ABSTRACT
BACKGROUND: Diabetes mellitus (DM) is a major chronic condition that is considered a strong indicator of poor cardiovascular outcomes, such as recurrent infarction and heart failure (HF), in individuals with acute myocardial infarction (AMI). However, the concept of left ventricular remodeling (LVR) following AMI in DM patients is not well understood and studied in Saudi Arabia. Thus, the aim of this study is to assess the association between LVR and DM in patients presenting with ST-elevation myocardial infarction (STEMI) who had reperfusion therapy with optimal medical therapy after percutaneous coronary intervention (PCI). METHODS: In this retrospective cohort study, 171 patients diagnosed with AMI who visited King Faisal Cardiac Center in King Abdulaziz Medical City, National Guard Hospital, Jeddah, Saudi Arabia, were chosen via the convenience sampling method. The study included patients with AMI who received echocardiograms upon admission and during a follow-up period of six to 12 months. The patients were divided into two groups based on their diabetic status: diabetic (DM) and non-diabetic (non-DM). To collect the data, trained medical students supervised by the principal investigator used the patients' medical records. RESULTS: The study showed that DM patients were more likely to have a history of hypertension, dyslipidemia, smoking, and stress hyperglycemia and had a higher hospitalization rate compared to the non-DM group. Although there was no statistically significant difference (p=0.253), both groups had a higher incidence of the left main trunk and/or left anterior descending artery affected. Regarding the echocardiographic finding, there were no significant differences between the two groups in terms of left ventricular ejection fraction, left ventricular internal diameter at end-diastole, left ventricular internal diameter at end-systole, and interventricular septum thickness. CONCLUSION: This paper suggests that there is no significant correlation between DM and non-DM patients in terms of LVR after AMI. However, DM patients had a statistically significant increased risk of developing HF and valvular heart disease compared to non-DM patients after AMI.
ABSTRACT
Diabetes mellitus type 2 is a major chronic condition that is considered common among elderly people, with multiple potential complications that could contribute to falls. However, this concept is not well understood; thus, the aim of this study is to estimate the prevalence of falls among diabetes patients. Methods: In this observational cross-sectional study, 309 diabetic patients aged 60 years or more who visited the primary healthcare centers of the Ministry of National Guard - Health Affairs in Jeddah were chosen via convenience sampling method. To collect the data, a structured Fall Risk Assessment questionnaire and Fall Efficacy Score scale were used. Results: The mean age of the participants was estimated to be 68.5 (SD: 7.4) years. Among the participants, 48.2% have fallen before, and 63.1% of them suffered falls in the past 12 months. The results showed that gait problems were independently associated with a higher likelihood of falls among elderly patients [odds ratio (OR)=1.98; 95% CI: 1.08-3.62; P=0.026]. Based on the linear regression analysis, we identified the following risk factors for lower falls efficacy: having gait problems (ß=12.50; 95% CI: 7.38-17.6; P<0.001), balance difficulties (ß=6.58; 95% CI: 1.35-11.8; P=0.014), and neurological/cognitive impairments (ß=9.62; 95% CI: 3.89-15.4; P=0.001), as well as having poor sleep quality (ß=8.11, 95% CI: 3.32-12.9; P<0.001). Conclusion: This paper suggests that diabetes mellitus is an independent fall risk factor among the elderly. Therefore, identifying such patients as being at higher risk and prompt referral to a specialist falls clinic is recommended.
