Saria Hassan1, Cherlie Magny-Normilus2, Deron Galusha2, Oswald P Adams3, Rohan G Maharaj4, Cruz M Nazario5, Maxine Nunez6, Marcella Nunez-Smith2. 1. Yale School of Medicine, Department of Medicine, 100 Church Street South, New Haven, CT 06510, United States; Emory University School of Medicine, Atlanta, GA 30322. Electronic address: saria.hassan@emory.edu. 2. Yale School of Medicine, Department of Medicine, 100 Church Street South, New Haven, CT 06510, United States. 3. University of the West Indies, Cave Hill Campus, Bridgetown, Barbados. 4. University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad, Trinidad and Tobago. 5. University of Puert Rico, Medical Sciences Campus, Graduate School of Public Health, San Juan, Puerto Rico 00921. 6. University of the Virgin Islands, School of Nursing, St. Thomas, US Virgin Islands.
Abstract
AIMS: To determine the level of glycemic control and cardiovascular (CVD) risk among adults with diabetes in the Eastern Caribbean. METHODS: Baseline data from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study (ECS) were used for the analysis. ECS participants were 40 years of age and older, residing in the US Virgin Islands, Puerto Rico, Trinidad, or Barbados. Participants completed a survey, physical exam, and laboratory studies. CVD risk was calculated using the Atherosclerotic CVD risk equation. Bivariate analysis followed by multinomial logistic regression was used to assess social and biological factors (education, lifestyle, access to care, medical history) associated with level of glycemic control. RESULTS: Twenty-three percent of participants with diabetes had an HbA1c ≥ 9% (>75 mmol/mol). Participants with diabetes had poorly controlled CVD risk factors: 70.2% had SBP ≥ 130 mmHg, 52.2% had LDL ≥ 100 mg/dl (2.59 mmol/L), and 73.2% had a 10-year CVD risk of more than 10%. Age and education level were significant, independent predictors of glycemic control. CONCLUSION: There is a high prevalence of uncontrolled diabetes among adults in ECS. The high burden of elevated CVD risk explains the premature mortality we see in the region. Strategies are needed to improve glycemic control and CVD risk factor management among individuals with diabetes in the Caribbean.
AIMS: To determine the level of glycemic control and cardiovascular (CVD) risk among adults with diabetes in the Eastern Caribbean. METHODS: Baseline data from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study (ECS) were used for the analysis. ECS participants were 40 years of age and older, residing in the US Virgin Islands, Puerto Rico, Trinidad, or Barbados. Participants completed a survey, physical exam, and laboratory studies. CVD risk was calculated using the Atherosclerotic CVD risk equation. Bivariate analysis followed by multinomial logistic regression was used to assess social and biological factors (education, lifestyle, access to care, medical history) associated with level of glycemic control. RESULTS: Twenty-three percent of participants with diabetes had an HbA1c ≥ 9% (>75 mmol/mol). Participants with diabetes had poorly controlled CVD risk factors: 70.2% had SBP ≥ 130 mmHg, 52.2% had LDL ≥ 100 mg/dl (2.59 mmol/L), and 73.2% had a 10-year CVD risk of more than 10%. Age and education level were significant, independent predictors of glycemic control. CONCLUSION: There is a high prevalence of uncontrolled diabetes among adults in ECS. The high burden of elevated CVD risk explains the premature mortality we see in the region. Strategies are needed to improve glycemic control and CVD risk factor management among individuals with diabetes in the Caribbean.
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Authors: S Hassan; T Ojo; D Galusha; J L Martinez-Brockman; O P Adams; R Maharaj; C Nazario; M Nunez; M Nunez-Smith Journal: Obes Sci Pract Date: 2018-06-05