मधुमेह जटिलताओं और चिकित्सा जर्नल

Prevalence of Prolonged QTc Interval and Associated Factors among Type Two Diabetic Patients at Kilimanjaro Christian Medical Centre, in North?Eastern Tanzania

Abstract

Flora G. Ruhangisa, Nyasatu G. Chamba, Kajiru G. Kilonzo, Elichilia R. Shao, Gloria A. Temu Clifford Tarimo, Isaack A. Lyaruu and Akrabi Huda

Objective: Diabetes Mellitus (DM) is steadily increasing globally; whereas Cardiac Autonomic Neuropathy (CAN) is one of the well-established complications of diabetes mellitus that is long standing and poorly controlled. Alteration in cardiac sympathetic innervations may result in QTc interval prolongation and predispose to arrthymias and sudden death. QTc interval prolongation in ECG is rapid, non-invasive and specific method in detecting CAN among type two diabetic patients. This study aimed to determine the prevalence of prolonged QTc interval among Type 2 DM (T2DM) patients at Kilimanjaro Christian Medical Center, Moshi Tanzania. This cross-sectional hospital-based study was carried out from October 2016 to March 2017 among 310 type 2 diabetic patients.

Results: The prevalence of prolonged QTc interval among T2DM was found to be 32%. Poor glycaemic control (OR: 2.55, P=<0.0001), Being Hypertensive (OR: 1.73, P=0.037), High Total cholesterol (OR: 1.52, P=0.001), High LDL-c (OR: 1.28, P=0.005), High Triglycerides (OR: 1.64, P=0.001), Fasting plasma glucose (OR: 1.08, P=0.017), Diabetes duration (OR: 1.09, P=<0.0001), Insulin regimen (OR: 2.14, P=0.011), Combined regimen (Oral hypoglycemic and Insulin) (OR: 4.55, P=0.015), High BMI (P=0.008) were significant factors. Multivariate logistic regression showed that poor glycaemic control, fasting plasma glucose, insulin regimen and combined regimen (insulin and oral hypoglycemic) were determinants for QTc prolongation among T2DM patients in this study.

Conclusion: This study revealed a high prevalence of prolonged QTc interval. Modifiable factors such as poor glycaemic control, dyslipidemia, hypertension, fasting plasma glucose and treatment modalities were associated with the QTc prolongation. Furthermore, longer diabetes duration was also associated with QTc prolongation. Thus there is need of having a tightly glycaemic control, screening and management of dyslipidemia as well as regular ECG check up to high risk group.