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Mohammed Abdelrahim, H., Mustafa Madani, A., & Mohammed El-Hadiyah, T. (2023). Assessment of Cardiovascular Risk Factors Among Sudanese Patients with Type 2 Diabetes. Sudan Journal of Medical Sciences (SJMS), 18(2), 221–230. https://doi.org/10.18502/sjms.v18i2.13605
https://doi.org/10.18502/sjms.v18i2.13605
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authors
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Hisham Mohammed Abdelrahim
Hisham Mohammed Abdelrahim
Department of Endocrinology, Faculty of Medicine, University of National Ribat, Khartoum, Sudan
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Abdelhaleem Mustafa Madani
Abdelhaleem Mustafa Madani
Pharmacology Department, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan
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Tarig Mohammed El-Hadiyah
Tarig Mohammed El-Hadiyah
Pharmacology Department, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan
Published Date
- Jun 30, 2023
Assessment of Cardiovascular Risk Factors Among Sudanese Patients with Type 2 Diabetes
Abstract
Background: Individuals with type 2 diabetes who have optimum condition management are exposed to a significantly higher risk of developing cardiovascular disease (CVD) compared to those who do not have diabetes. People with diabetes are estimated to have a fourfold greater risk of developing CVD than people without diabetes. CVD risk factors other than diabetes include older age, obesity hypertension, dyslipidemia, smoking, and a family history of coronary or kidney diseases.
Objectives: The study aims to assess the cardiovascular risk factors among type2 diabetes at Ribat Hospital Diabetes Clinic, Sudan.
Methods: T2 DM patients were evaluated for the presence of CVD risk factors by using data collecting form to extract data verbally and from patients’ files.
Results: Out of 147 T2 DM files, 92 (61.7 %) were female, 57 (38.3 %) were male, and 58 (38.9 %) patients were ≥ 60 year old. Patients who had poor glycemic control were 112 (75.2 %) and those who met the glycemic target were only 37 (24.8 %). Older age (P = 0.01) and diabetes duration (P = 0.026) were associated with poor glycemic control. Prevalence of hypertension was 61 (40.9 %), dyslipidemia 31 (20.8 %), and physical inactivity 112 (75.2 %). All patients had at least one CVD risk factor and those having all three risk factors were 48 (32.2 %).
Conclusion: All T2 DM diabetic patients in RHDC had at least one CVD risk factor and almost a third of them had all three risk factors. Poor glycemic control, physical inactivity, hypertension, and age ≥ 60 had a higher prevalence of CVD risk factors.
References
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[19] Gurudut, P., & Rajan, A. P. (2017). Immediate effect of passive static stretching versus resistance exercises on postprandial blood sugar levels in type 2 diabetes mellitus: A randomized clinical trial. Journal of Exercise Rehabilitation, 13, 581–587.
[20] Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., Chasan-Taber, L., Albright, A. L., Braun, B., & the American College of Sports Medicine, & the American Diabetes Association. (2010). Exercise and type 2 diabetes: The American College of Sports Medicine and the American Diabetes Association: Joint position statement. Diabetes Care, 33, e147–e167.
[21] Hayes, L. D., Grace, F. M., Sculthorpe, N., Herbert, P., Ratcliffe, J. W., Kilduff, L. P., & Baker, J. S. (2013). The effects of a formal exercise training programme on salivary hormone concentrations and body composition in previously sedentary aging men. SpringerPlus, 2, 18.
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[23] Kamuhabwa, A. R., & Charles, E. (2014). Predictors of poor glycemic control in type 2 diabetic patients attending public hospitals in Dar es Salaam. [PubMed.]. Drug, Healthcare and Patient Safety, 6, 155–165.
[24] Sibai, A. M., Costanian, C., Tohme, R., Assaad, S., & Hwalla, N. (2013). Physical activity in adults with and without diabetes: From the ‘high-risk’ approach to the ‘population-based’ approach of prevention. BMC Public Health, 13, 1002.
[25] Parajuli, J., Saleh, F., Thapa, N., & Ali, L. (2014). Factors associated with nonadherence to diet and physical activity among Nepalese type 2 diabetes patients: A cross sectional study. BMC Research Notes, 7, 758.
[26] Hirano, T. (2018). Pathophysiology of diabetic dyslipidemia. Journal of Atherosclerosis and Thrombosis, 25, 771–782.
[27] Haile, K., & Timerga, A. (2020). Dyslipidemia and its associated risk factors among adult type-2 diabetic patients at Jimma University Medical Center, Jimma, Southwest Ethiopia. Diabetes, Metabolic Syndrome and Obesity, 13, 4589–4597.
[28] Chamba, N. G., Shao, E. R., Sonda, T., & Lyaruu, I. A. (2017). Lipid profile of Type 2 diabetic patients at a tertiary hospital in Tanzania: Cross sectional study. Journal of Endocrinology and Diabetes, 4, 1–6.
