Abstract
OBJECTIVES:Calculate the incidence rate and predictors of progression to new onset Type 2 diabetes mellitus (T2DM) in hypertensive patients.
METHODS:An analytical retrospective cohort study was conducted in 9 primary care centers located at urban area of Qatif. It included 438 high risk patients with essential hypertension, 234 (53.4%) obese and 204 (46.6%) non-obese, who had normal fasting blood glucose and hemoglobin A1c or at prediabetes stage at baseline. Participants were followed for a mean duration of 38.3 months (1399.3 person-years). T2DM was diagnosed based on the American Diabetes Association criteria. Incidence rates for T2DM was calculated and its predictors were estimated using the Cox proportional hazards model.
RESULTS:The incidence rate for new onset T2DM among all, obese and non-obese patients with essential hypertension were 82.9 (95% confidence interval (CI)68.8–99.1), 100.7 (95% CI79.5–125.9), and 63.8 (95% CI46.7–85.1) per 1,000 person-years respectively. Yearly incidence of T2DM was the highest in the first and second years of follow up. It was 10.3% and 11.4% among obese, respectively, while it was 7.3% and 9.5% among non-obese, respectively. After two years of follow up, yearly incidence continued rising among among obese patients, only. Predictors of new onset T2DM were female gender, family history of diabetes, dyslipidemia, fasting blood glucose and body mass index.
CONCLUSION:In hypertensive patients, new-onset T2DM was highest in the first two years of follow up, particularly among obese patients. Targeting modifiable risk factors is mandatory to decrease the chance of onset.