Diabetes Mellitus and Cerebrovascular Accident among North African Population (Libya) Community Based Survey

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.