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This prospective cohort study investigated whether lower birthweight increases CVD risk after diagnosis of type 2 diabetes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Original midwife records were evaluated for 8417 participants recently diagnosed with type 2 diabetes in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. Patients were followed for the first occurrence of a composite CVD endpoint (myocardial infarction, coronary revascularisation, peripheral arterial disease, stroke, unstable angina, heart failure or CVD death), a three-component endpoint comprising major adverse cardiovascular events (MACE), and all-cause mortality. Ten-year risks were estimated using the Aalen\u2013Johansen estimator considering non-CVD death as a competing risk. HRs were determined by Cox regression. Models were controlled for sex, age, calendar year at birth, family history of diabetes and born-at-term status.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 1187 composite CVD endpoints, 931 MACE, and 1094 deaths occurred during a median follow-up period of 8.5 years. The 10-year standardised composite CVD risk was 19.8% in participants with a birthweight &lt;3000 g compared with 16.9% in participants with a birthweight of 3000\u20133700 g, yielding a risk difference (RD) of 2.9% (95% CI 0.4, 5.4) and an adjusted HR of 1.20 (95% CI 1.03, 1.40). The 10-year MACE risk for birthweight &lt;3000 g was similarly elevated (RD 2.4%; 95% CI 0.1, 4.7; HR 1.22; 95% CI 1.01, 1.46). The elevated CVD risk was primarily driven by stroke, peripheral arterial disease and CVD death. All-cause mortality showed no substantial difference.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions\/interpretation<\/jats:title>\n                <jats:p>Having a birthweight &lt;3000 g is associated with higher CVD risk among patients with type 2 diabetes, driven primarily by risk of stroke and CVD death.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00125-024-06170-z","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T23:02:22Z","timestamp":1716418942000},"page":"1616-1629","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Low birthweight in patients with type 2 diabetes is associated with elevated risk of cardiovascular events and mortality"],"prefix":"10.1007","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9514-8942","authenticated-orcid":false,"given":"Aleksander L.","family":"Hansen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6653-9020","authenticated-orcid":false,"given":"Charlotte","family":"Br\u00f8ns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9496-1297","authenticated-orcid":false,"given":"Leonie M.","family":"Engelhard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8227-1469","authenticated-orcid":false,"given":"Mette K.","family":"Andersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8748-3831","authenticated-orcid":false,"given":"Torben","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3179-1186","authenticated-orcid":false,"given":"Jens S.","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9046-2967","authenticated-orcid":false,"given":"Peter","family":"Vestergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0891-4224","authenticated-orcid":false,"given":"Kurt","family":"H\u00f8jlund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5613-7274","authenticated-orcid":false,"given":"Niels","family":"Jessen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2230-5780","authenticated-orcid":false,"given":"Michael H.","family":"Olsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4299-7040","authenticated-orcid":false,"given":"Henrik T.","family":"S\u00f8rensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9135-3474","authenticated-orcid":false,"given":"Reimar W.","family":"Thomsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3690-2191","authenticated-orcid":false,"given":"Allan","family":"Vaag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,22]]},"reference":[{"issue":"9","key":"6170_CR1","doi-asserted-by":"publisher","first-page":"e722","DOI":"10.1161\/CIR.0000000000001040","volume":"145","author":"JJ Joseph","year":"2022","unstructured":"Joseph JJ, Deedwania P, Acharya T et al (2022) Comprehensive management of cardiovascular risk factors for adults with type 2 diabetes: a scientific statement from the American Heart Association. 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The authors sincerely thank the DD2 management and DD2 data managers. An abstract version of this study was presented at the EASD 2023 annual meeting in Hamburg on 3 October 2023.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Acknowledgements"}},{"value":"Danish data protection legislation does not allow the authors to share any individual-level patient data. However, the Danish health registry data used in this study are accessible to researchers at authorised research institutions by application to the Danish Health Data Authority by email (forskerservice@sundhedsdata.dk). Requests to use data from the DD2 cohort can be made at the DD2 website ()","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"Open access funding provided by Lund University. The DD2 study was supported by the Danish Agency for Science (grant numbers 09-067009 and 09-075724), the Danish Health and Medicines Authority, the Danish Diabetes Association, the Region of Southern Denmark and the Novo Nordisk Foundation (grant numbers NNF17SA0030962-2, NNF20O0063292, NNF17SA0030364, NNF18CC0034900 and NNF23SA0084103). Project partners are listed on the  website. The study funders were not involved in the design of the study, the collection, analysis and interpretation of data or writing the report. They did not impose any restrictions regarding publication of the report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"All authors have read and approved the manuscript. CB owns stock in Novo Nordisk. MHO has received payments or honoraria for lectures, presentations or educational events from AstraZeneca and Boehringer Ingelheim, has an unpaid position as chair of the Danish Hypertension Society and is a nucleus member of the Working Group for Prevention and Rehabilitation, Danish Society of Cardiology. The Department of Clinical Epidemiology, Aarhus University, receives funding for other studies in the form of institutional research grants to (and administered by) Aarhus University. None of these studies have any relation to the present study. The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"AV conceived and designed the study and is the guarantor of the study. JSN is the principal manager of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2). ALH performed the statistical analysis, prepared the first draft of the manuscript and revised the draft. All authors contributed to the interpretation of data and critically revised the content of the draft. AV, RWT and HTS supervised the study. All authors gave final approval of the version to be published. As such, they had full access to all data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}