ESTIMATING THE RISK OF CARDIO VASCULAR DISEASES AMONG PAKISTANI DIABETICS USING UK PDS RISK ENGINE
AbstractBackground: The concept of risk estimation of Coronary Heart Disease (CHD) is helpful for clinician to identifying high risk populations for their effective treatment. Latest studies recommended only initiating cardio-protective treatment in diabetic patients based on personalized CHD risk estimates so as to reduce undue harm from overly aggressive risk factor modification. The United Kingdom Prospective Diabetes Study (UK PDS) Risk Engine is a widely used tool to assess the risk of Cardio Vascular diseases (CVD) in diabetics. The literature search so far did not reveal any study of risk assessment among Pakistani Diabetics. Methods: This descriptive study is based on the data of 470 type-2 diabetics seen in Department of Endocrinology and Metabolism, Services Institute of Medical Sciences, Lahore during 2011. The data of these 470 patients was analyzed through UKPDS Risk Engine. CHD risk was calculated. Results: The 10 years risk of CHD, fatal CHD, stroke and fatal stroke was 9.4%, 4.4%, 1.7% and 0.2% respectively. Conclusions: The present study show a lower risk of CVD occurring among Pakistani diabetics as compared to studies from western countries.Keywords: Cardiovascular, Risk Assessment, Diabetics, UK PDS, Risk Engine, Pakistan
Shera AS, Jawad F, Maqsood A. Prevalence of diabetes in Pakistan. Diabetes Res Clin Pract 2007;76: 219–22.
World Bank .1998. Pakistan-Towards a health sector strategy. World Development Sources. WDS 1998-2. Washington-DC: World Bank. http://documents.worldbank.org/curated/en/1998/04/693605/:towards-health-sector-strategy.
Lu SE, Beckles GL, Crosson JC, Bilik D, Karter AJ, Gerzoff RB, et al. Evaluation of risk equations for prediction of short-term coronary heart disease events in patients with long-standing type 2 diabetes: the translating research into action for diabetes (triad) study. BMC Endocrine Disorders 2012;12:12
Laakso M, Lehto S: Epidemiology of macrovascular disease in diabetes. Diabetes Rev 1997;5: 294–315.
Hakeem R, Fawwad A. Diabetes in Pakistan: Epidemiology, Determinants and Prevention. J Diabetol 2010;3:4
Implication of United Kingdom Prospective Diabetes. Study.Diabetes Care 2002 ; 25(1)
Simmons RK, Coleman RL, Price HC, Holman RR, Khaw K, Wareham NJ, et al. Performance of the UK Prospective Diabetes Study Risk Engine and the Framingham Risk Equations in Estimating Cardiovascular Disease in the EPIC- Norfolk Cohort. Diabetes Care 2009;32: 708–13.
Diabetes Trial Unit. UK-PDS Risk Engine. Available at www.dtu.ox.ac.uk/riskengine/ . Retrieved on 27.2.2015
Nathan DM, Cleary PA, Backlund JY, Genuth SM, Lachin JM, Orchard TJ, et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 2005;353(25):2643–53.
National Institute of Diabetes and Digestive and Kidney Diseases. National diabetes statistics fact sheet: general information and national estimates on diabetes in the United States, 2005. Bethesda,MD: U.S. Department of Health and Human Services, National Institutes of Health; 2005.
Stein J. Link Between Diabetes And Cardiovascular Risk Is Underappreciated. Available at http://www.medicalnewstoday.com/articles/229731.php. Retrieved on 11.12.12
Zeber J, Parchman ML. Cardiovascular disease in type 2 diabetes ; Attributable risk due to modifiable risk factors. Can Fam Physician 2010;56:e302-7.
van Dieren S, Peelen LM, Nöthlings U, van der Schouw YT, Rutten GEH, Spijkerman AMW, et al. External validation of the UK Prospective Diabetes Study (UKPDS) risk engine in patients with type 2 diabetes. Diabetologia. 2011; 54: 264–70.