Electrocardiogram abnormalities and renal impairment in patients with type 2 diabetes mellitus: A healthcare facilities‐based cross‐sectional study in Dang district of Nepal

Abstract

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.

Associations of Electrocardiographic Abnormalities in Stable Type 2 Diabetes Subjects: Experience from a Tertiary Health Facility in South Eastern Nigeria

“…Some other studies contrastingly found significant association between age and duration of T2DM and ECG abnormalities 25,[26][27][28] . In India most of the ECG abnormalities in asymptomtic T2DM subjects were observed among those with DM duration of 5-10 years.…”

“…This study found significant association between smoking habit and QRS axis abnormality, central obesity and QRS axis abnormality, dyslipidaemia and ST segment abnormality and exercise habit and ST segment abnormality. Khanal MK et al found significant association between age, body mass index (BMI) and duration of T2DM greater than 5 years and ECG abnormalities 25 . Sinamaw D et al found that overweight, fasting blood sugar (FBS) ≥ 130 mg/dl and duration of DM over 10 years were significantly associated with ECG abnormalities, while Harms PP et al found that hypertension was significantly associated with ECG abnormalities 8,26 .…”