[29] Hussein, A., Mahmoud, S. E. D., Awad, M. S., & Mahmoud, H. E. M. (2020). Assessment of cardiovascular risk factors in patients with type 2 diabetes in upper Egypt villages. Diabetes, Metabolic Syndrome and Obesity, 13, 4737–4746.
[30] Halter, J. B., Musi, N., McFarland Horne, F., Crandall, J. P., Goldberg, A., Harkless, L., Hazzard, W. R., Huang, E. S., Kirkman, M. S., Plutzky, J., Schmader, K. E., Zieman, S., & High, K. P. (2014). Diabetes and cardiovascular disease in older adults: Current status and future directions. Diabetes, 63, 2578–2589.
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[32] Kalofoutis, C., Piperi, C., Kalofoutis, A., Harris, F., Phoenix, D., & Singh, J. (2007). Type II diabetes mellitus and cardiovascular risk factors: Current therapeutic approaches. Experimental and Clinical Cardiology, 12, 17–28.
[33] Al Slail, F. Y., Abid, O., Assiri, A. M., Memish, Z. A., & Ali, M. K. (2016).Cardiovascular risk profiles of adults with type-2 diabetes treated at urban hospitals in Riyadh, Saudi Arabia. Journal of Epidemiology and Global Health, 6(1): 29–36.
[2] Wright, A. K., Suarez-Ortegon, M. F., Read, S. H., Kontopantelis, E., Buchan, I., Emsley, R., Sattar, N., Ashcroft, D. M., Wild, S. H., & Rutter, M. K. (2020). Risk factor control and cardiovascular event risk in people with type 2 diabetes in primary and secondary prevention settings. Circulation, 142, 1925–1936.
[3] Buyken, A. E., von Eckardstein, A., Schulte, H., Cullen, P., & Assmann, G. (2007). Type 2 diabetes mellitus and risk of coronary heart disease: Results of the 10-year follow-up of the PROCAM study. European Journal of Cardiovascular Prevention and Rehabilitation, 14, 230–236.
[4] Ohira, T., Shahar, E., Chambless, L. E., Rosamond, W. D., Mosley, T. H., Jr., & Folsom, A. R. (2006). Risk factors for ischemic stroke subtypes: The atherosclerosis risk in communities study. Stroke, 37, 2493–2498.
[5] Einarson, T. R., Acs, A., Ludwig, C., & Panton, U. H. (2018). Prevalence of cardiovascular disease in type 2 diabetes: A systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovascular Diabetology, 17, 83.
[6] Group, U. P. D. S., & the UK Prospective Diabetes Study (UKPDS) Group. (1998). Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet, 352, 837–853.
[7] Gaede, P., Vedel, P., Larsen, N., Jensen, G. V., Parving, H.-H., & Pedersen, O. (2003). Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. The New England Journal of Medicine, 348, 383–393.
[8] Stratton, I. M., Adler, A. I., Neil, H. A. W., Matthews, D. R., Manley, S. E., Cull, C. A., Hadden, D., Turner, R. C., & Holman, R. R. (2000). Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): Prospective observational study. BMJ (Clinical Research Ed.), 321, 405–412.
[9] Association, A. (2020). American diabetes association standards of medical care in diabetes-2020. Diabetes Care, 43, S14–S31.
[10] Alramadan, M. J., Magliano, D. J., Almigbal, T. H., Batais, M. A., Afroz, A., Alramadhan, H. J., Mahfoud, W. F., Alragas, A. M., & Billah, B. (2018). Glycaemic control for people with type 2 diabetes in Saudi Arabia - an urgent need for a review of management plan. BMC Endocrine Disorders, 18, 62.
[11] Cade, W. T. (2008). Diabetes-related microvascular and macrovascular diseases in the physical therapy setting. Physical Therapy, 88, 1322–1335.
[12] American Diabetes Association. (2019). 10. Cardiovascular disease and risk management: Standards of medical care in diabetes—2019. Diabetes Care, 42(Suppl 1), S103–S123.
[13] Collins, R., Armitage, J., Parish, S., Sleigh, P., Peto, R., & the Heart Protection Study Collaborative Group. (2003). MRC/BHF heart protection study of cholesterol-lowering with simvastatin in 5963 people with diabetes: A randomised placebo-controlled trial. Lancet, 361, 2005–2016.
[14] Alzaheb, R. A., & Altemani, A. H. (2018). The prevalence and determinants of poor glycemic control among adults with type 2 diabetes mellitus in Saudi Arabia. Diabetes, Metabolic Syndrome and Obesity, 11, 15–21.
[15] Khattab, M., Khader, Y. S., Al-Khawaldeh, A., & Ajlouni, K. (2010). Factors associated with poor glycemic control among patients with type 2 diabetes. Journal of Diabetes and Its Complications, 24, 84–89.
[16] Almetwazi, M., Alwhaibi, M., Balkhi, B., Almohaini, H., Alturki, H., Alhawassi, T., Ata, S., AlQahtani, N., Mahmoud, M., & Alshammari, T. (2019). Factors associated with glycemic control in type 2 diabetic patients in Saudi Arabia. Saudi Pharmaceutical Journal, 27, 384–388.
