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Prevalence of dyslipidaemia and hypertension in diabetic patients at Tygerberg Children’s Hospital
Thesis (MMed)--Stellenbosch University, 2022.
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| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2020
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| _version_ | 1867613956317642752 |
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| access_status_str | Open Access |
| author | Nuckchedee Dookhony, Luvina Devi |
| author2 | Zollner, Ekkehard |
| author_browse | Nuckchedee Dookhony, Luvina Devi Zollner, Ekkehard |
| author_facet | Zollner, Ekkehard Nuckchedee Dookhony, Luvina Devi |
| author_sort | Nuckchedee Dookhony, Luvina Devi |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MMed)--Stellenbosch University, 2022. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/107741 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:44:22.712Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/107741 Prevalence of dyslipidaemia and hypertension in diabetic patients at Tygerberg Children’s Hospital Nuckchedee Dookhony, Luvina Devi Zollner, Ekkehard Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. Dyslipidaemia Hypertension -- Risk factors Diabetics -- Risk factors Cardiovascular system -- Diseases UCTD Thesis (MMed)--Stellenbosch University, 2022. ENGLISH ABSTRACT: Background: Diabetes, dyslipidaemia and hypertension are independent risk factors for cardiovascular disease in adults. Poor glycaemic control, predisposing to dyslipidaemia, is frequently seen in diabetic children in South Africa. However, the local prevalence of dyslipidaemia and hypertension in South African children with diabetes is unknown. Aim: To determine the prevalence of dyslipidaemia and hypertension in paediatric diabetic patients seen at the paediatric endocrine clinic of Tygerberg Hospital (TBH). Primary objectives: • To calculate the prevalence of dyslipidaemia and hypertension in all diabetic patients and across age groups; • To compare the relationship of dyslipidaemia and hypertension in diabetes patients to BMI, HbA1c and duration of disease. Secondary objective: To determine whether lipid control and hypertension improve over time when comparing the time periods- 2007 to 2011(period 1) with 2012 to 2017 (period 2). Study design: This was a retrospective observational study comparing two time periods. Methods: The study population included diabetic patients, aged 1-18 years, seen at paediatric diabetes clinic of TBH between 2007 and 2017, diagnosed with diabetes for more than 5 years if pre-pubertal and more than 2 years if in puberty. For each patient the type of diabetes, age, sex, duration of disease, therapeutic regiment, height, weight, blood pressure (BP) and HbA1c, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), total triglycerides (TG), low density lipoprotein cholesterol (LDL-C) were recorded. The body mass index (BMI) was computed and expressed as percentiles for age and sex. Results: 145 patients with type 1 diabetes and 9 patients with type 2 diabetes were included in the study. 139 of the total (90.26%) were on a regimen of short-acting and intermediate- acting insulin, 89 patients (58%) had dyslipidaemia, 24/147 (16%) low HDL-C, 78/145 (54%) high LDL-C and 22/148 (15%) raised TG. There were no significant differences in lipid profile between the types of diabetes. 75/154 of the diabetes patients (48.7%) had hypertension. 144 of all patients (93%) had poor glycaemic control (HbA1c<7.5%). Dyslipidaemia prevalence was neither associated with the glycaemic control nor with the BMI percentile. The prevalence of dyslipidaemia increased sharply after a diabetes duration of more than 10 years. The same pattern was observed for hypertension. The latter was not associated with dyslipidaemia. 20/79 (36.36 [95%CI 24.72-49.85] %) with a normal BP had an elevated BMI i.e. ≥85ᵗʰ percentile (p=0.006). 4/13 (30.77 [95% CI 11.94-59.30] %) of the pre-adolescents (<10 years) had dyslipidaemia while its prevalence among the adolescents (≥10 years) was 85/141 (60.28 [95% CI 51.93-68.08] %) (p=0.039). 82/131 adolescents (62.6%) with poorly controlled diabetes had associated dyslipidaemia (p value 0.042). 71.67 [95% CI 58.95-81.67] %) of patients 16 years of age had dyslipidaemia (p=0.005). In this age group association with BMI, HbA1c or hypertension could not be demonstrated. 38/61(62.3 [95%CI 49.5-73.5] %) of patients seen in period 1 and 51/93 (54.84 [95%CI 44.6-64.7] %) in period 2 presented with dyslipidaemia (p=0.36). The prevalence of hypertension and overweight/obesity also did not differ between the 2 time periods. Conclusions: The prevalence of dyslipidaemia and hypertension is unacceptably high in paediatric diabetes patients seen at TBH. Poor glycaemic control is common among dyslipidaemic and normolipaemic patients. An elevated HbA1c and the BMI percentile have not been identified as a predictor of dyslipidaemia. Both the prevalence of dyslipidaemia and hypertension increase with increasing duration of diabetes. Adolescents, esp. those ≥16 years, have a higher prevalence of dyslipidaemia than non-adolescents, putting them at risk of cardiovascular complications. The prevalence of dyslipidaemia remained the same over a 10-year time period. It is recommended that a larger prospective multicentre study is repeated to confirm the findings. Medical and dietary interventions should be intensified and staffing to achieve this should be increased. As the medical personnel is too varied and stay in the department for only a short duration, the laboratory should inform the consultant by email or sms of the abnormal blood results (high LDL-C, low HDL-C and high TC). AFRIKAANS OPSOMMING: Geen opsomming beskikbaar. Masters 2020-02-19T10:53:34Z 2020-04-28T12:01:31Z 2020-02-19T10:53:34Z 2020-04-28T12:01:31Z 2020-03 Thesis http://hdl.handle.net/10019.1/107741 en_ZA Stellenbosch University 42 pages : illustrations application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Dyslipidaemia Hypertension -- Risk factors Diabetics -- Risk factors Cardiovascular system -- Diseases UCTD Nuckchedee Dookhony, Luvina Devi Prevalence of dyslipidaemia and hypertension in diabetic patients at Tygerberg Children’s Hospital |
| title | Prevalence of dyslipidaemia and hypertension in diabetic patients at Tygerberg Children’s Hospital |
| title_full | Prevalence of dyslipidaemia and hypertension in diabetic patients at Tygerberg Children’s Hospital |
| title_fullStr | Prevalence of dyslipidaemia and hypertension in diabetic patients at Tygerberg Children’s Hospital |
| title_full_unstemmed | Prevalence of dyslipidaemia and hypertension in diabetic patients at Tygerberg Children’s Hospital |
| title_short | Prevalence of dyslipidaemia and hypertension in diabetic patients at Tygerberg Children’s Hospital |
| title_sort | prevalence of dyslipidaemia and hypertension in diabetic patients at tygerberg children s hospital |
| topic | Dyslipidaemia Hypertension -- Risk factors Diabetics -- Risk factors Cardiovascular system -- Diseases UCTD |
| url | http://hdl.handle.net/10019.1/107741 |
| work_keys_str_mv | AT nuckchedeedookhonyluvinadevi prevalenceofdyslipidaemiaandhypertensionindiabeticpatientsattygerbergchildrenshospital |