Metabolic syndrome and pharmacotherapy outcomes in patients with type 2 diabetes mellitus

Shawqi H Alawdi, Mohammed Al-Dholae, Salah Al-Shawky
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Abstract

Metabolic syndrome is a group of metabolic abnormalities that increase predisposition to several diseases including ischemic heart disease and diabetes mellitus. The study aimed to investigate metabolic syndrome among patients with type-2 diabetes mellitus (DM), and its impact on pharmacotherapy outcomes.An observational cross-sectional study was performed on 910 patients with type-2 DM between June and December 2023. Fasting blood sugar, triglycerides, high-density lipoproteins (HDL), blood pressure, and abdominal obesity were measured. Metabolic syndrome was identified according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Pharmacotherapy outcomes were assessed according to American Association of Clinical Endocrinologists and American Diabetes Association guidelines using the ability to achieve adequate glycemic control and normal levels of blood pressure and fasting plasma lipoproteins.In total, 87.5% of type-2 DM patients had metabolic syndrome; the prevalence increased with age and was higher among females. Metabolic syndrome showed the following distribution of risk factors: insulin resistance (100%), low HDL (95.3%), elevated blood pressure (83%), triglycerides dyslipidemia (80.1%), and abdominal obesity (62.5%). Majority of the patients had either 5 or 4 risk factors of metabolic syndrome. The most common comorbidities were dyslipidemia (97.7%) and hypertension (83%). Treatment outcomes were insufficient where adequate glycemic control was only achieved in 12% of type-2 DM patients, and proper management of comorbid dyslipidemia and hypertension was achieved in 29% and 40.9% of patients, respectively. Adequate blood pressure control was less achieved in patients with metabolic syndrome (34.4%) than those without metabolic syndrome (77.2%). Similarly, dyslipidemia was less controlled in patients with metabolic syndrome (26.9%) than in those without metabolic syndrome (47.3%).Pharmacotherapy outcomes were inadequate for most patients with type-2 diabetes mellitus. Adopting early preventive and therapeutic interventions for metabolic syndrome is advised to improve treatment outcomes of the comorbid dyslipidemia and hypertension.
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2 型糖尿病患者的代谢综合征与药物治疗效果
代谢综合征是一组代谢异常,会增加包括缺血性心脏病和糖尿病在内的多种疾病的易感性。该研究旨在调查 2 型糖尿病(DM)患者的代谢综合征及其对药物治疗效果的影响。这项观察性横断面研究在 2023 年 6 月至 12 月期间对 910 名 2 型糖尿病患者进行了调查。研究测量了空腹血糖、甘油三酯、高密度脂蛋白(HDL)、血压和腹部肥胖。代谢综合征根据美国国家胆固醇教育计划成人治疗小组 III 标准进行鉴定。药物治疗结果根据美国临床内分泌医师协会和美国糖尿病协会的指南进行评估,采用的标准是血糖能否得到充分控制,血压和空腹血浆脂蛋白能否达到正常水平。代谢综合征的危险因素分布如下:胰岛素抵抗(100%)、低高密度脂蛋白(95.3%)、血压升高(83%)、甘油三酯血脂异常(80.1%)和腹部肥胖(62.5%)。大多数患者有 5 个或 4 个代谢综合征风险因素。最常见的合并症是血脂异常(97.7%)和高血压(83%)。治疗效果不佳,仅有 12% 的 2 型糖尿病患者实现了适当的血糖控制,分别有 29% 和 40.9% 的患者实现了并发症血脂异常和高血压的适当控制。有代谢综合征的患者(34.4%)比没有代谢综合征的患者(77.2%)的血压控制率低。同样,代谢综合征患者血脂异常的控制率(26.9%)也低于非代谢综合征患者(47.3%)。建议对代谢综合征采取早期预防和治疗干预措施,以改善合并血脂异常和高血压的治疗效果。
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