Are newly diagnosed type 2 diabetes patients at risk of developing some form of cardiovascular disease?

A new study has revealed that over 55 per cent of newly diagnosed type 2 diabetes mellitus (T2DM) patients in India have low HDL-C (High Density Lipid – Cholesterol) values, indicating that they are at higher risk of developing some form of cardiovascular disease in their lifetime. Type 2 diabetes is caused when the insulin hormone does not properly regulate glucose in the body.

Following the recent recommendations from the Lipid Association of India, and QRISK3 score2 (a prediction algorithm for cardiovascular disease), the study aimed at investigating the extent of cardiovascular disease (CVD) risk in newly diagnosed type 2 diabetes patients in India.

India Diabetes Study also suggested that 42 per cent of such patients are at a high risk of hypertension. The mean BMI of the patients was recorded to be 27.2 – classified as overweight, as per the Indian Consensus Group guidelines.

Co-authored by 16 doctors between 2020-2021, the study was conducted in partnership with over 1,900 physicians by Eris Lifesciences with a sample size of 5,080 patients with a mean age of 48 years, from across 27 states in India. It has been published in the Public Library of Science (PLOS) journal.

It is known that type 2 diabetes is caused when the insulin hormone does not properly regulate glucose in the body. (Source: Getty Images/Thinkstock)

Some of the key findings of the report are:

*92.5 per cent and 83.5 per cent of total patients are not on any cholesterol lowering and anti-hypertension treatment
*Low HDL-C value was the most frequent major risk (55.6 per cent)
*82.5 per cent patients appeared to have at least one cholesterol abnormality
*37.3 per cent patients were hypertensive and younger than 65 years of age
*According to the QRISK3 calculation, obese patients in the current population had 17.1 per cent risk of CVD as compared to 14.8 per cent for those with lower BMI
*11.2 per cent patients had Target Organ Damage – a chronic kidney disease in the 3b or higher stage

Dr R K Sahay, Department of Endocrinology, Osmania Medical College, Osmania General Hospital, Hyderabad, President of Endocrinology Society of India and the co-author of the study said, “Atherosclerotic cardiovascular disease is a significant risk factor in diabetic patients. Along with glucose control, it is important to follow a robust regimen that is inclusive of optimum lipid lowering treatment, in order to reduce CVD risk. Another important finding that emerged from the study is the increased average BMI (Body Mass Index) of Indians. Physical activity and diet control are crucial to managing diabetes effectively. ”

The findings support the fact that further nationwide cardiovascular disease risk identification programs and prevention strategies to reduce the occurrence of cardiovascular diseases are warranted, Dr A G Unnikrishnan, CEO and chief of endocrinology at Chellaram Diabetes Institute, Pune, and the Principal Investigator of the study told during the launch of the study.

While treatment should focus on dietary changes, physical activity and glucose control, addressing cardiovascular risk by strategies like blood pressure control and lipid management offer a more holistic way of management– as also suggested in the India Diabetes Study, he added.

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