Cardiovascular Risk Prediction in Patients with Type 2 Diabetes Using the DIAL Model: A Retrospective Study

Abstract

Background and Aims: Type 2 diabetes mellitus (T2DM) confers a substantially elevated cardiovascular risk, yet personalised lifetime-risk estimation tools are rarely applied in routine clinical practice. The DIAL (Diabetes Lifetime-perspective Prediction) model, endorsed by the European Society of Cardiology (ESC 2021), simultaneously estimates 10-year cardiovascular risk, lifetime risk, and cardiovascular event (CVE)-free life expectancy. To quantify 10-year and lifetime cardiovascular risk and CVE-free life expectancy in a hospital cohort of T2DM patients, and to identify clinical and biochemical determinants of these DIAL outputs. Methods: Retrospective study, Endocrinology Department, Mohammed V Military Teaching Hospital, Rabat (January 2021 – December 2022). One hundred adults with T2DM and complete records were included. DIAL scores were calculated via www.U-Prevent.com. Associations between clinical variables and DIAL outputs were examined by simple linear regression and logistic regression (Jamovi 2.3.2); significance threshold p < 0.05. Conclusions: Mean age was 58.2 years; mean HbA1c 11.1%; 56% had a prior cardiovascular event; 41% had chronic kidney disease (CKD). CVE-free life expectancy was < 10 years in 19% of patients; 23% had a 10-year cardiovascular risk > 10%; and 21% had a lifetime risk > 70%. In multivariable-adjusted linear regression, CVE-free life expectancy was significantly reduced by CKD, prior CVD (–6.7 years), hypertension (–6.0 years), and cumulative diabetes duration (–0.03 years per year). Ten-year and lifetime cardiovascular risks increased progressively with albuminuria severity and CKD stage. Renal impairment, prior CVD, hypertension, and long diabetes duration are the dominant risk drivers.