CE Ezenwaka, NV Offiah
Correspondence: Dr C E Ezenwaka, ezenwaka@ttst.net.tt
ABSTRACT
Objective To assess the cardiovascular disease (CVD) risk factors in elderly (> or = 60 years) and younger patients with Type 2 diabetes visiting two primary care clinics in Trinidad.
Materials and Methods Fasting blood samples were taken from one hundred and ninety-one (127 females, 64 males) patients with Type 2 diabetes visiting two primary care clinics between 1 January and 30 April 2000. Anthropometric indices, blood pressure, plasma glucose, serum lipids and insulin were measured. Homeostasis Model Assessment (HOMA) was used to assess basal insulin resistance (IR).
Results Of the 191 patients studied, 58.6% were <60 years old while 41.4% were > or = 60 years old. The younger patients had higher prevalence rates of cigarette smoking and use of alcoholic drinks (p < 0.05). The female younger patients had significantly higher mean body mass index (BMI), glycated haemoglobin (HbA1c), triglyceride, total-cholesterol, fasting plasma glucose and IR than the elderly female patients (p < 0.05). Similarly, the younger male patients had significantly higher mean HbA1c, creatinine, fasting plasma glucose, IR and lower HDL-cholesterol levels than the elderly male patients (p < 0.05). Generally, the younger patients had significantly higher prevalence rates of hypertriglyceridaemia, obesity, poorer glycaemia and blood pressure control.
Conclusion The results indicate that younger patients withType 2 diabetes had poorer metabolic control and higher prevalence rates of CVD risk factors than the elderly patients. The greater risk of CVD in younger patients was not independent of gender and ethnicity.
Keywords: cardiovascular disease, elderly, primary care, Type 2 diabetes
Singapore Med J 2002; 43(10): 497-503