Examining the prevalence of cardiovascular complications among individuals with early-onset type 2 diabetes: a cross-sectional analysis at a tertiary care hospital
DOI:
https://doi.org/10.18203/2349-3933.ijam20241621Keywords:
Investigation, Cardiovascular, Complications, Early-onset and type-2 diabetesAbstract
Background: Type 2 diabetes mellitus poses a global health threat, with over 60% of cases in Asia. T2DM significantly increases the risk of diabetic cardiomyopathy and cardiovascular disease, contributing to heart failure through mechanisms like myocardial infarction. Diabetic patients face a two to fourfold increased likelihood of developing coronary artery disease and myocardial infarction. The objective of this investigation was to assess the frequency of cardiovascular complications in individuals with early-onset type 2 diabetes.
Methods: This cross-sectional observational study was conducted at the Department of Cardiology, Jashore Medical College, Jashore, Bangladesh. The study duration was one year from January 2023 to December 2023. and focused on adult Type 2 Diabetes patients admitted to tertiary care wards. Inclusion criteria encompassed ages 20-35, both sexes, Type 2 Diabetes diagnosis, and voluntary participation. Exclusion criteria included age under 20, severe concomitant diseases, Gestational Diabetes, advanced renal failure, and Type 1 Diabetes.
Results: This study analyzed 270 cases, with participants predominantly aged 32-35 years (48.52%). Gender distribution showed 56.36% female and 43.64% male participants. Echocardiographic findings revealed normal electrocardiograms in 81.82% of cases, with myocardial infarction observed in 16 cases showing diverse cardiac abnormalities. Diabetic patients exhibited left ventricular diastolic dysfunction 1(0.91%) and hypertrophy 2(1.82%).
Conclusions: The high prevalence of risk factors like obesity and hypertension highlights the intricate connection between metabolic and cardiovascular health. Early monitoring and intervention in young adults with type 2 diabetes are crucial for reducing cardiovascular risks.
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References
Low Wang CC, Hess CN, Hiatt WR, Goldfine AB. Clinical update: cardiovascular disease in diabetes mellitus: atherosclerotic cardiovascular disease and heart failure in type 2 diabetes mellitus mechanisms, management, and clinical considerations. Circulation. 2016;133(24):2459-502.
Pagliaro BR, Cannata F, Stefanini GG, Bolognese L. Myocardial ischemia and coronary disease in heart failure. Heart Failure Rev. 2020;25(1):53-65.
Shah MS, Brownlee M. Molecular and cellular mechanisms of cardiovascular disorders in diabetes. Circulation Res. 2016;118(11):1808-29.
Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009;301(20):2129-40.
Hotta N, Nakamura J, Iwamoto Y, Ohno Y, Kasuga M, Kikkawa R, et al. Causes of death in Japanese diabetics: a questionnaire survey of 18,385 diabetics over a 10‐year period. J Diab Invest. 2010;1(2):66-76.
Agarwal A, Gossain VV. Diabetes in the Elderly. Drugs Diab. 2021;31:183.
McAloon CJ, Osman F, Glennon P, Lim PB, Hayat SA. Global epidemiology and incidence of cardiovascular disease. Academic Press. 2016;1:57-96.
Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham study. JAMA. 1979;241(19):2035-8.
Grundy SM, Benjamin IJ, Burke GL, Chait A, Eckel RH, Howard BV, et al. Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation. 1999;100(10):1134-46.
Kim JA, Koh KK, Quon MJ. The union of vascular and metabolic actions of insulin in sickness and in health. Arterioscleros Thrombos Vasc Biol. 2005;25(5):889-91.
Kaur J, Singh P, Sowers JR. Diabetes and cardiovascular diseases. Am J Therap. 2002;9(6):510-5.
De Rosa S, Arcidiacono B, Chiefari E, Brunetti A, Indolfi C, Foti DP. Type 2 diabetes mellitus and cardiovascular disease: genetic and epigenetic links. Front Endocrinol. 2018;9:2.
Patel TP, Rawal K, Bagchi AK, Akolkar G, Bernardes N, Dias DD, Gupta S, Singal PK. Insulin resistance: an additional risk factor in the pathogenesis of cardiovascular disease in type 2 diabetes. Heart failure Rev. 2016;21:11-23.
Murea M, Ma L, Freedman BI. Genetic and environmental factors associated with type 2 diabetes and diabetic vascular complications. RDS. 2012;9(1):6.
Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics 2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146-603.
Woods M, Mitchell JA, Wood EG, Barker S, Walcot NR, Rees GM, Warner TD. Endothelin-1 is induced by cytokines in human vascular smooth muscle cells: evidence for intracellular endothelin-converting enzyme. Mol Pharmacol. 1999;55(5):902-9.
Petersen KF, Dufour S, Befroy D, Garcia R, Shulman GI. Impaired mitochondrial activity in the insulin-resistant offspring of patients with type 2 diabetes. New Eng J Med. 2004;350(7):664-71.
Wang CC, Hess CN, Hiatt WR, Goldfine AB. Atherosclerotic cardiovascular disease and heart failure in type 2 diabetes mechanisms, management, and clinical considerations. Circulation. 2016;133(24):2459.
Ross R. Atherosclerosis an inflammatory disease. New Eng J Med. 1999;340(2):115-26.
Patil RS, Shetty LH, Chidananda CG, Raj VS, Trivedi AS, Raghu RT, et al. Coronary artery disease in young diabetics (under 40 years): Are they Different?. J Indian Coll Cardiol. 2020;10(4):163-7.
Sosale B, Sosale AR, Mohan AR, Kumar PM, Saboo B, Kandula S. Cardiovascular risk factors, micro and macrovascular complications at diagnosis in patients with young onset type 2 diabetes in India: CINDI 2. Indian J Endocrinol Metab. 2016;20(1):114.
Gupta A, Gupta R, Sharma KK, Lodha S, Achari V, Asirvatham AJ, et al. Prevalence of diabetes and cardiovascular risk factors in middle-class urban participants in India. BMJ Diab Res Care. 2014;2(1):32.
Sardesai VV, Kokane HT, Mukherjee S, Sangle SA. A study of electrocardiographic and 2D echocardio-graphic changes in type 2 diabetes mellitus patients without cardiovascular symptoms. J Family Med Prim Care. 2022;11(3):1036.
Shrestha NR, Sharma SK, Karki P, Shrestha NK, Acharya P. Echocardiographic evaluation of diastolic function in asymptomatic type 2 diabetes. JNMA. 2009;48(173):20-3.