article · SAS Journal of Medicine
People with type 2 diabetes face elevated cardiovascular risks, yet personalised lifetime risk estimation tools are rarely applied in standard clinical practice. Applying the DIAL prediction model to a cohort of one hundred adult diabetes patients treated at a hospital in Rabat demonstrated substantial cardiovascular vulnerability. Almost a fifth of patients had an estimated cardiovascular event-free life expectancy of less than ten years, nearly a quarter faced a ten-year cardiovascular risk above ten per cent, and over a fifth had a lifetime risk exceeding seventy per cent. Further analysis established that chronic kidney disease, earlier cardiovascular events, hypertension, and long diabetes duration served as the primary drivers of risk. Prior cardiovascular disease and hypertension each decreased event-free life expectancy by six years or more, with overall risks escalating alongside the severity of kidney impairment and albuminuria.
Cardiovascular complications are a leading cause of illness and death among people living with type 2 diabetes. Long-term assessment tools such as the DIAL model illustrate how conditions like high blood pressure and kidney disease shorten life expectancy. Understanding these cumulative risk factors helps clinicians recognise high-risk patients earlier and tailor preventive therapies to avert life-threatening cardiovascular events.
This research evaluates an existing web-based risk estimation tool within a hospital cohort. Potential users include hospital clinicians, primary care practitioners, and health software developers interested in incorporating lifetime cardiovascular risk calculators into clinical decision-support systems. Because the study assesses an existing, publicly accessible tool rather than creating a proprietary product, it sits at an applied clinical testing stage rather than an early-stage development pathway.
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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.
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DOI: 10.36347/sasjm.2026.v12i08.009
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