New risk calculator can help prevent heart attacks and strokes in people with type 2 diabetes

A new risk calculator will help to identify people with type 2 diabetes who are at high risk of developing heart and circulatory diseases with greater accuracy than ever before, thanks to research we’ve funded.

 
By spotting high-risk individuals years in advance, doctors will be able to offer vital preventative treatment that can help save lives by warding off future heart attacks and strokes. 

The risk calculator is included in the new European Society of Cardiology (ESC) Guidelines advising doctors on the management of cardiovascular disease in people with type 2 diabetes, which were announced at the ESC’s annual Congress in August.
 
There are around 4.5 million people in the UK with type 2 diabetes, and one third of adults with diabetes die from a heart or circulatory disease.

The SCORE2-Diabetes risk calculator, published in the European Heart Journal, will allow doctors to estimate the risk of developing a heart or circulatory disease in the next 10 years, with much improved accuracy. The new algorithm extends the existing SCORE2 risk calculator, which has been in use across Europe since 2021. 

Much greater accuracy 

To build the new algorithm, an international team led by researchers at the University of Cambridge used over 10 years of anonymised data from nearly 230,000 people with type 2 diabetes but no history of heart or circulatory diseases, across seven countries.

During the 10-year follow-up there were over 43,000 cardiovascular events, including fatal or non-fatal heart attacks and strokes. 

Testing SCORE2-Diabetes on data from over 210,000 people across four European countries, the researchers found it could estimate risk for people with type 2 diabetes with much greater accuracy than the original algorithm.

The risk tool was then statistically ‘recalibrated’ using region-specific cardiovascular and risk factor data to allow it to estimate cardiovascular risk more accurately according to country of residence. 
 
Thanks to this ability to recalibrate, the researchers say SCORE2-Diabetes is an improvement on existing diabetes-specific models, which are not adaptable for Europe’s diverse populations and variation in heart and circulatory disease rates.

The researchers will continually recalibrate the algorithm to reflect any changes in populations’ cardiovascular disease rates and risk factors over time. 

‘A valuable advance’

Professor Sir Nilesh Samani, our Medical Director, said: “People with diabetes are overall nearly twice as likely to die of heart disease or stroke as those who do not have the condition.

“This increased risk can be substantially reduced by interventions such as blood pressure control and statins, but this requires more accurate identification of those at increased risk.  
 
“SCORE2-Diabetes is a valuable advance that will allow doctors to tailor pre-emptive treatments for individuals with type 2 diabetes based on their personal risk of heart and circulatory diseases.

“Such an approach is vital as clinicians in the UK and across Europe find new ways to reduce the high levels of ill health associated with diabetes.” 

Our research successes