TY - JOUR
T1 - Electrocardiogram abnormalities and renal impairment in patients with type 2 diabetes mellitus
T2 - A healthcare facilities-based cross-sectional study in Dang district of Nepal
AU - Khanal, Mahesh Kumar
AU - Bhandari, Pratiksha
AU - Dhungana, Raja Ram
AU - Gurung, Yadav
AU - Rawal, Lal B.
AU - Pandey, Gyanendra
AU - Bhandari, Madan
AU - Bhuiyan, Rijwan
AU - Devkota, Surya
AU - de Courten, Maximilian
AU - de Courten, Barbora
N1 - Funding Information:
This work is supported by National Natural Science Foundation of China (52007062), Fundamental Research Fund for the Central University (2020MS088).
Funding Information:
The authors very much appreciate the support of Pratik Bhandari, a PhD candidate at Deakin University, Australia. The authors sincerely acknowledge the help from Provincial Ayurveda Hospital for facilitation of data collection of the original mixed-method study. We thank field supervisors, volunteers and health professionals of the health facilities of Tulsipur Sub-Metropolitan City. Importantly, we want to thank the participants of the study. This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
Publisher Copyright:
© 2023 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
PY - 2023/4
Y1 - 2023/4
N2 - Aims/Introduction: The global burden of diabetes mellitus is rising substantially, with a further increase in cardiovascular and kidney disease burden. These public health problems are highly prevalent in low- and middle-income countries, including Nepal. However, there is limited evidence on cardiac and renal conditions among patients with type 2 diabetes mellitus. We determined the status of electrocardiogram (ECG) abnormalities and renal impairment among patients with type 2 diabetes mellitus in Nepal. Methods: We carried out a cross-sectional study in Tulsipur Sub-Metropolitan City of Nepal using a multistage stratified sampling technique to recruit patients with type 2 diabetes mellitus. We used World Health Organization stepwise approach to surveillance (WHO STEPS) questionnaires and carried out resting ECG to collect data of 345 patients with type 2 diabetes mellitus. Logistic regression analysis assessed the factors associated with ECG abnormalities and renal impairment. Results: The study showed that 6.1% of participants had major ECG abnormalities (95% confidence interval [CI] 3.8–8.6%), which were associated with hypertension (P = 0.01%) and low socioeconomic status (P = 0.01). The proportion of major and/or minor ECG abnormalities was 47.8% (95% CI 40.5–51%), and were significantly associated with age (odds ratio [OR] 1.04, 95% CI 1.01–1.07), higher education (OR 3.50, 95% CI 1.31–9.33), unemployment (OR 3.02, 95% CI 1.08–8.48), body mass index (OR 1.09, 95% CI 1.02–1.17) and duration of type 2 diabetes mellitus >5 years (OR 2.42, 95% CI 1.19–4.93). The proportion of renal impairment was 3.5% (95% CI 1.5–4.5%) which was associated with older age (OR 1.08, 95% CI 1.00–1.17) and hypertension (OR 12.12, 95% CI 1.07–138.22). Conclusion: A significant proportion of patients with type 2 diabetes mellitus had ECG abnormalities and renal impairment, which were significantly associated with hypertension. Therefore, hypertension management and early screening are essential to prevent future cardiorenal complications among patients with type 2 diabetes mellitus.
AB - Aims/Introduction: The global burden of diabetes mellitus is rising substantially, with a further increase in cardiovascular and kidney disease burden. These public health problems are highly prevalent in low- and middle-income countries, including Nepal. However, there is limited evidence on cardiac and renal conditions among patients with type 2 diabetes mellitus. We determined the status of electrocardiogram (ECG) abnormalities and renal impairment among patients with type 2 diabetes mellitus in Nepal. Methods: We carried out a cross-sectional study in Tulsipur Sub-Metropolitan City of Nepal using a multistage stratified sampling technique to recruit patients with type 2 diabetes mellitus. We used World Health Organization stepwise approach to surveillance (WHO STEPS) questionnaires and carried out resting ECG to collect data of 345 patients with type 2 diabetes mellitus. Logistic regression analysis assessed the factors associated with ECG abnormalities and renal impairment. Results: The study showed that 6.1% of participants had major ECG abnormalities (95% confidence interval [CI] 3.8–8.6%), which were associated with hypertension (P = 0.01%) and low socioeconomic status (P = 0.01). The proportion of major and/or minor ECG abnormalities was 47.8% (95% CI 40.5–51%), and were significantly associated with age (odds ratio [OR] 1.04, 95% CI 1.01–1.07), higher education (OR 3.50, 95% CI 1.31–9.33), unemployment (OR 3.02, 95% CI 1.08–8.48), body mass index (OR 1.09, 95% CI 1.02–1.17) and duration of type 2 diabetes mellitus >5 years (OR 2.42, 95% CI 1.19–4.93). The proportion of renal impairment was 3.5% (95% CI 1.5–4.5%) which was associated with older age (OR 1.08, 95% CI 1.00–1.17) and hypertension (OR 12.12, 95% CI 1.07–138.22). Conclusion: A significant proportion of patients with type 2 diabetes mellitus had ECG abnormalities and renal impairment, which were significantly associated with hypertension. Therefore, hypertension management and early screening are essential to prevent future cardiorenal complications among patients with type 2 diabetes mellitus.
KW - Electrocardiogram abnormalities
KW - Renal impairment
KW - Type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=85147509598&partnerID=8YFLogxK
U2 - 10.1111/jdi.13985
DO - 10.1111/jdi.13985
M3 - Article
C2 - 36747483
AN - SCOPUS:85147509598
SN - 2040-1116
VL - 14
SP - 602
EP - 613
JO - Journal of Diabetes Investigation
JF - Journal of Diabetes Investigation
IS - 4
ER -
