Patients With Type 2 Diabetes Have an Increased Demand for Pacemaker Treatment: A Comparison With Age- and Sex-Matched Control Subjects From the General Population

• Published in: Diabetes care Vol. 43; no. 11; pp. 2853 - 2858
• Main Authors: Rautio, Elina, Gadler, Fredrik, Gudbjörnsdottir, Soffia, Franzén, Stefan, Rydén, Lars, Svensson, Ann-Marie, Mellbin, Linda G.
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.11.2020
• Subjects: Age; Age Factors; Aged; Aged, 80 and over; Blood pressure; Body Mass Index; Bradycardia - complications; Bradycardia - epidemiology; Bradycardia - therapy; Cardiovascular disease; Cardiovascular diseases; Coronary artery disease; Demand; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Endocrinology and Diabetes; Endokrinologi och diabetes; Female; Follow-Up Studies; Glycated Hemoglobin A - analysis; Health hazards; Health risks; Heart diseases; Humans; Lipids; Male; Middle Aged; Pacemaker, Artificial; Pacemakers; Patients; Population studies; Prevalence; Proportional Hazards Models; Prospective Studies; Registries; Regression analysis; Research design; Risk analysis; Risk Factors; Sex; Surgical implants; Sweden - epidemiology; Sweden
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc20-0084

Patients with type 2 diabetes have an increased risk for cardiovascular disease, including arrhythmias. The prevalence of bradyarrhythmia and the subsequent need for treatment with pacemakers (PMs) is less well explored in a contemporary patient population. The current study explores ) whether patients with type 2 diabetes have an increased demand for PM implantation compared with an age- and sex-matched control population without diabetes and ) patient characteristics associated with an increased demand for receiving a PM. In this population-matched registry study, a total of 416,247 patients with type 2 diabetes from the Swedish National Diabetes Registry and 2,081,235 age- and sex-matched control subjects selected from the general population were included between 1 January 1998 and 31 December 2012 and followed until 31 December 2013. Mean follow-up time was 7 years. Cox proportional hazards regression analyses were performed to estimate the demand of PM treatment and the factors identifying patients with such demand. Type 2 diabetes was associated with an increased need of PM treatment (hazard ratio 1.65 [95% CI 1.60-1.69]; < 0.0001), which remained (1.56 [1.51-1.60]; < 0.0001) after adjustments for age, sex, educational level, marital status, country of birth, and coronary heart disease. Risk factors for receiving a PM included increasing age, HbA , BMI, diabetes duration, and lipid- and blood pressure-lowering medication. The need for PM treatment is higher in patients with type 2 diabetes than in matched population-based control subjects. Age, diabetes duration, and HbA seem to be risk factors for PM treatment.