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A study of electrocardiographic and lipid changes in patients with type II diabetes mellitus

Mousomi Roy, Arindom Banerjee, Manoj Chakravarty.




Abstract

Background: Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia resulting from variable interactions of hereditary and environmental factors due to defects in insulin secretion, insulin action, or both. People with type II DM have a 2-fold higher risk of developing cardiovascular disease (CVD) compared to the general population. Resting electrocardiogram (ECG) abnormalities are associated with excess risk of diabetes-induced CVD morbidity and mortality. Around 50% of all diabetics, whether type I or II, are known/found to have dyslipidemia. The frequency of developing dyslipidemia has been found to be higher in people with poorly controlled type II DM. Abnormal blood lipid levels resulting from altered lipid metabolism are considered to be major contributing factors in macrovascular complications, coronary artery disease, etc., that are known to be associated with diabetes.

Aims and Objectives: This study aims to observe and analyze whether dyslipidemia and ECG abnormalities are present concurrently in patients suffering from type II DM, and whether any correlation exists between lipid profile and ECG changes in these patients.

Materials and Methods: A cross-sectional study was carried out in a tertiary care hospital affiliated to a medical college situated in East Godavari district of Andhra Pradesh over a period of 1⅟2 years. One hundred known diabetic patients (as determined by the inclusion criteria) were selected for the study. Blood samples were analyzed for glucose (fasting and postprandial), glycosylated hemoglobin, and lipid profile. Resting 12 leads ECG was taken at the outpatient department for all patients.

Results: Statistical analysis was carried out using SPSS software (version 23.00) and results were statistically analyzed and correlated. The values of blood cholesterol, low-density lipoproteins, and triglycerides were found to be significantly elevated with a high degree of correlation. High-density lipoproteins values were found to be low in these patients. ECG showed significant decrease in the amplitude of P waves, and duration of QRS complex and QT interval was also increased in these patients.

Conclusion: Dyslipidemia and resting ECG abnormalities are common in people with type II DM including those without a history of CVD. The resting ECG assists in cardiac screening of asymptomatic type II diabetic individuals and helps to detect cardiac abnormalities. Regular monitoring of glycemic and lipid profiles and maintaining a strict glycemic control helps in averting complications associated with diabetes and cardiovascular diseases.

Key words: Diabetes; Dyslipidemia; Electrocardiogram Abnormalities






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