[17] Salman, R. A., & Al-Rubeaan, K. A. (2009). Incidence and risk factors of hypertension among Saudi type 2 diabetes adult patients: An 11-year prospective randomized study. Journal of Diabetes and Its Complications, 23, 95–101.
[18] Lastra, G., Syed, S., Kurukulasuriya, L. R., Manrique, C., & Sowers, J. R. (2014). Type 2 diabetes mellitus and hypertension: An update. Endocrinology and Metabolism Clinics, 43, 103–122.
[19] Gurudut, P., & Rajan, A. P. (2017). Immediate effect of passive static stretching versus resistance exercises on postprandial blood sugar levels in type 2 diabetes mellitus: A randomized clinical trial. Journal of Exercise Rehabilitation, 13, 581–587.
[20] Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., Chasan-Taber, L., Albright, A. L., Braun, B., & the American College of Sports Medicine, & the American Diabetes Association. (2010). Exercise and type 2 diabetes: The American College of Sports Medicine and the American Diabetes Association: Joint position statement. Diabetes Care, 33, e147–e167.
[21] Hayes, L. D., Grace, F. M., Sculthorpe, N., Herbert, P., Ratcliffe, J. W., Kilduff, L. P., & Baker, J. S. (2013). The effects of a formal exercise training programme on salivary hormone concentrations and body composition in previously sedentary aging men. SpringerPlus, 2, 18.
[22] Duclos, M., Oppert, J. -M., Verges, B., Coliche, V., Gautier, J. -F., Guezennec, Y., Reach, G., Strauch, G., & the SFD diabetes and physical activity working group. (2013). Physical activity and type 2 diabetes. Recommendations of the SFD (Francophone Diabetes Society) diabetes and physical activity working group. Diabetes & Metabolism, 39, 205–216.
[23] Kamuhabwa, A. R., & Charles, E. (2014). Predictors of poor glycemic control in type 2 diabetic patients attending public hospitals in Dar es Salaam. [PubMed.]. Drug, Healthcare and Patient Safety, 6, 155–165.
[24] Sibai, A. M., Costanian, C., Tohme, R., Assaad, S., & Hwalla, N. (2013). Physical activity in adults with and without diabetes: From the ‘high-risk’ approach to the ‘population-based’ approach of prevention. BMC Public Health, 13, 1002.
[25] Parajuli, J., Saleh, F., Thapa, N., & Ali, L. (2014). Factors associated with nonadherence to diet and physical activity among Nepalese type 2 diabetes patients: A cross sectional study. BMC Research Notes, 7, 758.
[26] Hirano, T. (2018). Pathophysiology of diabetic dyslipidemia. Journal of Atherosclerosis and Thrombosis, 25, 771–782.
[27] Haile, K., & Timerga, A. (2020). Dyslipidemia and its associated risk factors among adult type-2 diabetic patients at Jimma University Medical Center, Jimma, Southwest Ethiopia. Diabetes, Metabolic Syndrome and Obesity, 13, 4589–4597.
[28] Chamba, N. G., Shao, E. R., Sonda, T., & Lyaruu, I. A. (2017). Lipid profile of Type 2 diabetic patients at a tertiary hospital in Tanzania: Cross sectional study. Journal of Endocrinology and Diabetes, 4, 1–6.
[29] Hussein, A., Mahmoud, S. E. D., Awad, M. S., & Mahmoud, H. E. M. (2020). Assessment of cardiovascular risk factors in patients with type 2 diabetes in upper Egypt villages. Diabetes, Metabolic Syndrome and Obesity, 13, 4737–4746.
[30] Halter, J. B., Musi, N., McFarland Horne, F., Crandall, J. P., Goldberg, A., Harkless, L., Hazzard, W. R., Huang, E. S., Kirkman, M. S., Plutzky, J., Schmader, K. E., Zieman, S., & High, K. P. (2014). Diabetes and cardiovascular disease in older adults: Current status and future directions. Diabetes, 63, 2578–2589.
[31] Bello-Ovosi, B. O., Ovosi, J. O., Ogunsina, M. A., Asuke, S., & Ibrahim, M. S. (2019). Prevalence and pattern of dyslipidemia in patients with type 2 diabetes mellitus in Zaria, Northwestern Nigeria. The Pan African Medical Journal, 34, 123.
[32] Kalofoutis, C., Piperi, C., Kalofoutis, A., Harris, F., Phoenix, D., & Singh, J. (2007). Type II diabetes mellitus and cardiovascular risk factors: Current therapeutic approaches. Experimental and Clinical Cardiology, 12, 17–28.
[33] Al Slail, F. Y., Abid, O., Assiri, A. M., Memish, Z. A., & Ali, M. K. (2016).Cardiovascular risk profiles of adults with type-2 diabetes treated at urban hospitals in Riyadh, Saudi Arabia. Journal of Epidemiology and Global Health, 6(1): 29–36.