Increased risk of cardiovascular disease in newly diagnosed Type 2 diabetic patients in a primary health care center in Trinidad

Ezenwaka, Chidum E.; Davis, Gershwin

doi:10.1016/s0168-8227(00)00165-0

Cited by 18 publications

(24 citation statements)

References 26 publications

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“…Alternatively, increased serum triglycerides in women with type 2 diabetes might express a more profound metabolic disturbance; the most commonly recognized risk factors of insulin resistance are highly correlated to each other (42). Furthermore, women have a more significant increase in triglyceride levels with the onset of diabetes (43). Microalbuminuria predicted mortality only in men, also in accordance with a previous report (11).…”

Section: Survival In Type 2 Diabetessupporting

confidence: 83%

Survival in Patients With Type 2 Diabetes in a Swedish Community

et al. 2002

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OBJECTIVE—To explore risk factors for all-cause mortality in patients with type 2 diabetes treated in primary care. RESEARCH DESIGN AND METHODS—A prospective population-based study of 400 patients with type 2 diabetes who consecutively completed an annual checkup in primary care in Skara, Sweden, during 1992–1993. Vital status was ascertained to year 2000. Baseline characteristics as predictors for mortality were analyzed by Cox regression and expressed as relative risks (RRs), with 95% CIs. RESULTS—During a mean follow-up time of 5.9 years, 131 patients died (56 deaths per 1,000 patients per year). In both sexes, all-cause mortality was predicted by HbA1c (by 1%; RR 1.14, 95% CI 1.01–1.27), and by LDL-to-HDL cholesterol ratios (1.15, 1.00–1.32). Increased mortality was also seen with prevalent hypertension (1.72, 1.21–2.44), microalbuminuria (1.87, 1.27–2.76), and previous cardiovascular disease (1.70, 1.15–2.50). Subanalyses revealed that increased mortality related to HbA1c was restricted to hypertensive patients with type 2 diabetes (1.23, 1.04–1.47). Serum triglycerides (by 1 mmol/l) predicted all-cause mortality in women (1.25, 1.06–1.47). CONCLUSIONS—Poor glucose and lipid control and hypertension predicted all-cause mortality. Survival was also predicted by prevalent microalbuminuria and by previous cardiovascular disease. Confirming results from clinical trials, this population-based study has implications for primary and secondary prevention.

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Section: Survival In Type 2 Diabetessupporting

confidence: 83%

Survival in Patients With Type 2 Diabetes in a Swedish Community

et al. 2002

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“…In this country, diabetes accounts for about 13.6% of hospital admissions with an estimated government expenditure of about TTD 10.66 million (USD 1.69 million) per annum [18]. Of greater concern was a report that at diagnosis, patients with type 2 diabetes in the primary care setting already had a significant cluster of CVD risk factors largely due to obesity [11]. Again, in this population, we recently demonstrated that excess body mass was a major contributing factor to an increased risk of CVD in apparently healthy male factory workers [12].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Risk in Obese and Nonobese Patients with Type 2 Diabetes in the West Indies

Ezenwaka

Offiah

2001

Journal of Biomedical Science

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Objective: To evaluate the impact of obesity on glycemic control and the risk of progressing to cardiovascular disease (CVD) in obese and nonobese type 2 diabetic patients in primary care settings. Methods: One hundred and ninety patients (64 men, 126 women) with type 2 diabetes (mean duration 9.2 years) were studied after an overnight fast. Weight, height, waist and hip circumferences and blood pressure were measured and blood samples were taken for glucose, glycated hemoglobin (HbA_1c), total cholesterol, triglyceride, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol and creatinine determinations. Results: About 85% of the patients had HbA_1c levels >7.0%, and 48% had a diastolic blood pressure (BP) >83 mm Hg, while 40% had a total cholesterol/HDL-cholesterol ratio greater than 6. The prevalence rates of hypercholesterolemia, hypertriglyceridemia, high BP and ratios of total cholesterol to HDL-cholesterol between the obese and nonobese patients were similar irrespective of sex (p > 0.05). Multiple linear regression analysis confirmed that ethnicity, sex, age and duration of diabetes had significant impact on the cardiovascular risk in this population. Conclusion: Both obese and nonobese diabetic patients had poor glycemic control and their risk of CVD was not independent of age, sex, ethnicity and duration of diabetes. We suggest strict metabolic control and improved diabetes health education at the primary care level.

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“…For instance, in Trinidad and Tobago, a multi-ethnic population undergoing socioeconomic transformation , type 2 diabetes accounts for about 13.6% of hospital admissions, with an estimated annual government expenditure of US$1.69 million (9). Previous reports have shown that, at diagnosis, patients with type 2 diabetes visiting a primary healthcare setting in Trinidad already had a signi cant cluster of cardiovascular risk factors due to obesity (10); a trend also reported in healthy workers (11). It is known that abdominal obesity is associated with insulin resistance and is predictive of the development of type 2 diabetes and coronary artery disease (5).…”

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confidence: 99%