,” said Tfelt-Hansen, according to Medscape. 

“The way we could try to prevent [SCD], of course, could be [by] better treatment for patients who have diabetes, but we need to prevent type 2 diabetes in the first place. And, as cardiologists in particular, it is essential for us to step up and do this,” said Tfelt-Hansen.

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