Background: Diabetes mellitus significantly contributes to cardiovascular morbidity, particularly in rural populations with limited healthcare access. This study investigated the spectrum of cardiac complications among individuals with diabetes in rural Uttar Pradesh, India, along with associated risk factors. Methodology: A hospital-based study was conducted at the Department of General Medicine, Uttar Pradesh University of Medical Sciences (UPUMS), Saifai, Etawah, from March 2024 to March 2025. A total of 150 diabetic patients attending the outpatient department (OPD) were assessed for cardiac complications using clinical findings, baseline electrocardiogram, treadmill stress test, and four-dimensional (4D) echocardiography. Glycosylated hemoglobin (HbA1c) was measured via high-performance liquid chromatography. Statistical analyses included one-way analysis of variance with Tukey's honestly significant difference (HSD) post hoc tests for HbA1c and duration of diabetes, as well as multinomial logistic regression to evaluate risk factors. Results: Of 150 patients, 99 (66%) had cardiac complications. Among those with cardiac complications, 34 (34%) had coronary artery disease (CAD), 33 (33%) had diastolic dysfunction, and 32 (32%) had diabetic cardiomyopathy. Analysis of variance showed significant differences in HbA1c (F=3.70, p=0.013) and duration of diabetes (F=16.73, p<0.000001) across groups. Post hoc tests indicated CAD patients had significantly higher HbA1c and longer diabetes duration. Multinomial logistic regression identified higher HbA1c, low-density lipoprotein cholesterol, triglycerides, total cholesterol, age, duration of diabetes, hypertension, smoking, and sedentary lifestyle as significant CAD risk factors (p<0.05). Conclusions: CAD was associated with elevated HbA1c, prolonged diabetes duration, and multiple modifiable risk factors. Early screening and targeted interventions are essential for managing cardiac complications in rural diabetic populations.
Kumar et al. (Sat,) studied this question.