Incidence and Cardiovascular Risk Factors Profile in Obese and Non-obese Type 2 Diabetes Mellitus subjects aged between 30 and 80 years in the polyclinic, in an Omani Population: ICD OMAN a Decade-Long Bawshar Study
Dr. Shiju Raman Unni, MRCP, Melba Sheila D’Souza, RN, CMSN, Dr. Hani Naguib MD ,Dr.Nasser Al Kindi MD, Maryam Al Baluchi, Avinash Daniel Pinto, Mr. Shiv Kumar, Dr. Hanan Mahrooqi MD, Dr. Stan Landau FRCP
Background: Coronary heart disease (CHD) and stroke are the major cardiovascular diseases (CVD) among populations with Type 2 diabetes mellitus (T2DM), leading to significant morbidity and mortality. Objective: To identify the incidence and cardiovascular risk factor profiles of obese and non-obese Omani T2DM patients aged between 30 and 80 years followed since ten years in the polyclinic. Design: An observational longitudinal retrospective cohort design was used. Setting: A secondary care polyclinic in Bawshar, Muscat, Oman, was utilized where DM patients were seen three days a week. Sample Size: A Convenient sample of 130 patients with T2DM between 1st November 2019 to 31st January 2020, who were free of CVD at baseline (January 2010) were involved in the study. Materials and Methods: Socio-demographic data and CVD risk factor assessments at the baseline were retrieved from patient’s records. The first CVD outcomes were traced from the date of diagnosis of T2DM to January 31st 2020. The study compared the CVD risk factors among obese and non-obese T2DM patients at baseline. Data were analyzed using Statistical Package for social sciences (SPSS)Statistics Inc., Chicago, US version 25.0. Incidence was expressed in percentage with 95% confidence intervals (CI). p-value< 0.05 was considered Statistically significant. Results: The overall cumulative incidence of CVD was 16.15% over 10 years period. Middle aged (46 to 65years) individuals developed CVD with p value of 0.0028, p< 0.05. Out of 23 middle aged obese women 8 developed CVD compared to non-obese middle aged women with p value of 0.0375, p <0.05. Obese patients had uncontrolled Glycosylated hemoglobin (HbA1c) more than 8 mmol/l with calculated p value of 0.0018, p<0.05. Conclusion: The study revealed higher cumulative incidence of CVD, 16.15% with incidence density of 16 per 1000 persons per year with no gender difference and higher prevalence of CVD risk factors among Omani T2DM patients. Middle aged patients with no gender difference and obese women compared to non-obese women had higher incidence of CVD. Obese patients had uncontrolled HbA1c with no gender difference. Limitations: The study was retrospective in nature, and the sample recruited was a convenient sample which could cause selection bias. Recommendations: The outcomes of the study recommend the Ministry of Health, Oman, to provide GLP-1 agonists for middle-aged obese women to reduce the incidence of CVD by weight reduction and better glycemic control which is currently unavailable in the institution.
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