Pattern of electrocardiographic changes among diabetes mellitus patients attending diabetic clinics in Dar es Salaam
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Date
2025
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Kairuki University
Abstract
Background: People affected with Diabetes mellitus have two-three folds increased risk of cardiovascular disease compared to the general population. Early cardiac involvement in diabetes may be silent and can progress undetected until advanced stages of disease manifest with serious complications. Electrocardiographic changes can serve as early markers of cardiac involvement and provide insight into the progression of cardiovascular complications in diabetic patients. The increase in the burden of Diabetes mellitus in Dar es Salaam the and its known association with cardiovascular disease calls for early screening and detection of diabetes related cardiovascular complication as means to prevent and alleviate the burden of diabetes morbidity and mortality.
Objective: To determine pattern of electrocardiographic changes among diabetes mellitus
patients attending Diabetes clinics in Dar es Salaam.
Methodology: A health-facility based descriptive cross-sectional study was conducted among Diabetes mellitus patients attending Diabetes clinics in Dar es Salaam, with a sample size of 206 study participants. A structured questionnaire was used for Data collection; which included socio-demographic characteristics and pertinent clinical that included general and cardiovascular factors - Blood pressure, electrocardiographic findings and laboratory tests. The Minnesota coding classification was used to interpreted the electrocardiographic findings.
Results: Among 206 Diabetes mellitus patient who were in the final data analysis mean age was 50.08 ± 22.82 years, median age of 57 years, with 50% of the population between age of 24 years and 66 years, (IQR of 42.25 years). The minimum age was 7 years and the maximum age was 101 years. They were 74 males (5.9%) and 132 females (64.1%). Of the 206 study participants 157 (76.2%) had Type 2 Diabetes mellitus and 49 (2.8%) had Type 1 Diabetes mellitus. At least one electrocardiographic changes was noted among 126 (61%) of study participants. Ischaemic changes were the most observed ECG changes (18.9%), ST elevation, ST depression and T wave inversion being most prevalent (8.7%). There was a significant association between age and the prevalence of ECG abnormalities (χ² = 87.510, p-value = 0.004). Significantly higher burden of ECG change was observed in Type 2 Diabetes mellitus compared to Type 1 Diabetes mellitus patients, with a χ² of 18.447 and p-value = 0.010.
Conclusions: The prevalence of ECG changes among Diabetes mellitus study participants in Dar es Salaam is 61%; with ischaemic changes and conduction changes being the commonest in type 2. Moreover, Rhythm changes are more common among Type 1 Diabetes mellitus patients.
Recommendations: At baseline and regular ECG screening in Diabetes mellitus patients is needed for preventive strategies, early detection and management of cardiovascular complications. Emphasis should be for elderly patients and Type 2 Diabetes mellitus patients, to enhance risk stratification, guide therapeutic choices, inform individualized follow-up schedules to detect early ECG abnormalities and mitigate arrhythmic risk.
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A dissertation proposal submitted in partial fulfillment of the requirements for the degree of Master of Medicine in Internal Medicine at Kairuki university
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Deogratius, Sarah 2025. Pattern of electrocardiographic changes among diabetes mellitus patients attending diabetic clinics in Dar es Salaam. Dissertation. Kairuki University