Case Control Study
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World J Diabetes. Jul 15, 2025; 16(7): 107647
Published online Jul 15, 2025. doi: 10.4239/wjd.v16.i7.107647
Impact of longer diabetes duration and lower estimated glomerular filtration rate on cardiovascular complications and mortality: A nationwide population-based study
Hong Sang Choi, Bongseong Kim, Kyung-Do Han, Sang Heon Suh, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
Hong Sang Choi, Sang Heon Suh, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju 61469, South Korea
Bongseong Kim, Kyung-Do Han, Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, South Korea
Author contributions: Choi HS, Suh SH, Kim CS, Bae EH, Ma SK, Kim SW contributed to conceptualization; Han KD and Kim B contributed to data curation, formal analysis; Choi HS contributed to writing–original draft; Choi HS, Suh SH, Kim B, Han KD, Kim CS, Bae EH, Ma SK, and Kim SW contributed to writing-review and editing; Kim SW contributed to supervision; Choi HS and Kim SW contributed to funding acquisition.
Supported by the National Research Foundation of Korea grant funded by the Korea government, No. RS-2023-00217317; and the Korea Health Technology R and D Project through the Korea Health Industry Development Institute funded by the Ministry of Health and Welfare, Republic of Korea, No. RS-2024-00439029.
Institutional review board statement: The study was approved by the Institutional Review Board of Chonnam National University Hospital (CNUH-EXP-2024-136).
Informed consent statement: The Institutional Review Board of Chonnam National University Hospital (No. CNUH-EXP-2024-136) waived the ethical approval and informed consent requirements for this study. Hence, consent was not obtained because the participants’ records and information were anonymized and de-identified before analysis.
Conflict-of-interest statement: No potential conflict of interest relevant to this article was reported.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: Anonymized data are publicly available from the National Health Insurance Sharing Service (https://nhiss.nhis.or.kr/bd/ab/bdaba000eng.do).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Soo Wan Kim, MD, PhD, Professor, Department of Internal Medicine, Chonnam National University Medical School, Jebongro 42, Gwangju 61469, South Korea. skimw@chonnam.ac.kr
Received: March 27, 2025
Revised: April 18, 2025
Accepted: June 3, 2025
Published online: July 15, 2025
Processing time: 110 Days and 10 Hours
Core Tip

Core Tip: This study investigated the complex impact of longer diabetes duration and glomerular filtration rate (GFR) on cardiovascular diseases and mortality. We reveal an association between longer diabetes duration and an increased risk of myocardial infarction and ischemic stroke, even when the GFR is within the normal range. With increasing diabetes duration, mortality increased in subjects with GFR < 60 mL/min/1.73 m2. These findings highlight that for cardiovascular risk estimation, diabetes duration should be considered an important risk factor.