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Temporal trends and factors associated with diabetes mellitus among patients hospitalized with heart failure: Findings from Get With The Guidelines-Heart Failure registry
Abstract
Background The contribution of diabetes to the burden of heart failure (HF) remains largely undescribed. Assessing diabetes temporal trends among US patients hospitalized with HF and their relation with quality measures in real-world practice can help to define this burden.Methods Using data from the Get With the Guidelines-Heart Failure registry, we assessed temporal trends in diabetes prevalence among patients with HF and in subgroups with reduced ejection fraction (HFrEF; EF < 40%), borderline EF (HFbEF; 40%≤EF <50%), or preserved EF (HFpEF; EF ≥ 50%), hospitalized between 2005 and 2015. Logistic regression was used to assess whether in-hospital outcomes and HF quality of care were related to trends.Results Among 364,480 HF hospitalizations, 160,171 had diabetes (44.0% overall, 41.8% in HFrEF, 46.7% in HFbEF, 45.5% in HFpEF). There was a temporal increase in diabetes frequency in HF patients (43.2%-45.8%; P trend <.0001), including among those with HFrEF (42.0%-43.6%; P trend <.0001), HFbEF (46.0%-49.2%; P trend <.0001), or HFpEF (43.6%-46.8%, P trend <.0001). Diabetic patients had a longer hospital stay (adjusted odds ratio 1.14, 95% CI 1.12-1.16), but lower in-hospital mortality (adjusted odds ratio 0.93 [0.89-0.97]) compared with those without diabetes, with limited differences in quality measures. Temporal trends in diabetes were not associated with in-hospital mortality or length of stay. There were no temporal interactions of most HF quality measures with diabetes status.Conclusions Approximately 44% of hospitalized HF patients have diabetes, and this proportion has been increasing over the past 10years, particularly among those patients with new-onset HFpEF.
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“Approximately 45% of people admitted for HFpEF have diabetes, and most people with HFpEF have obesity (320,321).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [320]
In the citing paper
“Approximately 45% of people admitted for HFpEF have diabetes, and most people with HFpEF have obesity (320,321).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [320]
In the citing paper
“Increasing evidence has demonstrated the benefits of GLP-1 RA or dual GIP/GLP-1 RA on symptoms and outcomes for people with HFpEF and obesity, and while most people with HFpEF have obesity, approximately 45% have diabetes (304,305).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [304]
In the citing paper
“Increasing evidence has demonstrated the benefits of GLP-1 RA or dual GIP/GLP-1 RA on symptoms and outcomes for people with HFpEF and obesity, and while most people with HFpEF have obesity, approximately 45% have diabetes (304,305).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [304]
In the citing paper
“Increasing evidence has demonstrated the benefits of GLP-1 RA or dual GIP/GLP-1 RA on symptoms and outcomes for people with HFpEF and obesity, and while most people with HFpEF have obesity, approximately 45% have diabetes (304,305).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [304]
In the citing paper
“In the past decade, HFpEF has taken on great importance in individuals with diabetes who represent about 45% of people suffering from this type of HF, with a significantly increasing proportion in those with new-onset HFpEF [73].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [73]
In the citing paper
“and a slight increase in the prevalence was reported in North America over time.49,52”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [49]
In the citing paper
“In registries of hospitalized HF patients in North America and Europe, the prevalence of T2DM is around 40-45%, 49 -52”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [49]
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Metadata
- Authors
- Echouffo-Tcheugui, J. B., Xu, H., DeVore, A. D., Schulte, P. J., Butler, J., Yancy, C. W., Bhatt, D. L., Hernandez, A. F., Heidenreich, P. A., & Fonarow, G. C.
- Affiliations
- Brigham and Women's Hospital (US)
- Duke Clinical Research Institute (US)
- Mayo Clinic (US)
- Stony Brook University (US)
- Northwestern University (US)
- VA Palo Alto Health Care System (US)
- University of California, Los Angeles (US)
- Corresponding author
- Echouffo-Tcheugui, Justin B.
- ORCID
- Venue
- American Heart Journal
- Publisher
- Elsevier BV
- Published
- 2016-12
- Volume
- 182
- Pages
- 9-20
- ISSN
- 0002-8703 (ISSN-L)
- OpenAlex
- W2508250664
- Cited by
- 160
- References
- 41
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 24 · 2023: 16 · 2022: 28 · 2021: 21 · 2020: 22 · 2019: 13 · 2018: 11 · 2017: 5
- FWCI
- 7.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of California, Los Angeles
- Ahmanson Foundation
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- diabetes mellitus, heart failure, temporal trends, heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, in-hospital mortality, length of hospital stay, quality of care, new-onset diabetes, hospitalized patients
- MeSH terms
- Aged, Aged, 80 and over, Diabetes Mellitus, Female, Heart Failure, Hospitalization, Humans, Male, Middle Aged, Registries, Socioeconomic Factors, Stroke Volume, United States, Comorbidity, Prevalence, Hospital Mortality
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