<p>Assessment of Cardiovascular Risk Factors in Patients with Type 2 Diabetes in Upper Egypt Villages</p>

Abstract

Background: A large percentage of diabetic patients also have other components of metabolic syndrome, which is a group of cardiovascular (CV) hazard factors related to both diabetes mellitus (DM) and cardiovascular diseases (CVD). We do not know about the prevalence of CV risk factors in diabetic patients in Upper Egypt. We aimed to assess the CV risk factors in type 2 diabetic patients in Upper Egypt villages. Methods: We conducted a cross-sectional study that included 800 patients with type 2 DM. We classified the participants into three groups according to the hemoglobin A1c (HbA1c) levels. We assessed the prevalence of other cardiovascular risk factors and their association with HbA1c levels through a detailed history, full clinical examination, and laboratory tests. Results: We found that 75% of the participants were males, 25.5% elderly, 60.25% had hypertension, 60.75% had dyslipidemia, 33.25% were overweight or obese, 19.75% had a family history of coronary artery disease (CAD), 55.75% had established CVD, 42.5% were smokers, and only 12.25% were physically inactive. We found that 84% of the participants had ≥ two cardiovascular risk factors other than DM. HbA1c level was ≥ 7% in 77% of patients. After multivariate regression analysis, we found a significant association of higher systolic blood pressure (BP), more elevated diastolic BP, higher body mass index (BMI), increased waist circumference, old age, long duration of DM, and an increase in the number of clustered CV risk factors with a higher HbA1c level. At the same time, insulin therapy was significantly associated with a lower HbA1c level. Conclusion: All type 2 diabetic patients in Upper Egypt villages have other associated CV risk factors. The clustering of cardiovascular risk factors showed a significant association with higher HbA1c levels. These findings require the thought of associated CV risk factors in choosing medical treatments to optimize glycemic control and multifactorial intervention to improve CV risk.

Prevalence of Cardiovascular Risk Factors Among Patients With Diabetes Mellitus Type 2 at King Fahad University Hospital, Saudi Arabia

“…In poorly controlled HbA1C, 78% of patients were current smokers, while 16% of patients were ex-smokers, and only 5% of patients had never smoked. A similar finding was noted by Hussein et al (2020) with 60% of patients with poorly controlled HbA1C were smokers [ 17 ]. Smoking was a dependent risk factor that might affect HbA1C only when other risk factors were present.…”

“…In our study, 58% of the participants had poor HbA1C control while 20% had fair HbA1C control. HbA1C level was significantly higher in participants with elevated SBP (mmHg), PP (mmHg), and high BMI which is similar to Hussein et al's (2020) findings with 77% of participants who had uncontrolled HbA1C [ 17 ]. Additionally, Peng et al (2013) stated that patients with elevated HbA1C had a worse CV and metabolic risk than those with normal HbA1C [ 18 ].…”

“…(2013) [17,24]. This link might be attributed to the presence of shared risk factors and inflammatory processes seen in both HTN and hyperglycemia [17,25].…”

“…This matches the result of Artha et al (2019), which found a significant positive correlation between HbA1C level and lipid profile [ 15 ]. On the contrary, Hussein et al (2020) result showed no significant relationship between HbA1C and lipid profile [ 17 ]. In our study, 92% had normal total cholesterol, equivalent to a study made in Riyadh by Al Slail et al (2015), which presented that optimal total cholesterol was present in 82% of participants [ 21 ].…”

Poor glycemic control, cardiovascular disease risk factors and their clustering among patients with type 2 diabetes mellitus: A cross-sectional study from Nepal

“…More than half of the study participants had four to eight CVD risk factors, including poor glycemic control. A similar prevalence was reported in a study by Hussein et al, which determined that 16%, 37%, 24.5% and 22.5% had one, two, three, and four or more risk factors clustering of CVD among patients with T2DM [ 46 ]. The clustering of four or more risk factors in the current study is associated with gender, age, level of education, ethnicity, duration of diabetes, and use of hypoglycemic oral medications.…”