Cardiovascular disease risk assessment and treatment among person with type 2 diabetes mellitus at the primary care level in rural central India

Abstract

Introduction: Despite evidence in support of assessment and treatment of risk factors to prevent cardiovascular disease (CVD) among people with type 2 diabetes mellitus (T2DM), studies have shown gaps in practises at the primary care level. The study was undertaken to find out the prevalence and management of risk factors for CVD in patients with T2DM from rural area India. Methodology: A crosssectional study was conducted in a tertiary care hospital in rural India. Around 192 persons with T2DM over 35 years of age were interviewed and examined using a structured questionnaire to determine the presence of CVD risk factors, previous assessment and management of these risk factors. Results: The mean age was 58.91 (SD 11.30) years. Tobacco use and harmful consumption of alcohol were reported by 67.7% and 27%, respectively. Nearly 43.8% were doing moderateintensity physical activity, 2.1% were consuming more than 6 servings of green leafy vegetables/fruits per week, 22.9% were overweight and 5.2% were obese. A family history of CVD was present in 12.5%. About 75% of participants were having one or more risk factors for CVD, and a comprehensive CVD risk assessment was done by 15%. The most commonly assessed risk factor was blood pressure (84.3%) and blood sugar (40%). Around 30% were advised for weight reduction and 23.4% were advised to quit tobacco. Dietary counseling and diet plan were prepared for 17 (8.9%) participants. Conclusion: Nearly threefourths were receiving treatment for hypertension. The majority of people with T2DM in rural areas had one or more CVD risk factors; however, very few were assessed and treated for CVD risk factors at the primary care level. Patient education and training of the diabetes care providers at the primary care level may be useful for comprehensive CVD risk assessment and treatment to prevent CVD complications in patients of T2DM.

Alcohol abuse in older adults with type 2 diabetes mellitus in primary health care: a cross-sectional study

“…We noted that 20% of older adults who engaged in alcohol abuse used tobacco, and this characteristic requires attention, especially due to the known risk factor for cardiovascular diseases 25 . Moreover, studies have highlighted that smoking can accelerate microvascular complications from diabetes caused by hyperglycemic harm to small blood vessels 26 .…”

Estimation of Cardiovascular Risk Profile among Diabetic Patients Attending Tertiary Care Hospital

“…However, unlike in the present study, waist circumference was a significant factor for CVD risk estimation. 13 Research conducted on cardiovascular risk factors in patients with type 2 diabetes with special reference to gender concluded that there is a distinct gender-based risk clustering of obesity, poor glycemic control, hypertension, and dyslipidemia with lower levels of smoking and alcohol consumption among women. Men were reported to have obesity (84%), poor glycemic control (32%), hypertension (34%), dyslipidemia (20%), smoking (61%), and consumption of alcohol (52%).…”

“…However, unlike in the present study, waist circumference was a significant factor for CVD risk estimation. 13…”

A Case Report on Management of Third Toe Gangrene by Amputation in a Diabetic Female

“…Diabetes patients with peripheral vascular disease and poor glycemic control are more likely to develop Onychomycosis. [17][18][19][20] According to a study, subclinical atherosclerosis, the main cause of death in diabetic patients, is linked to Onychomycosis in people with diabetes. Due to the coexisting neuropathy, the enlarged, brittle nails that are typical of this infection have the potential to harm the nearby skin without being observed.…”