Diabetes Mellitus and Cerebrovascular Accident among North African Population (Libya) Community Based Survey
Mohamed Kaled A. Shambesh *
Department of Community Medicine, Medical Faculty, University of Tripoli, Libya.
Taher Mohamed Emahbes
Department of Community Medicine, Faculty of Medicine, University of Tripoli, Libya.
Fayroz Ahmed Kamal
Department of Community Medicine, Medical Faculty, University of Tripoli, Libya.
Zeinab Elmehdi Saleh
Department of Community Medicine, Medical Faculty, University of Tripoli, Libya.
Iman Mohamed Shambesh
Department of English, Faculty of Education, University of Tripoli, Libya.
*Author to whom correspondence should be addressed.
Abstract
Diabetes mellitus (DM) is a very common medical disorder and a major health problem in North Africa including Libya. DM is associated with an increase in the risk of stroke and hospitalization.
Objectives: To estimate the importance of DM as a stroke risk factor among people living in Libyan community.
Methodology: The study was community based descriptive cross-sectional study used CHADS2 Questionnaire, as well a local Libyan classification of stroke risk factors called Community Stroke Risk Classification (CSRC).
Area: North Africa (North of Libya, the capital Tripoli).
Time: Five years from 2010-2014.
Population: Sampling was done from a large cohort of individuals living in the community, 7497 individuals were screened looking for risk factors of stroke.
Results: The prevalence of DM among our participants (7497 individuals) was 39% (2908 patients), among males and females was 54.1% and 45.9% respectively (P =0.0001). Among different age groups, males have higher rates compared to females except in very young (10-19) and very old (>80) where females dominated. The male to female ratio among total population screened was 21%: 17.8% (1573:1335 respectively).
DM prevalence increased with age, with higher rates among age over 40 (P <0.0001).
53% of DM patients had hypertension (1538 patients), 21.3% had Congestive Heart Failure (CHF) (618 patients), 13% had Atrial Fibrillation (AF) (382 patients), 22% had Transient Ischemic Attach (TIA) (643 patients), 12.3% had Prior Stroke (PS) (359 patients), All those risk factors accompanying DM increased with age increase (P<0.0001).
100% of DM patients had risk of stroke on CHADS2 and CSRC scores, which mainly concentrated in intermediate and high scores.
Conclusion: DM is a major risk factor of stroke among Libyan population and had very high risk scores in CHADS2 and CSRC.
Keywords: DM, stroke, CHADS2, CSRC.