Liu JJ, Liu S, Wang J, et al. - Presence of at least the same absolute risk and 2-fold age- adjusted relative risk for incident heart failure (HF) was observed in individuals with early- onset diabetes (diagnosed before 40 years old) vs those with usual-onset (diabetes diagnosed between 41 to 65 years old).

• Early-onset diabetes has been linked with unfavourable cardiovascular risk.

• This study involved 606 persons with early-onset diabetes and 1258 counterparts with usual-onset diabetes, without HF history.

• Participants were followed for a median of 7.1 years in a regional hospital.

• In early- and usual- onset groups, 62 and 108 HF events occurred.

• 1.20 folds unadjusted and 1.91 folds age- adjusted hazards for incident HF were noted in early-onset group vs usual-onset counterparts.

• In early-onset diabetes, excess cardio-renal risk factors but not a long diabetes duration represent main drivers for HF development.