CARDIOVASCULAR EVENTS IN TYPE 2 DIABETIC PATIENTS

Abstract

Objective: Cardiovascular diseases represent the first cause of death of patients with type 2 diabetes. The aim of our work is to identify the prevalence of cardiovascular disease in type 2 diabetes. Design and method: This is a retrospective descriptive study conducted over a period of three years (January 2013- January 2016) including type 2 diabetic patients followed up at the nephrology consultation of Mongi slim hospital. Clearance was calculated according to the MDRD formula. The stage of chronic kidney disease (CKD) was defined according to the KDIGO 2012 classification. Results: Our study included 42 patients with diabetic kidney disease followed at our nephrology consultation. The mean age was 63.3 [31-80] with a sex ratio M/F = 1.47. Eighty-eight percent of our patients had hypertension. At the first consultation our patients already had macrovascular disease: 4 patients were suffering from peripheral artery disease, 4 patients had heart failure, a history of ischemic stroke was found in 4 patients and acute coronary syndrome in 11 patients. Regarding cardiovascular risk factors, obesity was found in 13 patients, 6 patients were smokers and 25 patients (59.5%) had dyslipidemia with a mean cholesterol level of 4.48 +/- 1.09 mmol/l. The mean fasting blood glucose level was 10.5 +/-5.23 mmol/l and a mean glycated hemoglobin was 8.24 +/-2.22%. The renal impact was as follows: chronic kidney disease stage 3A in 12 patients (28.6%), stage 3B in 14 patients (33.3%), stage 4 in 6 patients (14.3%) and stage 5 in 2 patients. During the course of the study, 7 patients had an acute coronary syndrome and 1 patient had an ischemic stroke. Conclusions: Diabetes is a cardiovascular risk factor in itself. Although nothing can be done about the non-modifiable risk factors (heredity, age, gender), it is possible to act early and effectively on the other modifiable factors.