Abstract
Background – Recognition of cardiovascular (CVD) risk profile and its patterns at the time of diagnosis of diabetes would enable adoption of most appropriate primary prevention strategies to reduce morbidity and mortality from vascular disease. We aimed to study the prevalence and pattern of modifiable CVD risk factors in patients at the time of diagnosis of type 2 diabetes. Methods- In this single center, cross sectional study, 412 newly diagnosed patients with type 2 diabetes were studied on prevalence of low density lipoproteins (LDL), triglycerides (TG), high density lipoproteins (HDL) and systolic and diastolic blood pressure (SBP and DBP) . Prevalence of each risk factor was determined according to the American diabetes association criteria. Associations of each risk factor (dependent variable) with gender, age at onset of diabetes, waist circumference (WC) and body mass index (BMI) (independent variables) were studied using logistic regression. Results – Males accounted for 71% of sample and Mean (SD) age 49(11) years. The most prevalent lipid abnormality was LDL > 100 mg (81%) and low HDL and raised TG were detected in 17.1%, 18.5%. SBP> 140 mm Hg and DBP > 90 mm Hg were prevalent in 15% and 12%. Male gender (OR 7.98 – 95% CI 4.39 -14-49) and younger age at onset of diabetes (OR 0.95 95% CI 0.93 -0.98) were significantly associated with lower HDL. The younger age was significantly associated with adverse TG levels (OR 0.95, 95% CI 0.93-0.95) . Significant associations were detected with SBP and DBP with age (OR 1.09, 95% CI 1.05 - 1.13) and OR 1.062 95% CI 1.006 - 1.121). Discussion – Adverse LDL levels are present in 8 out of 10 patients at the time of diagnosis of diabetes. Modifiable CVD risk factors vary according to the age at onset of diabetes with more atherogenic dyslipidemia prevalent in younger and elevated blood pressure in older patients.
Highlights
Cardio-vascular diseases (CVD) contribute substantially to morbidity and mortality among individuals with type 2 diabetes (T2DM)(1)
Modifiable CVD risk factors vary according to the age at onset of diabetes with more atherogenic dyslipidemia prevalent in younger and elevated blood pressure in older patients
Studies conducted in multi ethnic settings revealed that individuals of South Asian ethnicity possess more adverse CVD risk factor profile and they succumb to cardiovascular diseases prematurely as compared to Caucasians[7]
Summary
Cardio-vascular diseases (CVD) contribute substantially to morbidity and mortality among individuals with type 2 diabetes (T2DM)(1). Lifestyle modifications and pharmacological interventions targeted at reducing blood pressure and altering adverse lipid profile have shown to reduce cardiovascular morbidity and mortality among individuals with T2DM[3,4]. With rising burden of T2DM in South Asia, knowledge on the prevalence, pattern and associations of modifiable CVD risk factors in patients with newly diagnosed diabetes would enable clinicians to pay more attention on those with higher CVD risk. Recognition of cardiovascular (CVD) risk profile and its patterns at the time of diagnosis of diabetes would enable adoption of most appropriate primary prevention strategies to reduce morbidity and mortality from vascular disease. We aimed to study the prevalence and pattern of modifiable CVD risk factors in patients at the time of diagnosis of type 2 diabetes
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