A study of micro vascular complications and associated risk factors in newly diagnosed patients of type 2 diabetes mellitus

Abstract

INTRODUCTIONDiabetes mellitus type 2 is the most common non communicable chronic metabolic disorder caused by the relative insufficiency of insulin secretion and insulin action. If it is not properly treated or left untreated it is characterized by chronic hyperglycaemia and disordered carbohydrate, lipid and protein metabolism and is associated with the development of specific microvascular complications and of non-specific macrovascular disease. The global prevalence and economic cost of diabetes and its complications are abnormally increasing and become a real problem of developed and developing countries like India and this is projected to increase substantially over the next 2 decades. According to the diabetes atlas, seventh edition 2015 published by the IDF. The total number of people with diabetes in India currently around 69.2 million is expected to rise to 123.5 million by 2040. 2Diabetes complications can affect many parts of body, manifesting in different ways in different people. Moreover, at least one complication is present in large ABSTRACT Background: Diabetes and its complications are one of the leading causes of death and disability worldwide. The aim of the study is to elucidate the prevalence and associated risk factors of microvascular complication among diabetes mellitus type 2 population of Ajmer, Rajasthan India. Methods: This is the study of 464 newly detected type 2 diabetic people screened for their biochemical parameters, attending outpatient department comprising of 256 male and 208 female. The presence of complications was evaluated by relevant investigations. Results: Microvascular complication namely retinopathy was diagnosed in 344 (74%) of type 2 diabetic patients, neuropathy in 200 (43%), nephropathy in 138 (30%). Linear regression analysis concluded that age, body mass index, duration, family history, stress, glycated haemoglobin (HbA1C), triglyceride and total cholesterol were significantly associated with these vascular complications. Prevalence of microvascular complications increases with age, duration, body mass index (BMI), hereditary and poor glycemic control. Conclusions: Retinopathy and neuropathy were the most prevalent microvascular complication in type 2 diabetic population.

A prospective evaluation of microvascular complications in diabetes mellitus patients at time of diagnosis

“…This finding is supported by the work of Omar MA, Motala AA et al, and Rema M, Ponnaiya M, Mohan Vet al 13,14 This association between plasma glucose and microangiopathy was statistically significant. Which is further supported by the work of Prakash B, Yadav LK et al 15 Sabanayagam et al, has concluded that continuous linear association between HbA1c and microvascular complications, and Sohaib A. Virk, Kim et al, has reported that HbA1c independently contribute to increased oxidative stress which support our finding. 16,17 Mean of glycosylated haemoglobin was 9.76±1.17 % in microangiopathy group and it was more common in patient whose glycosylated haemoglobin was more than 10.6% which corroborate with these finding.…”

Alteration of cardiovascular autonomic activity in type 2 diabetes mellitus

“…Arif ZA et al study, and Prakash B et al, usedEwing's method to diagnosed CAN in studied patients similar to present study 12,16,17. The mean age of studied patients in this study was 48.76±8.41 years with the larger part of patients in the age group 51-60 years (47.5%), and also mostly patients were male (68.9%).…”

“…Authors have used the crosssectional design similarly Arif ZA et al, study and Prakash B et al, also did same observational study that carried out in a tertiary care center. 12,16 This study was best suitable study-type for knowing the prevalence of disease onto a population within limited period of time and it required fewer resources than other type of case control or cohort study. CAN is by far one of the most studied forms among the different forms of diabetic autonomic neuropathies.…”

“…14 Blood glucose levels of diabetes mellitus were confirmed by classification and diagnosis criteria lay by WHO (1999). 16 All these tests were conducted using random kit from USA. 16 CAN was assessed according to Ewing's protocol.…”

“…16 All these tests were conducted using random kit from USA. 16 CAN was assessed according to Ewing's protocol. 17 Data were analyzed with statistical package for social sciences (SPSS), version 23 (SPSS Inc., Chicago, IL).…”