Risk of Typical Diabetes-Associated Complications in Different Clusters of Diabetic Patients: Analysis of Nine Risk Factors.

Diabetic patients are often diagnosed with several comorbidities. The aim of the present study was to investigate the relationship between different combinations of risk factors and complications in diabetic patients. We used a longitudinal, population-wide dataset of patients with hospital diagnoses and identified all patients ( We identified five clusters associated with an increased risk of complications. A combined diagnosis of arterial hypertension (aHTN) and dyslipidemia was shared by all clusters and expressed a baseline of increased risk. Additional diagnosis of (1) smoking, (2) depression, (3) liver disease, or (4) obesity made up the other four clusters and further increased the risk of complications. Cluster 9 (aHTN, dyslipidemia and depression) represented diabetic patients at high risk of angina pectoris "AP" (RR: 7.35, CI: 6.74-8.01), kidney disease (RR: 3.18, CI: 3.04-3.32), polyneuropathy (RR: 4.80, CI: 4.23-5.45), and stroke (RR: 4.32, CI: 3.95-4.71), whereas cluster 10 (aHTN, dyslipidemia and smoking) identified patients with the highest risk of AP (RR: 10.10, CI: 9.28-10.98), atherosclerosis (RR: 4.07, CI: 3.84-4.31), and loss of extremities (RR: 4.21, CI: 1.5-11.84) compared to the controls. A comorbidity of aHTN and dyslipidemia was shown to be associated with diabetic complications across all risk-clusters. This effect was amplified by a combination with either depression, smoking, obesity, or non-specific liver disease.