Macrovascular and microvascular complications in <scp>US</scp> Medicare enrollees with type 2 diabetes with and without atherosclerotic cardiovascular disease

What is the context and purpose of this research study? People with type 2 diabetes (T2D), especially those with hardening of the arteries or atherosclerotic cardiovascular disease (ASCVD), are at risk of developing problems with large and small blood vessels throughout their bodies. These problems can lead to serious health risks and death. We wanted to determine how many Medicare people with T2D, with and without ASCVD, developed problems with their large and small blood vessels over time. What was done? We used Medicare claims data to measure how many people with T2D, and a subset with T2D+ASCVD, developed problems with these blood vessels from January 1, 2006, through December 31, 2021. What were the main results? In the year after developing T2D, we found that 3.90% of patients developed problems with their large blood vessels. The most common large blood vessel problems that occurred within the first year of developing T2D (or T2D+ASCVD) were coronary heart disease (T2D, 3.24%; T2D+ASCVD, 8.10%) and peripheral artery disease (T2D, 1.97%; T2D+ASCVD, 7.33%). In the year after developing T2D (or T2D+ASCVD), we found that 16.88% of people with T2D and 21.16% of people with T2D+ASCVD developed problems with their small blood vessels. The most common small blood vessel problems were nerve damage (T2D, 8.34%; T2D+ASCVD, 10.65%) and kidney disease (T2D, 7.02%; T2D+ASCVD, 9.12%) in the first year. What is the originality and relevance of this study? This was the first study where we measured large and small blood vessel problems in people with T2D+ASCVD in a Medicare population. This study also provides an update to previous studies that measured large and small blood vessel problems in people with T2D. By highlighting the frequency of large and small blood vessel problems in people with T2D, we hope to raise awareness about the importance of annual screening in people with T2D, especially people with existing ASCVD, and manage according to the established guidelines.