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Review
. 2021 Jun;12(6):1631-1659.
doi: 10.1007/s13300-021-01060-8. Epub 2021 May 3.

Epidemiology and Economic Burden of Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus in Spain: A Systematic Review

Esther Artime  1 , Irene Romera  2 , Silvia Díaz-Cerezo  2 , Elías Delgado  3   4   5   6
Affiliations
Review

Epidemiology and Economic Burden of Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus in Spain: A Systematic Review

Esther Artime et al. Diabetes Ther. 2021 Jun.

Abstract

Introduction: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in people with type 2 diabetes mellitus (T2DM). The objectives of this systematic literature review were to identify and synthesize published data describing the epidemiology and mortality of CVD in the T2DM population and the associated economic burden.

Methods: We conducted a systematic review searching the PubMed and MEDES databases from 2009 to 2019 using predefined selection criteria. Peer-reviewed observational studies reporting primary or secondary data on CVD prevalence, incidence, mortality, resource use and costs in patients with T2DM in Spain, written in English and Spanish, were included. Data were tabulated and summarized descriptively.

Results: Of 706 articles identified, 52 were included in the review. Most studies were based on data from hospital discharge databases and registries. The reported prevalence of CVD among patients with T2DM ranged from 6.9 to 40.8%. The prevalence of coronary heart disease ranged from 4.7 to 37%, stroke from 3.5 to 19.6%, peripheral artery disease from 2.5 to 13.0%, and heart failure from 4.3 to 20.1%. In-hospital CVD mortality rates ranged from 5.6 to 10.8%. Direct costs due to CVD in hospitalized patients with T2DM were increased (> 50%) compared with patients without CVD. No studies analysed indirect costs of CVD in patients with T2DM.

Conclusions: The burden of CVD among patients with T2DM, combined with the elevated costs of care, highlights the importance of early prevention as part of integrated management of the disease to improve clinical and economic outcomes.

Keywords: Burden of disease; Cardiovascular disease; Costs; Diabetes mellitus, type 2; Incidence; Mortality; Prevalence.

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Figures

Fig. 1
Fig. 1
Flow diagram showing the selection process of the included articles. DM1 Type 1 diabetes mellitus
Fig. 2
Fig. 2
Prevalence of CVD in patients with diabetes mellitus in national and regional studies published from 2009 to 2019. CVD Cardiovascular disease
See this image and copyright information in PMC

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