Electrocardiographic T wave abnormality and associated factors among type 2 diabetic patients in Amhara National Regional State Referral Hospitals, Ethiopia: Multicenter institution-based cross-sectional study

Background: The T wave on an electrocardiogram (ECG) represents typically ventricular repolarization. However, various waveform morphologies may indicate benign or clinically significant injury or insult to the myocardium. There is no study about the electrocardiographic T wave abnormalities among type 2 DM patients in Ethiopia. Therefore, this study determined the overall prevalence and the associated factors of T wave abnormalities among people living with T2DM in Amhara National Regional State referral hospitals, Ethiopia. Methods: A multicenter institution-based cross-sectional study was conducted from 01 January to 30 March 2022. Simple random sampling and systematic sampling techniques were employed to select the referral hospitals and study participants, respectively. A digital electrocardiograph was used to measure the T wave patterns, and an interviewer-administered questionnaire to collect sociodemographic and some clinical factors. Epi-data version-4.6 and Stata-14 were used for data entry and statistical analysis, respectively. The descriptive statistics were presented with tables and graphs. A binary logistic regression model was fitted to identify associated factors of T wave abnormality. In the final model, statistical significance was decided at p < 0.05, and the strength of association was indicated using an adjusted odds ratio with 95% CI. Results: Two-hundred and fifty-eight participants (response rate=99.6%) were included for the analysis. The prevalence of overall T wave abnormality was 21.7% (95% CI: 19, 29.2%). Higher monthly income (>90$) (AOR=0.16 [0.06, 0.46]), hypertension 5.55 ( AOR=5.55 [2.12, 14.49]), fasting blood sugar of > 130mg/dl 6.38 (AOR=6.38 [1.94, 20.94]), were statistically significant factors of T wave abnormality. Conclusions: Higher income, hypertension, and higher fasting blood sugar were significantly associated with ECG abnormality. The findings of this study suggest the need to institute routine ECG screening for all T2DM patients to reduce silent myocardial ischemia and further complications.