DOI: http://dx.doi.org/10.18203/2349-3933.ijam20200664

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

Ramadhenu Rajendra Prasad, Valluri Some Sekhar, M. Rajyalakshmi

Abstract


Background: The microvascular complication is also showing increasing trend. This is because of lack of awareness and lack of regular screening programme. Early diagnosis and Intensive glycemic control has been the most effective approach to prevent the progress of microvascular complication.

Methods: Based on exclusion and inclusion criteria 100 patients were enrolled for this study. For diagnosis of diabetes mellitus, we used American Diabetes Association (ADA) guidelines was followed. Detail history of patient was taken related to microvascular complication and they underwent extensive medical examination for the assessment of microvascular complications.

Results: Mean age of patient with microangiopathy was 59.942±7.18 years and without microangiopathy was 54.31±13.15years. Microangiopathy was common in patient whose HbA1c was more than 10.7. Out of 26 patient 20 patient having microangiopathy. Neuropathy was present in 31 patients and absent in 69 patients.

Conclusions: It was observed that a continuous linear association between HbA1c and microvascular complications. This is more common in patient in patient with higher HbA1c. Neuropathy is most common which is followed by nephropathy and retinopathy least among all.


Keywords


Diabetes mellitus, Newly diagnosed, Neuropathy, Retinopathy

Full Text:

PDF

References


Maitra A. The endocrine system. Robbins and Cortan Pathologic basis of disease. Chapter 24. 8th edition. Elsevier publication; 2009:1130-1145.

Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Emerging Risk Factors Collaboration. Lancet. 2010;26;375:2215-22.

Diabetes, world health organisation, Key facts, 30 October 2018. world health organisation. Available at: https://www.who.int/news-room/fact-sheets/detail/diabetes. Accessed July 2019.

Gakidou E, Mallinger L, Abbott-Klafter J, Guerrero R, Villalpando S, Ridaura RL, et al. Management of diabetes and associated cardiovascular risk factors in seven countries: a comparison of data from national health examination surveys. Bull World Health Org. 2011;89:(3)172-83.

Spijkerman AM, Dekker JM, Nijpels G, Adriaanse MC, Kostense PJ, Ruwaard D, et al. Microvascular complications at time of diagnosis of type 2 diabetes are similar among diabetic patients detected by targeted screening and patients newly diagnosed in general practice: the hoorn screening study. Diabetes Care. 2003 Sep 1;26(9):2604-8.

Bansal D, Gudala K, Esam HP, Nayakallu R, Vyamusani RV, Bhansali A. Microvascular complications and their associated risk factors in newly diagnosed type 2 diabetes mellitus patients. Inter J Chronic Dis. 2014;2014.

Beckman JA, Creager MA. Vascular complications of diabetes. Circulation Res. 2016 May 27;118(11):1771-85.

Sample size calculator. Available at: https://www.calculator.net/sample-size-calculator.html. Accessed 19 July 2019

American Diabetes Association. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes-2018. Diabetes Care. 2018;41(Suppl. 1):S13-S27.

Fowler MJ. Microvascular and macrovascular complications of diabetes. Clini Diabetes. 2008 Apr 1;26(2):77-82.

Azura MS, Adibah HI, Juwita S. Risk factor of peripheral neuropathy among newly diagnosed type 2 diabetic patients in primary care clinic. Inter J Collaborative Res Int Med Public Health. 2012;4(11):1858-67.

Raina A. Prevalence of microvascular complications in newly diagnosed type-2 diabetes mellitus. Inter J Scient Study.2016;3:102-5.

Omar MA, Motala AA, Jialal I, Seedat MA. Microvascular complications and non-insulin-dependent diabetes of the young in South African Indians. Diabetes Res. 1986 Nov;3(9):483-5.

Rema M, Ponnaiya M, Mohan V. Prevalence of retinopathy in non-insulin dependent diabetes mellitus at a diabetes centre in southern India. Diabetes Res Clini Pract. 1996;34(1):29-36.

Prakash B, Yadav LK. A study of micro vascular complications and associated risk factors in newly diagnosed patients of type 2 diabetes mellitus. Int J Community Med Public Health. 2018;5:2338-43.

Sabanayagam C, Liew G, Tai ES, Shankar A, Lim SC, Subramaniam T, et al. Relationship between glycated haemoglobin and microvascular complications: is there a natural cut-off point for the diagnosis of diabetes?. Diabetol. 2009 Jul 1;52(7):1279.

Virk SA, Donaghue KC, Cho YH, Benitez-Aguirre P, Hing S, Pryke A, et al. Association between HbA1c variability and risk of microvascular complications in adolescents with type 1 diabetes. J Clini Endocrinol Metab. 2016 Sep 1;101(9):3257-63.

Kosiborod M, Gomes MB, Nicolucci A, Pocock S, Rathmann W, Shestakova MV, et al. Vascular complications in patients with type 2 diabetes: prevalence and associated factors in 38 countries (the DISCOVER study program). Cardiovas Diabetol. 2018 Dec 1;17(1):150.

Bui HD, Jing X, Lu R, Chen J, Ngo V, Cui Z, et al. Prevalence of and factors related to microvascular complications in patients with type 2 diabetes mellitus in Tianjin, China: a cross-sectional study. Ann Translat Med. 2019 Jul;7(14):325.

Agrawal R, Ola V, Bishnoi P, Gothwal S, Sirohi P, Agrawal R. Prevalence of micro and macrovascular complications and their risk factors in type-2 diabetes mellitus. JAPI. 2014 Jun;62:505-8.