Prevalence of Cardiovascular and Renal Co-morbidities in Patients with Type 2 Diabetes in the Gulf, a Cross-sectional Observational Study

Abstract

Introduction: Understanding comorbid conditions with type 2 diabetes mellitus (T2DM) is critical for clinical decision-making regarding the choice of pharmacotherapy. This study aimed at describing the prevalence and coprevalence of comorbidities, including chronic kidney disease (CKD) and cardiovascular disease (CVD) (coronary artery disease (CAD), cerebrovascular disease, peripheral arterial disease (PAD) and congestive heart failure (CHF)) among patients with T2DM. Methods: A cross-sectional multi-center observational study on 300 patients with T2DM. Data were collected from patients' records during the enrollment visit. Results: Overall, 38%, 10% and 2% of the patients had one, two and three comorbidities, respectively, with the number of comorbidities significantly increasing with age. The most prevalent comorbidities were CVD (17.3%), CAD (15%) and CKD (44.3%), mostly stages 2 and 3. However, the prevalence of CHF (0.7%), PAD (2.3%) and cerebrovascular diseases (1.3%) was low. The highest percentage of anti-hyperglycemic agents used was metformin (81%), dipeptidyl peptidase-4 inhibitors (46%), sodium-glucose co-transporter 2 inhibitors (37%), insulin (36%) and sulfonylurea (34%).

Behavioral, psychological, and clinical outcomes of Arabic-speaking people with type 2 diabetes during COVID-19 pandemic

“…The most common types of comorbidities identified in this study were also consistent with previous findings [31] , [32] . The relatively high prevalence of diabetes and related comorbidities creates the perfect storm for poor outcomes in patients with COVID-19 infection.…”

Current gaps in management and timely referral of cardiorenal complications among people with type 2 diabetes mellitus in the Middle East and African countries: Expert recommendations

“…24 Another multinational study (CAPTURE) showed that people with T2DM and established CVD (33%) have a higher burden of renal dysfunction (microalbuminuria [31.8% vs 20.6%], macroalbuminuria [10 prevalent comorbidities in T2DM. 26 People with T2DM have almost quadruple the risk (hazard ratio [HR] 3.77, P = .001), while those with coronary heart disease are 2.47 (P = .004) times more likely to develop CKD stages 3-5. 27 A multinational registry of T2DM reported that cardiorenal disease was consistently the most frequent first manifestation (60%), stemming from 24% HF and 36% CKD, with HF being associated with a 2-fold risk of CKD and vice versa.…”

“…Another multinational study (CAPTURE) showed that people with T2DM and established CVD (33%) have a higher burden of renal dysfunction (microalbuminuria [31.8% vs 20.6%], macroalbuminuria [10.8% vs 6.8%], and estimated glomerular filtration rate [eGFR] of ≤ 59 mL/min/1.73 m 2 [30.7% vs 15.4%]) compared to those without CVD 25 . CKD (44.3%) and CVD (17.3%) are the most prevalent comorbidities in T2DM 26 . People with T2DM have almost quadruple the risk (hazard ratio [HR] 3.77, P = .001), while those with coronary heart disease are 2.47 ( P = .004) times more likely to develop CKD stages 3‐5 27 .…”

“…The combination of HF and CKD is associated with the highest CV risk (HR 3.91; 95% CI, 3.02‐5.07) and all‐cause mortality risk (HR 3.14; 95% CI, 2.90‐3.40) 28 . Table S1 provides an overview of the cardiorenal burden and associated risk factors in MENA and AFR 9,15,16,20‐23,26,27,29‐36 . Reliable and consistent approaches are needed to measure routine cardiorenal parameters to guide clinical decision‐making in T2DM.…”

“… 28 Table S1 provides an overview of the cardiorenal burden and associated risk factors in MENA and AFR. 9 , 15 , 16 , 20 , 21 , 22 , 23 , 26 , 27 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 Reliable and consistent approaches are needed to measure routine cardiorenal parameters to guide clinical decision‐making in T2DM. Alongside the substantial burden, cardiorenal diseases incur the highest short‐ and long‐term health care costs in T2DM and are important parameters associated with increased health care resource utilization.…”