Cardiovascular risk profile and treatment patterns in patients with type 2 diabetes in specialized cardiology outpatient care in Colombia: A retrospective cross-sectional study.

Abstract

Type 2 diabetes mellitus (T2DM) is strongly associated with cardiovascular morbidity, yet real-world evidence integrating cardiovascular comorbidities, metabolic characteristics, echocardiographic findings, and treatment patterns remains limited in Colombia. This study characterized the cardiovascular profile and treatment patterns of patients with T2DM attending specialized cardiology care and explored factors associated with glycated hemoglobin (HbA1c) >7%. A single-center, retrospective cross-sectional study included 138 adults with confirmed T2DM attending a high-complexity cardiology outpatient clinic in Barranquilla, Colombia, during 2023 to 2024. Patients were classified as HbA1c ≤7% or >7% using the most recent value documented at the latest outpatient visit. Clinical, laboratory, electrocardiographic, echocardiographic, and prescribed medication variables were evaluated. Univariable analyses were followed by an exploratory multivariable logistic regression model using the enter method. Mean age was 67.3 ± 11.5 years, 71.7% were male, and 70.3% had HbA1c >7%. Patients with HbA1c >7% were older (68.6 ± 11.6 vs 64.2 ± 10.9 years; P = .034) and had higher total cholesterol (203.5 ± 48.1 vs 181.7 ± 42.8 mg/dL; P = .010) and low-density lipoprotein cholesterol (124.9 ± 36.1 vs 106.0 ± 39.1 mg/dL; P = .010). Cerebrovascular disease occurred in 11.3% of patients with HbA1c >7% and none with HbA1c ≤7% (P = .034). The absence of prespecified echocardiographic abnormalities was less frequent with HbA1c >7% (15.5% vs 34.1%; P = .014). Sodium-glucose cotransporter-2 (SGLT2) inhibitor use was documented in 16.7% overall and was more frequent with HbA1c ≤7% (26.8% vs 12.4%; P = .037). In the exploratory multivariable model, total cholesterol was associated with HbA1c >7% (adjusted odds ratio [OR] per 10 mg/dL = 1.10; 95% confidence interval [CI], 1.01-1.20; P = .033), whereas the absence of prespecified echocardiographic abnormalities was inversely associated (adjusted OR = 0.36; 95% CI, 0.15-0.88; P = .026). SGLT2 inhibitor use was not significant after adjustment (adjusted OR = 0.56; 95% CI, 0.20-1.58; P = .274). In this Colombian real-world cohort, HbA1c >7% was common. Higher total cholesterol was positively associated with HbA1c >7%, whereas the absence of prespecified echocardiographic abnormalities was inversely associated with this outcome. The association with SGLT2 inhibitor use did not persist after adjustment. These cross-sectional findings support integrated cardiometabolic assessment in specialized outpatient care.