Aims: Diabetes and its comorbidities substantially contribute to morbidity. This study aimed to investigate the prevalence of cardiovascular diseases and diabetic kidney disease (CKD) among patients with type 2 diabetes (T2DM) and prediabetes, and the association of variables related to the treatment of T2DM with the risk of comorbidities.

Methods: We collected the data by extracting laboratory test results from real-world data of the catchment area of Turku University Hospital between 2005 and 2019 (fP-Gluk, 2-h glucose stress test, B-HbA1c). Cardiovascular diseases were ascertained using ICD10 codes from 1999 onward. CKD was diagnosed based on the measurement of estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (U-AlbKre). The prevalence of comorbidities was studied in a cohort 1 in 2019 that included 37,209 patients with type 2 diabetes and 42,554 with prediabetes. The risk of comorbidities was studied in a cohort 2 of 41,664 T2DM patients during the years 2007–2019. We analyzed the emergence of type 2 diabetes comorbidities by logistic regression.

Results: Patients with T2DM exhibited a higher prevalence of all comorbidities compared with individuals with prediabetes. Hyperglycemia was associated with a higher risk of complications in all disease groups. Highest risk ratio in glycemic burden was in CKD (OR 1.006, 95% CI 1.005–1.006). Use of cholesterol-lowering drugs, GLP-1 receptor agonists and SGLT2 inhibitors was associated with a lower risk in comorbidities (p < 0.0001).

Conclusions: Early risk factor modification, optimal glycaemic control, and appropriate drug selection may substantially reduce the development of comorbidities.