Treatment Adherence and Incidence of Coronary Heart Disease in Type 2 Diabetes Mellitus Patients

Ahmad Sahlan Baniu, Rani Sauriasari, Woro Riyadina, Pradana Soewondo

Abstract


Previous studies showed that uncontrolled blood sugar and long-term use of several types of antidiabetic could increase the risk of coronary heart disease (CHD). This study aimed to compare the incidence of CHD in type 2 diabetes mellitus (T2DM) patients showing treatment adherence and non-adherence behavior over four years. This was a retrospective cohort study with data sets obtained from the Bogor Cohort Study of Non-Communicable Disease Risk Factors. All study subjects were not diagnosed with CHD at the beginning of the study. The sample was divided into two groups; one had adhered to treatment from health centers and followed the treatment instructions (adherent group), while the other had not followed the treatment instructions (non-adherent group). Of 5,690 subjects, 276 were eligible for this study (84 in the adherent and 192 in the non-adherent group). The incidence of CHD in the non-adherent group was 2.3% higher than in the adherent group (p-value = 0.564) and had a 1.7 times greater risk of developing CHD, but not statistically significant (adjusted HR = 1.739; 95% CI = 0.673-4.490). The non-adherent T2DM patients had a greater risk of developing CHD than adherent T2DM patients.

Keywords


coronary heart disease, diabetes mellitus, treatment adherence

Full Text:

PDF

References


 1. Carnethon MR, Biggs ML, Barzilay J, Kuller LH, Mozaffarian D, Mukamal K, et al. Diabetes and coronary heart disease as risk factors for mortality in older adults. Am J Emerg Med. 2010; 123 (6): 556.e1-556.e9.

 2. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics—2014 update. Circulation. 2014; 129 (3): e28–292.

 3. Low Wang CC, Hess CN, Hiatt WR, Goldfine AB. Atherosclerotic cardiovascular disease and heart failure in type 2 diabetes – mechanisms, management, and clinical considerations. Circulation. 2016; 133 (24):2459–502.

 4. Li Y, Hu Y, Ley SH, Rajpathak S, Hu FB. Sulfonylurea use and incident cardiovascular disease among patients with type 2 diabetes: prospective cohort study among women. Diabetes Care. 2014; 37 (11): 3106–13.

 5. Roumie CL, Greevy RA, Grijalva CG, Hung AM, Liu X, Murff HJ, et al. Association between intensification of metformin treatment with insulin versus sulfonylureas and cardiovascular events and all-cause mortality among patients with diabetes. JAMA. 2014; 311 (22): 2288–96.

 6. Herman ME, O’Keefe JH, Bell DSH, Schwartz SS. Insulin therapy increases cardiovascular risk in type 2 diabetes. Prog Pediatr Cardiol. 2017; 60 (3): 422–34.

 7. Euser AM, Zoccali C, Jager KJ, Dekker FW. Cohort studies: prospective versus retrospective. NEC. 2009; 113 (3): c214–7.

 8. American Association Diabetes. Classification and diagnosis of diabetes: standards of medical care in diabetes. Diabetes Care. 2021; 44 (Supplement 1): S15–33.

 9. Soelistijo, Soebagijo Adi, Lindarto D, Decroli E, Permana H, Sucipta KW, Kusnadi Y, et al. Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 dewasa di Indonesia 2019. PB. PERKENI; 2019.

 10. Robinson RS. Purposive Sampling. In: Michalos AC, editor. Encyclopedia of quality of life and well-being research. Dordrecht: Springer Netherlands. 2014 p. 5243–5.

 11. Lemeshow S, World Health Organization, editors. Adequacy of sample size in health studies. Chichester. New York : New York, NY, USA: Published on behalf of the World Health Organization by Wiley; Distributed in the U.S.A., Canada, and Japan by Liss. 1990 p. 239.

 12. Husni H, Lapau B, Hardhana B. Hubungan dislipidemia dan diabetes mellitus dengan kejadian penyakit jantung koroner di RSUD Ulin Banjarmasin. CNJ: Caring Nursing Journal. 2018; 2 (2): 66–9.

 13. Dahlan S. Seri 2 besar sampel dalam penelitian kedokteran dan kesehatan. Jakarta: Epidemiologi Indonesia; 2019.

 14. Hajar R. Risk factors for coronary artery disease: historical perspectives. Heart Views. 2017; 18 (3): 109–14.

 15. Kaaffah S. Evaluasi perilaku berobat terhadap penurunan parameter glikemik penderita diabetes melitus tipe 2: studi kohor Bogor. [Master's Thesis]. Depok (ID): Universitas Indonesia; 2019.

 16. Stettler C, Allemann S, Jüni P, Cull CA, Holman RR, Egger M, et al. Glycemic control and macrovascular disease in types 1 and 2 diabetes mellitus: meta-analysis of randomized trials. American Heart Journal. 2006; 152 (1): 27–38.

 17. Fung CSC, Wan EYF, Wong CKH, Jiao F, Chan AKC. Effect of metformin monotherapy on cardiovascular diseases and mortality: a retrospective cohort study on Chinese type 2 diabetes mellitus patients. Cardiovascular Diabetology. 2015; 14 (1): 137.

 18. Simpson SH, Lee J, Choi S, Vandermeer B, Abdelmoneim AS, Featherstone TR. Mortality risk among sulfonylureas: a systematic review and network meta-analysis. The Lancet Diabetes & Endocrinology. 2015; 3 (1): 43–51.

 19. Stoekenbroek RM, Rensing KL, Moens SJB, Nieuwdorp M, DeVries JH, Zwinderman AH, et al. High daily insulin exposure in patients with type 2 diabetes is associated with increased risk of cardiovascular events. Atherosclerosis. 2015; 240 (2): 318–23.

 20. Fox CS, Sullivan L, D’Agostino RB, Wilson PWF. The significant effect of diabetes duration on coronary heart disease mortality: the Framingham heart study. Diabetes Care. 2004; 27 (3): 704–8.

 21. Wannamethee SG, Shaper AG, Whincup PH, Lennon L, Sattar N. Impact of diabetes on cardiovascular disease risk and all-cause mortality in older men: influence of age at onset, diabetes duration, and established and novel risk factors. Arch Intern Med. 2011; 171 (5).

 22. Ference BA, Ginsberg HN, Graham I, Ray KK, Packard CJ, Bruckert E, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European atherosclerosis society consensus panel. European Heart Journal. 2017; 38 (32): 2459–72.

 23. Arsana PM, Rosandi R, Manaf A, Budhiarta A, Permana H, Sucipta KW, et al. Panduan pengelolaan dislipidemia di Indonesia - 2015. Jakarta: PB. PERKENI; 2015.

 24. Setyaji DY, Prabandari YS, Gunawan IMA. Aktivitas fisik dengan penyakit jantung koroner di Indonesia. Jurnal Gizi Klinik Indonesia.2018; 14 (3): 115–21.




DOI: http://dx.doi.org/10.21109/kesmas.v17i2.5453

Refbacks

  • There are currently no refbacks.