Patterns and determinants of cardiovascular disease risk in type 2 diabetes mellitus: insights into the current state of diabetes management in Nigeria

Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among individuals with type 2 diabetes mellitus (T2DM), especially in low- and middle-income countries. Understanding the pattern and determinants of CVD risk in these settings is essential to improving diabetes care and reducing CVD-related morbidity and mortality. This study investigated the patterns and determinants of CVD risk among T2DM patients receiving specialized diabetes care in Nigeria, with the aim of informing effective risk evaluation and management strategies. Methods: A hospital-based cross-sectional study was conducted among 150 T2DM patients in Nigeria selected via systematic random sampling. Demographic, clinical, and biochemical data were collected using structured research proforma. A 10-year CVD risk was assessed using updated World Health Organization (WHO) laboratory-based CVD risk assessment chart. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 25. Chi-square and analysis of variances (ANOVA) were used to compare variables across risk groups while ordinal logistic regression was employed to identify significant determinants of CVD risk. Results: Among the study participants, 13.3% (n=20) had a very low CVD risk (<5%), 34.0% (n=51) had a low risk (5 – <10%), 30.7% (n=46) had a moderate risk (10–<20%), and 22.0% (n=33) were classified as high risk (≥20%). Elevated diastolic blood pressure (OR = 1.131, 95% CI: 1.068 – 1.198; p < 0.001), longer diabetes duration (OR = 1.151, 95% CI: 1.076 – 1.231; p < 0.001), and anti-hypertensive therapy (AOR = 2.645, 95% CI: 1.194 – 5.860; p = 0.016) were the significant determinants of CVD risk status in the study population. Conclusions: This study reveals that while a substantial proportion of Nigerian T2DM patients in specialized care are in the lower CVD risk categories, significant number remain at moderate to high risk. Diastolic hypertension, diabetes duration, and antihypertensive therapy were identified as key determinants. These findings emphasize the need for improved CVD risk assessment and early intervention in similar clinical settings.