Assessment of electrocardiogram abnormality and associated factors among apparently healthy adult type 2 diabetic patients on follow-up at Jimma Medical Center, Southwest Ethiopia: Cross-sectional study

Abstract

Background Diabetes mellitus is a group of metabolic disorders causing long-term damage to the cardiovascular system which remains asymptomatic among diabetic patients. An electrocardiograph is a simple and first-line tool in the screening of cardiovascular diseases. Objective To assess electrocardiogram abnormality and associated factors among apparently healthy adult type 2 diabetes patients on follow-up at Jimma Medical Center, 2019. Materials and methods Institutional based cross-sectional study was conducted from April 1 to May 30, 2019, at Jimma Medical Center among selected type 2 diabetes patients. Systematic random sampling was employed to select the study participants. The World Health Organization stepwise approach and interviewer-administered semi-structured questionnaires were employed to collect basic data. Resting Electrocardiography was done using a standard 12-lead electrocardiograph machine. The collected data were checked for completeness, coded, entered into the Epi-data Version 4.0.2. and exported to SPSS Version 21. Descriptive statistics like frequencies, percentages, mean and standard deviations were carried out. Binary and multiple logistic regression was done and a p value of less than 0.05 was used as a level of significance. Results A total of 344 type 2 diabetes patients were interviewed and underwent electrocardiography making a 100% response rate. Electrocardiographic abnormality was identified among 209 (61%) of the respondents. Not attending formal education [AOR = 3.07, 95%, CI = 1.37–6.87], solid oil use, [AOR = 1.79, 95%, CI = 1.07–2.98], body mass index ≥ 25 kg/m2 [AOR = 2.74, 95%, CI = 1.67–4.50] and long duration of diabetes ≥ 10 years [AOR = 3.36, 95%, CI = 1.46–7.71] were associated with electrocardiogram abnormality. Conclusions and recommendation In this study, the majority (3/5th) of the participant had electrocardiogram abnormality. Not attending formal education, longer duration of diabetes ≥ 10 years, solid oil use, and increased body mass index ≥ 25 kg/m2 were independent predictors of electrocardiographic abnormality. Integrating electrocardiogram screening in routine diabetic management can pick cardiac complications of diabetes.

Patterns and associated factors of electrocardiographic abnormality among type 2 diabetic patients in Amhara National Regional State Referral Hospitals, Ethiopia: a multicenter institution-based cross-sectional study

“…Compared to T2DM patients who had DM duration below 2 years, those who had DM duration of over 10 years had 4.5 times more likely to develop ECG abnormality. This was supported by previous studies in the USA [ 15 ], Netherlands [ 19 ], India [ 33 ], Sub-Saharan Africa [ 39 ], Nigeria [ 20 ], and Ethiopia [ 21 ]. The reason for this result might be due to an overtime increase in blood sugar that can damage the blood vessels and the nerves that control the heart.…”

“…This difference might be due to socioeconomic variations [ 35 ]. Moreover, this study was lower than the recently published study in Jimma medical center (Ethiopia (61%) [ 21 ]. For that discrepancy, cultural and lifestyle differences could be accountable in that person living in Jimma, Ethiopia could use substances (Khat endemic area) which would affect the health conditions.…”

“…These metabolites activate accessory metabolic pathways, like, as the sorbitol and protein kinase C pathways that result in the formation of oxidative free radicals and the deposition of advanced glycation end products [ 44 – 46 ]. However, a study showed in Jimma (Ethiopia), that fasting blood sugar was not significantly associated with ECG abnormality [ 21 ]. This difference might be due to adherence to diabetic medication, and self-glucose monitoring practice awareness creation for the patients [ 47 ].…”

“…In Nigeria, age and duration of DM were associated with ECG abnormalities [ 20 ]. Moreover, a recently published article in Ethiopia (at Jimma Medical Center) showed DM duration above 10 years, being overweight, and not attending formal education were significantly associated with ECG abnormalities [ 21 ].…”

“…In Ethiopia, at Jimma Medical Center in Oromia Region, the prevalence of ECG abnormality was 61% among apparently healthy adult T2DM patients [ 21 ]. Nonetheless, this study was conducted only on healthy adult type 2 diabetic patients.…”