Otieno C F, Vaghela V, Mwendwa F W, Kayima J K, Ogola E N
Department of Medicine, College of Health Sciences, University of Nairobi, P. O. Box 19676, 00202 Nairobi, Kenya.
East Afr Med J. 2005 Dec;82(12 Suppl):S184-90. doi: 10.4314/eamj.v82i12.9380.
To determine the proportion of specific cardiovascular risk factors in ambulatory patients with type 2 diabetes and the levels of control achieved in them.
Prospective, cross-sectional study over a six month period.
Out-patient diabetic clinic of the Kenyatta National Hospital.
Two hundred and eleven patients with type 2 diabetes.
Sociodemographic attributes, duration of diabetes, levels of glycaemia, body weight, blood pressure, fasting lipids and modes of treatment.
A total of 211 patients were enrolled, 57.3% were females. The mean (SD) age for women was 54.45 (9.44) and that of men was 55.8 (9.02) years. About 77% of the study population were on oral glucose-lowering agents with or without insulin but less than 30% achieved HbA1c < 7%; 15% were active cigarette smokers; about 50% were hypertensive with female predominance but 65% of them did not achieve desired blood pressure level inspite of treatment. Just over 50% had raised LDL-cholesterol and over 75% had raised total cholesterol but only three men were on statins without achieving desired targets. Body mass index above 30 kg/m2 as a measure obesity was found in 32% of females and 16% males. Most of the study patients admitted use of Aspirin at certain times in the course of their diabetes.
The study showed that specific cardiovascular risk factors of hyperglycaemia, dyslipidaemia, hypertension and obesity were prevalent although not adequately controlled to targets. Statin use was extremely low in people who already needed them. Regular Aspirin use was infrequent because many patients did not quite understand its role in their diabetes treatment. It is recommended that a more pro-active approach in multifactorial address of cardiovascular risk factors be used in high-risk patients with type 2 diabetes to forestall future cardiovascular events.
确定门诊2型糖尿病患者中特定心血管危险因素的比例及其控制水平。
为期6个月的前瞻性横断面研究。
肯雅塔国家医院门诊糖尿病诊所。
211例2型糖尿病患者。
社会人口学特征、糖尿病病程、血糖水平、体重、血压、空腹血脂及治疗方式。
共纳入211例患者，其中57.3%为女性。女性的平均（标准差）年龄为54.45（9.44）岁，男性为55.8（9.02）岁。约77%的研究人群正在使用口服降糖药，无论是否联合胰岛素治疗，但糖化血红蛋白（HbA1c）<7%的患者不到30%；15%为现吸烟者；约50%患有高血压，女性居多，但其中65%尽管接受了治疗仍未达到理想血压水平。略超过50%的患者低密度脂蛋白胆固醇升高，超过75%的患者总胆固醇升高，但只有3名男性服用他汀类药物且未达到理想目标。以体重指数高于30kg/m²作为肥胖指标，32%的女性和16%的男性存在肥胖。大多数研究患者承认在糖尿病病程中的某些时候使用过阿司匹林。
该研究表明，高血糖、血脂异常、高血压和肥胖等特定心血管危险因素普遍存在，但未得到充分控制以达到目标。他汀类药物在已需要使用的人群中使用率极低。常规阿司匹林使用率低，因为许多患者不太了解其在糖尿病治疗中的作用。建议对2型糖尿病高危患者采用更积极的多因素心血管危险因素干预方法，以预防未来心血管事件的发生。
