Burden of cardio-renal-metabolic conditions in adults with type 2 diabetes within the Diabetes Collaborative Registry

Diabetes Obes Metab. 2018 Aug;20(8):2000-2003. doi: 10.1111/dom.13303. Epub 2018 Apr 19.


We examined the prevalence of cardio-renal-metabolic (CaReMe) conditions and their combinations among 530 747 adults with type 2 diabetes in a USA-based outpatient registry of 271 primary care, cardiology and endocrinology offices. We evaluated the following CaReMe conditions: hypertension, hyperlipidaemia, coronary artery disease (CAD), chronic kidney disease (CKD), cerebrovascular disease, peripheral artery disease, atrial fibrillation, heart failure, and gout or hyperuricaemia; prevalence estimates were adjusted based on the distribution of diabetes by age in the US population in 2015. We found that it was uncommon for patients to have isolated type 2 diabetes without other CaReMe conditions, with only 6.4% having no other CaReMe conditions and 51% having ≥3 other CaReMe conditions. The most prevalent individual conditions were hypertension (83%), hyperlipidemia (81%), CAD (32%) and CKD (20%), and the most common combinations included various groupings of hypertension, hyperlipidaemia, atherosclerotic cardiovascular disease and CKD. Older age, male sex and tobacco use were each associated with increased numbers of CaReMe conditions. These findings highlight the clinical need for novel treatment strategies for diabetes that address both glycaemia and coexisting disease states.

Keywords: cardiometabolic; cardiovascular disease; diabetes mellitus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Comorbidity
  • Cost of Illness
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Cardiomyopathies / epidemiology*
  • Diabetic Cardiomyopathies / etiology
  • Diabetic Nephropathies / epidemiology*
  • Diabetic Nephropathies / etiology
  • Female
  • Humans
  • Interdisciplinary Communication
  • Male
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / etiology
  • Middle Aged
  • Prevalence
  • Registries
  • Risk
  • Sex Factors
  • Tobacco Use / adverse effects
  • United States / epidemiology
  • Young Adult