European Journal of Cardiovascular Medicine

Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency or resistance. The global burden of diabetes has been increasing exponentially, with the International Diabetes Federation (IDF) reporting that approximately 537 million adults worldwide had diabetes in 2021, and this number is projected to rise significantly by 2045 [1]. Poor glycemic control, as indicated by high HbA1c levels, is a major risk factor for developing microvascular and macrovascular complications, including cardiovascular diseases (CVD) [2].

Studies have demonstrated that the duration of diabetes plays a crucial role in determining patient outcomes, with longer disease duration associated with an increased risk of complications [3]. Epidemiological data indicate that nearly 80% of diabetes-related mortality is attributed to cardiovascular events, highlighting the strong link between diabetes and CVD [4]. Risk factors such as hypertension, dyslipidemia, smoking, and a family history of CVD further exacerbate the complications in diabetic patients [5].

This study aims to assess the demographic distribution, glycemic control, disease duration, management approaches, and cardiovascular risk factors among diabetic patients. The findings will provide valuable insights into the current trends in diabetes management and associated risk factors, helping improve preventive and therapeutic strategies.

A cross-sectional study was conducted among 100 diabetic patients attending a tertiary care hospital. Data were collected on demographic characteristics, mean HbA1c levels, duration of diabetes, management strategies, and cardiovascular risk factors.

Inclusion Criteria: Patients diagnosed with Type 2 Diabetes Mellitus (T2DM) for at least one year.

Exclusion Criteria: Patients with Type 1 Diabetes Mellitus, gestational diabetes, and those with severe comorbid conditions requiring hospitalization.

Data Collection Patients were categorized based on age, gender, and duration of diabetes. Glycemic control was assessed using HbA1c levels, and diabetes duration was categorized as ≤5 years and >5 years. Management strategies were classified as OHA alone or a combination of OHA and insulin. Cardiovascular risk factors such as hypertension, dyslipidemia, smoking, alcoholism, and tobacco chewing were documented based on medical history and patient interviews.

Statistical analysis was performed descriptive statistics and percentages were used to analyze the data.

Table 1   Gender

Of the 100 patients considered for this study, nearly two-third patients (63 %) were male and more than one-third patients (37 %) were female.

Table 2   Age

More than half of the patients in this study (57 %) belonged to the age group 41 – 60 years. More than one-fifth of the patients (22 %) were aged more than 60 years while the remaining patients (21 %) were from the age group 20 – 40 years.

Table 3   Mean HbA1c

Mean HbA1c for the 100 patients in this study was found to be 8.2.

Table 4   Duration of Diabetes

Nearly two-third of the patients (61 %) considered for this study had Diabetes for a period of more than 5 years. While the remaining (39 %) of the patients had Diabetes for a period of less than or equal to 5 years.

Table 5   Management of Diabetes

Of the 100 patients considered for this study, more than half of the patients (56 %) were given OHA + Insulin to manage Diabetes and the remaining (44 %) patients were given only OHA to manage Diabetes.

Table 6   Cardiovascular Risk Factors

Nearly two-third of the patients considered for this study (63 %) had Dyslipidemia. Hypertension was observed in (41%) patients while (37 %) had High Risk of Cardiovascular Diseases. Nearly one-third of the patients (32 %) had Family History of Cardiovascular Diseases. Of the other Cardiovascular Risk Factors Alcoholism was observed in (29 %) patients, Smoking was found in (19 %) patients and Tobacco Chewing was recorded in (7 %) patients.

This study revealed a significant gender disparity in diabetes prevalence, with 63% of patients being male and 37% female. Similar findings were reported in previous studies, where male predominance was linked to higher metabolic syndrome risk, lifestyle choices, and genetic factors [6].

The mean HbA1c of 8.2 indicates suboptimal glycemic control, consistent with global studies showing poor diabetes management in many populations [7]. The American Diabetes Association (ADA) recommends an HbA1c target of <7% to minimize complications, emphasizing the importance of early intervention and stringent glycemic control [8].

A longer disease duration was observed in 61% of the patients (>5 years), and research has shown that extended diabetes duration correlates with higher complication risks, particularly cardiovascular diseases and neuropathy [9]. Chronic hyperglycemia contributes to endothelial dysfunction, increasing the likelihood of atherosclerosis and ischemic events [10].

In terms of management, 56% of the patients required a combination of OHA and insulin, reflecting the progressive nature of diabetes and the necessity for intensified treatment strategies. Studies suggest that combination therapy is more effective in achieving glycemic targets, especially in patients with longer disease duration or insulin resistance [11].

Cardiovascular risk factors were highly prevalent in this study, with dyslipidemia (63%) and hypertension (41%) being the most common. The Framingham Heart Study established that dyslipidemia and hypertension significantly elevate cardiovascular risk in diabetic individuals [12]. In addition, 37% of the study population was categorized as high risk for cardiovascular disease, underscoring the need for aggressive risk factor management, including lifestyle interventions and pharmacological treatment [13].

Tobacco use, including smoking (19%) and chewing (7%), was noted among patients. Smoking exacerbates insulin resistance and endothelial dysfunction, thereby accelerating diabetes-related complications [14]. Alcohol consumption was observed in 29% of the patients, which has been associated with both positive and negative effects on glycemic control depending on consumption levels and patterns [15].

These findings align with existing literature that underscores the multifactorial nature of diabetes and its complications, reinforcing the need for a comprehensive and individualized approach to management [16].

This study underscores the critical need for improved diabetes management strategies, given the high prevalence of poor glycemic control and associated cardiovascular risk factors. The findings emphasize the necessity of early diagnosis, stringent glycemic monitoring, and proactive intervention to mitigate diabetes-related complications. Multidisciplinary diabetes care teams, including endocrinologists, cardiologists, dietitians, and lifestyle coaches, should be integrated into routine clinical practice to provide comprehensive care. Patient education on self-management, adherence to medications, and lifestyle modifications such as dietary changes and physical activity must be prioritized. Additionally, routine screening for cardiovascular risk factors should be incorporated into diabetes management protocols to reduce long-term morbidity and mortality. Further longitudinal research is needed to evaluate the effectiveness of various intervention strategies in improving long-term outcomes in diabetic patients.

Ethical Clearance: Ethical Clearance Certificate was obtained from the Institutional Ethics Committee (IEC) prior to commencement of study.

Conflict of Interest: Nil - No conflict of interest.

Source of funding: Self

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