Publication:

Cardiovascular risk factors and determinants of clinical outcomes in type 2 diabetic patients at a tertiary-care centre

Background The prevalence of type 2 diabetes mellitus (T2DM) is growing rapidly worldwide. The global burden of T2DM in 2013 was 382 million and projected to 592 million by 2035, accounting for 7.8% of the adult population. The objective of this study was to record treatments, risk factor control, determinants of glycaemic control and cardiovascular outcomes in type 2 diabetes (T2DM).

Methods We included adult T2DM patients and followed up for 6 months. Patients were categorised into good (HbA1c 8.5%). We used multiple logistic regression to identify determinants of glycaemic control and outcomes.

Results We recruited 785 patients with a mean age of 55.43 (±11.1) years, and 43.8% were women. At baseline, patients with poor control (45%) were younger and from lower socioeconomic strata (73.5%). At 6 months, the American Diabetes Association (ADA) targets of HbA1c was met only in 27.52%, systolic blood pressure (SBP) in 81.47% and low density lipoprotein (LDL) cholesterol in 48.86% patients. Patients with sedentary or low physical activity (Odds ratio 11.51, 95% confidence interval 3.48, 37.98; p<0.001) and with diabetes for a longer duration (OR 1.14 [1.07-1.22], p<0.001) were more likely to be in poor glucose control. Patients having sedentary or low physical activity (OR 6.66 [1.730-25.63] p = 0.006) and higher LDL cholesterol (OR 1.04 [1.01-1.07], p = 0.008) were more likely to get microvascular complications.

Conclusions Management of modifiable risk factors and early control of hyperglycaemia should be given more importance.