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. 2022 Aug 9:13:940309.
doi: 10.3389/fendo.2022.940309. eCollection 2022.

Prevalence and risk factors of vascular complications in type 2 diabetes mellitus: Results from discover Middle East and Africa cohort

Khadija Hafidh  1 , Rachid Malek  2 , Khalid Al-Rubeaan  3 , Adri Kok  4 , Fahri Bayram  5 , Akram Echtay  6 , Viraj Rajadhyaksha  7 , Ahmed Hadaoui  8
Affiliations

Prevalence and risk factors of vascular complications in type 2 diabetes mellitus: Results from discover Middle East and Africa cohort

Khadija Hafidh et al. Front Endocrinol (Lausanne). .

Abstract

Background: We evaluated the prevalence of vascular complications and associated risk factors in individuals with type 2 diabetes mellitus (T2DM) initiating second-line glucose-lowering therapy from the Middle East and Africa (MEA) cohort of the 3-year prospective DISCOVER study involving 15,992 patients in 38 countries.

Methods: Baseline cross-sectional data collected from healthcare settings were used to assess micro and macrovascular complications prevalence as crude and age- and sex-standardised. The multi-variable analysis assessed factors associated with these complications.

Results: Of 3,525 enrolled patients (mean age: 54.3 ± 10.8 years), >40% had hypertension and hyperlipidaemia. Metformin monotherapy was the first-line therapy in 56.5%, followed by metformin+sulphonylurea (20.3%). Crude and standardised prevalence of microvascular complications were 17.7% and 16.9% (95% confidence interval [CI], 16.77-16.98) and macrovascular complications were 10.7% and 8.7% (95% CI, 8.59-8.76). Factors significantly (p<0.05) associated with micro and macrovascular complications (odds ratios [95% CI]) were age (1.24 [1.12-1.39] and 1.58 [1.35-1.84]), male sex (1.33 [1.04-1.70] and 1.71 [1.22-2.40]), hyperlipidaemia (1.33 [1.07-1.65] and 1.96 [1.46-2.63]) and hypertension (1.75 [1.40-2.19] and 2.84 [2.07-3.92]).

Conclusion: A substantial burden of vascular complications with prominent risk factors in the MEA cohort calls for early preventive interventions.

Keywords: Middle East and Africa; macrovascular complication; microvascular complications; risk factors; type 2 diabetes; vascular complication.

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Conflict of interest statement

KH has received speaker fees and research support from AstraZeneca, Boehringer Ingelheim, Servier, Sanofi, Merck & Co., Novartis, Novo Nordisk, Pfizer, and Eli Lilly. RM has received honoraria as a speaker and a board member from Novo Nordisk, Sanofi, Eli Lilly, AstraZeneca, Merck, Novartis and Hikma. FB reports speaker honoraria and travel sponsorship from Bilim Ilaç, Abbott, Novo Nordisk, Sanofi Genzyme, Pfizer, and Eczacibasi Ilaç, and advisory board and consultancy fees from Novo Nordisk, Sanofi Genzyme, Abbott, Pfizer, and Bilim Ilaç. AE has received advisory board fees from AstraZeneca, Boehringer Ingelheim, Merck, and Novo Nordisk, and speaker fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck, Novartis, Novo Nordisk, and Sanofi. AK has received speaker and advisory board fees from Novo Nordisk, AstraZeneca, Merck & Co., Eli Lilly, Aspen Pharma, Sanofi, Boehringer Ingelheim, Cipla, Mylan, Pharmadynamics, Adcock Ingram, and Pfizer. AH and VR are employees of AstraZeneca. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. This study received funding from AstraZeneca. AstraZeneca as funder had the following involvement with the study: study design, study management as per ICH GCP Sponsor responsibilities guidelines, decision to publish and the preparation of the manuscript. The data collection was performed by local CROs contracted by AstraZeneca and Data analysis was carried out by an independent academic centre (Mid America Heart Institute).

Figures

Figure 1
Figure 1
(A), Multi‐variable Analysis of Factors Associated With Microvascular Complications. BM, body mass index; HbA1c, glycated haemoglobin; T2DM, type 2 diabetes mellitus. (B), Multi‐variable Analysis of Factors Associated With Macrovascular Complications BMI, body mass index; HbA1c, glycated haemoglobin; T2DM, type 2 diabetes mellitus.
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