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.

中文翻译：

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东加勒比健康结果研究网络 (ECHORN) 队列研究中成年糖尿病患者的血糖控制和心血管危险因素管理

宗旨

确定东加勒比地区成年糖尿病患者的血糖控制水平和心血管 (CVD) 风险。

方法

来自东加勒比健康成果研究网络 (ECHORN) 队列研究 (ECS) 的基线数据用于分析。ECS 参与者年满 40 岁，居住在美属维尔京群岛、波多黎各、特立尼达或巴巴多斯。参与者完成了调查、体检和实验室研究。使用动脉粥样硬化性 CVD 风险方程计算 CVD 风险。采用双变量分析和多项逻辑回归来评估与血糖控制水平相关的社会和生物因素（教育、生活方式、获得护理、病史）。

结果

23% 的糖尿病参与者的 HbA1c ≥ 9% (>75 mmol/mol)。糖尿病参与者的 CVD 危险因素控制不佳：70.2% 的 SBP ≥ 130 mmHg，52.2% 的 LDL ≥ 100 mg/dl (2.59 mmol/L)，73.2% 的 10 年 CVD 风险超过 10%。年龄和教育水平是血糖控制的重要独立预测因素。

结论

在 ECS 的成年人中，不受控制的糖尿病患病率很高。CVD 风险升高的沉重负担解释了我们在该地区看到的过早死亡率。需要制定策略来改善加勒比地区糖尿病患者的血糖控制和 CVD 风险因素管理。