Glycemic control and management of cardiovascular risk factors among adults with diabetes in the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study

      Highlights

      • There is a high prevalence of uncontrolled diabetes among adults in the Eastern Caribbean.
      • There is a high burden of cardiovascular risk among this population.
      • Elevated cardiovascular risk among individuals with diabetes contributes to premature mortality.
      • Interventions to improve glycemic control should target older adults and those with lower education levels.

      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.

      Abbreviations:

      ASCVD (atherosclerotic cardiovascular disease), CVD (cardiovascular disease), DM2 (type II diabetes), ECHORN (Eastern Caribbean Health Outcomes Research Network), HbA1c (hemoglobin A1c), HDL (high density lipoprotein), LDL (low density lipoprotein), USVI (US Virgin Islands)

      Keywords

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