# Spectrum of Cardiac Complications in Diabetic Patients in Rural Uttar Pradesh, India: A Hospital-Based Study

## TL;DR

This study examines heart problems in diabetic patients in rural India, finding that many have heart disease linked to poor blood sugar control and lifestyle factors.

## Contribution

The study identifies specific cardiac complications and their risk factors in rural diabetic populations using a comprehensive diagnostic approach.

## Key findings

- 66% of diabetic patients had cardiac complications, with CAD, diastolic dysfunction, and diabetic cardiomyopathy being most common.
- Higher HbA1c and longer diabetes duration were significantly associated with coronary artery disease.
- Modifiable risk factors like hypertension, smoking, and sedentary lifestyle were linked to CAD in diabetic patients.

## Abstract

Background: Diabetes mellitus significantly contributes to cardiovascular morbidity, particularly in rural populations with limited healthcare access. This study investigated the spectrum of cardiac complications among individuals with diabetes in rural Uttar Pradesh, India, along with associated risk factors.

Methodology: A hospital-based study was conducted at the Department of General Medicine, Uttar Pradesh University of Medical Sciences (UPUMS), Saifai, Etawah, from March 2024 to March 2025. A total of 150 diabetic patients attending the outpatient department (OPD) were assessed for cardiac complications using clinical findings, baseline electrocardiogram, treadmill stress test, and four-dimensional (4D) echocardiography. Glycosylated hemoglobin (HbA1c) was measured via high-performance liquid chromatography. Statistical analyses included one-way analysis of variance with Tukey's honestly significant difference (HSD) post hoc tests for HbA1c and duration of diabetes, as well as multinomial logistic regression to evaluate risk factors.

Results: Of 150 patients, 99 (66%) had cardiac complications. Among those with cardiac complications, 34 (34%) had coronary artery disease (CAD), 33 (33%) had diastolic dysfunction, and 32 (32%) had diabetic cardiomyopathy. Analysis of variance showed significant differences in HbA1c (F=3.70, p=0.013) and duration of diabetes (F=16.73, p<0.000001) across groups. Post hoc tests indicated CAD patients had significantly higher HbA1c and longer diabetes duration. Multinomial logistic regression identified higher HbA1c, low-density lipoprotein cholesterol, triglycerides, total cholesterol, age, duration of diabetes, hypertension, smoking, and sedentary lifestyle as significant CAD risk factors (p<0.05).

Conclusions: CAD was associated with elevated HbA1c, prolonged diabetes duration, and multiple modifiable risk factors. Early screening and targeted interventions are essential for managing cardiac complications in rural diabetic populations.