Exploring the link between diabetes duration and cardiovascular disease in patients with type 2 diabetes

Type 2 diabetes mellitus (T2DM) is strongly associated with cardiovascular disease (CVD). This study aimed to examine the association between diabetes duration and major cardiovascular outcomes, including coronary artery disease (CAD), congestive heart failure (CHF), cerebrovascular accident (CVA), and peripheral arterial disease (PAD), among Thai adults with T2DM using nationwide data from 2018. This cross-sectional study utilized data from the "Assessment in Quality of Care among Patients Receiving a Diagnosis of Type 2 Diabetes and Hypertension Visiting the Ministry of Public Health and Bangkok Metropolitan Administration Hospital" database in Thailand. Adult patients aged ≥ 18 years with T2DM were included, and those without documented diabetes duration were excluded. Diabetes duration was stratified into four groups: <5 years, 5-9 years, 10-14 years, and ≥ 15 years. Multivariable logistic regression analyses were performed to evaluate the association between diabetes duration and cardiovascular outcomes after adjusting for age, sex, body mass index, hypertension, dyslipidemia, smoking status, alcohol consumption, and glycemic control. Among 34,131 participants, the overall prevalence of CAD, CHF, CVA, and PAD was 1.9%, 0.8%, 1.5%, and 0.3%, respectively. Compared with a diabetes duration of < 5 years, a duration of ≥ 15 years was associated with higher odds of CAD (adjusted odds ratio [AOR] 1.80, 95% confidence interval [CI] 1.38-2.34), CHF (AOR 2.34, 95% CI 1.60-3.44), and PAD (AOR 6.47, 95% CI 3.09-13.58), whereas no significant association was observed for CVA. These findings suggest a cross-sectional association between longer diabetes duration and a higher prevalence of certain cardiovascular diseases, particularly CAD, CHF, and PAD, among adults with T2DM. Longitudinal studies are needed to confirm causality and to guide clinical interventions targeting cardiovascular risk in this population.