TY - JOUR
T1 - Poor glycemic control, cardiovascular disease risk factors and their clustering among patients with type 2 diabetes mellitus
T2 - A cross-sectional study from 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 - Devkota, Surya
AU - de Courten, Maximilian
AU - de Courten, Barbora
N1 - Funding Information:
We want to acknowledge tremendous help from Pratik Bhandari, a PhD candidate from Deakin University, Australia, for providing technical support and language correction. Authors are thankful to Provincial Ayurveda Hospital Development Committee for providing laboratory reagents to conduct biochemical tests. We are grateful for the relentless fieldwork by supervisors- Dr. Ashish Kumar Jha, Dr. Pradeep Adhikari, Dr. Rakesh Yadav, and Dr. Bijay Kishor Thakur. Data collection would not be completed without support from senior volunteers; Dr. Bikash Rijal, Dr. Dharma Raj Chaudhary, Dr. Mahendra Khadka, Dr. Gita Shahu, Dr. Trishmita Chaudhary, Dr, Reshu Budhathoki, Dr. Sushma Chaudhary, Dr. Sumitra Rana, Dr. Shikhar Pokhrel, Dr. Krishna Singh Dhami, Dr. Abha Adhikari, Dr. Manoj Yadav, Ms Parbati Oli, Ms. Lalita Dangi, and Ms. Sonu D. C. Additionally, we want to thank junior volunteers; Mr. Umesh Tharu, Ms. Sweta Kafle, Ms. Urmila Sharma, Ms. Sushmita Shrestha, Ms. Sunita Sunar, Mr. Sanjib Tharu, Ms. Samjhana Dhodari, Ms. Samjhana Tharu, Ms. Kriti Singh Chaudhary, Ms. Ashma Budhathoki, Mr. Samir Rawol, Ms. Sailbala Sharma, Mr. Rita Kuwar, Mr. Rajaram Upadhyay, Mr. Kapil Neupane, Mr. Keshav Khanal, Rabina Chaudhary, Mr. Jeewan Sharma, and Mr. Mitra Bhusal for contributing in data collection. We cannot forget valuable contribution and effort given by laboratory staff of Provincial Ayurveda hospitals; Mrs. Hira Pokhrel, Mr. Rohit K. C., Ms. Dilmaya Gharti, Ms. Pratiksha Oli. Our research implementation would not be finished without moral support from all Tulsipur Sub-metropolitan city health workers. We want to extend our thanks to the head of the department of health of Tulsipur Sub-metropolitan city Mr. Om P. Neupane, and other senior staff, Mr. Bimal K.C. Additionally, we want to thank Mr. Dorna Oli,Jiban Bhandari and Hari Rijal of Rapti Life Care Hospital, Mr. Jaye Prakash Oli of Dirghayu Polyclinic, ward chairmen of respective wards, Diabetic Society of Tulsipur for supporting the implementation of the research project. In the end, we are grateful to the participants of the study.
Publisher Copyright:
Copyright: © 2022 Khanal et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2022/7/25
Y1 - 2022/7/25
N2 - Background Cardiovascular disease (CVD) is the most common complication of diabetes mellitus (DM). To prevent morbidity and mortality among patients with type 2 diabetes mellitus (T2DM), optimization of glycemic status and minimizing CVD risk factors is essential. As Nepal has limited data on these CVD risk parameters, we assessed the prevalence of poor glycemic control, CVD risk factors, and their clustering among patients with T2DM. Methods Using a cross-sectional study design, we collected data of 366 patients with T2DM. We applied a multistage cluster sampling technique and used the WHO STEPS tools. Binary logistic and Poisson regression was applied to calculate odds and prevalence ratio of clustering of risk factors, considering P< 0.05 statistically significant. Results The mean age of participants was 54.5±10.7 years and 208 (57%) were male. The prevalence of poor glycemic control was 66.4% (95% C.I: 61.5–71.2). The prevalence of smoking, alcohol users, inadequate fruit and vegetables intake and physical inactivity were 18% (95% C.I:14 to 21.9), 14.8% (95% C.I:11.1 to 18.4), 98.1% (95% C.I: 96.7–99.4), and 9.8% (95% C.I:6.7–12.8), respectively. Overall, 47.3% (95% C.I: 42.1–52.4) were overweight and obese, 59% (95% C.I: 52.9–63) were hypertensive, and 68% (95% C.I: 63.2–72.7) had dyslipidemia. Clustering of two, three, four, five and more than five risk factors was 12.6%, 30%, 30%,19%, and 8.7%, respectively. Four or more risk factors clustering was significantly associated with gender, age, level of education, T2DM duration, and use of medication. Risk factors clustering was significantly higher among males and users of anti-diabetic medications with prevalence ratio of 1.14 (95% C.I:1.05–1.23) and 1.09 (95% C.I: 1.09–1.18)], respectively. Conclusions The majority of the patients with T2DM had poor glycemic control and CVD risk factors. Policies and programs focused on the prevention and better management of T2DM and CVD risk factors should be implemented to reduce mortality in Nepal.
AB - Background Cardiovascular disease (CVD) is the most common complication of diabetes mellitus (DM). To prevent morbidity and mortality among patients with type 2 diabetes mellitus (T2DM), optimization of glycemic status and minimizing CVD risk factors is essential. As Nepal has limited data on these CVD risk parameters, we assessed the prevalence of poor glycemic control, CVD risk factors, and their clustering among patients with T2DM. Methods Using a cross-sectional study design, we collected data of 366 patients with T2DM. We applied a multistage cluster sampling technique and used the WHO STEPS tools. Binary logistic and Poisson regression was applied to calculate odds and prevalence ratio of clustering of risk factors, considering P< 0.05 statistically significant. Results The mean age of participants was 54.5±10.7 years and 208 (57%) were male. The prevalence of poor glycemic control was 66.4% (95% C.I: 61.5–71.2). The prevalence of smoking, alcohol users, inadequate fruit and vegetables intake and physical inactivity were 18% (95% C.I:14 to 21.9), 14.8% (95% C.I:11.1 to 18.4), 98.1% (95% C.I: 96.7–99.4), and 9.8% (95% C.I:6.7–12.8), respectively. Overall, 47.3% (95% C.I: 42.1–52.4) were overweight and obese, 59% (95% C.I: 52.9–63) were hypertensive, and 68% (95% C.I: 63.2–72.7) had dyslipidemia. Clustering of two, three, four, five and more than five risk factors was 12.6%, 30%, 30%,19%, and 8.7%, respectively. Four or more risk factors clustering was significantly associated with gender, age, level of education, T2DM duration, and use of medication. Risk factors clustering was significantly higher among males and users of anti-diabetic medications with prevalence ratio of 1.14 (95% C.I:1.05–1.23) and 1.09 (95% C.I: 1.09–1.18)], respectively. Conclusions The majority of the patients with T2DM had poor glycemic control and CVD risk factors. Policies and programs focused on the prevention and better management of T2DM and CVD risk factors should be implemented to reduce mortality in Nepal.
UR - http://www.scopus.com/inward/record.url?scp=85135281902&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0271888
DO - 10.1371/journal.pone.0271888
M3 - Article
C2 - 35877664
AN - SCOPUS:85135281902
SN - 1932-6203
VL - 17
JO - PLoS ONE
JF - PLoS ONE
IS - 7 July
M1 - e0271888
ER -
