Impact of cardiovascular complications among patients with Type 2 diabetes mellitus: a systematic review

Abstract

Macrovascular and microvascular complications that accompany Type 2 diabetes mellitus (T2DM) add to the burden among patients. The purpose of this systematic review is to conduct a comprehensive search of the medical literature investigating the prevalence of cardiovascular (CV) complications and assess their impact on healthcare costs, quality of life and mortality among patients with T2DM in the context of microvascular complications. A total of 76 studies and reports were used in this systematic review. Hypertension was the most prevalent complication among patients with T2DM. The additional cost burden due to CV complications was higher than any other complication except end-stage renal disease. Quality of life was much lower among patients with CV complications and T2DM, and mortality was higher than either illness alone.

Keywords:

• cardiovascular conditions
• complications
• healthcare costs
• mortality
• prevalence
• quality of life
• Type 2 diabetes mellitus

Acknowledgements

We would like to acknowledge Mr. Robert Bechtol and Mr. Wade Lee for their assistance in the literature search.

Financial & competing interests disclosure

This systematic review was funded by Bristol-Myers Squibb and AstraZeneca. J Sheehan is an employee of AstraZeneca. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Cardiovascular (CV) conditions were the most prevalent followed by microvascular conditions.

• At a patient level, end-stage renal disease was the highest contributor to total costs (US$56,700–US$63,000 per patient) as well as direct costs followed by CV (US$7500– US$25,000 per patient) and microvascular conditions (US$9000– US$14,000). However, at a population level, CV conditions were the highest contributor to healthcare expenditures (US$23 billion).

• The presence of any chronic comorbidity reduced the quality of life significantly in Type 2 diabetes mellitus patients.

• CV conditions were the major contributor to mortality among Type 2 diabetes mellitus patients.