A Hospital Based Cross-Sectional Study on Asymptomatic Cardiac Changes in Patients with Type 2 Diabetes Mellitus at a Tertiary Care Hospital, Khammam

Author(s): Krishna Chaitanya Alam1, Durga Sai Kumar Reddi2

Silent ischemia can be predicted with simple, non-invasive and cost-effective
technique called electrocardiogram (ECG) in asymptomatic diabetic patients. Risk
of morbidity and mortality due to cardiac diseases is high in those with diabetes
mellitus. Data on electrocardiogram changes is scarce in India in type-2 diabetic
patients without symptoms. Therefore, this study was undertaken to study ECG
changes in type-2 diabetic patients without symptoms of heart disease.
Hospital based cross-sectional study was carried out over 18 months among 50
cases of type 2 diabetic patients without cardiovascular disease symptoms.
Haematological investigations performed for all patients included lipid profile,
fasting blood sugar, and HbA1c. 12-lead electrocardiogram in resting position was
carried out, and abnormalities in the recorded electrocardiogram were noted in
the study questionnaire.
Mean age of patients was 53.86 ± 3.34 years. Mean duration of diabetes was
11.27 ± 4.19 years. Majority (44 %) were using oral hypoglycaemic drugs and
insulin. Mean values of fasting blood sugar (204.92 ± 22.83) and HbA1c (7.32 ±
0.60 %) were raised. Total cholesterol was 188.4 ± 20.39 mg / dl; high density
lipoprotein was 40.24 ± 5.67 mg / dl; low density lipoprotein was 98.64 ± 14.01
and the triglycerides were 182.9 ± 18.44 mg / dl. 28 % had ECG changes and
among them the most common was ST depression with T wave inversion in 35.7
% followed by left ventricular hypertrophy (LVH) in 28.6 %. Among variables
compared between the two groups, only duration of diabetes (years), and HbA1c
(%) were found to be statistically significant (P < 0.05).
This study shows that type 2 diabetes patients especially of longer duration should
undergo cardiac evaluation even though they do not have any symptoms relating
to cardiovascular system.