A study to evaluate different conditions leading to diagnosis of T2DM in a tertiary care hospital in Eastern India

Nirmalya Roy; Kingshuk Bhattacharjee; Esha Gupta

doi:10.18203/2349-3933.ijam20170103

Authors

Nirmalya Roy Department of Medicine, K.P.C. Medical College, Jadavpur, Kolkata, India
Kingshuk Bhattacharjee Medical Services, Biocon Limited, Bangalore, Karnataka, India
Esha Gupta Department of Medicine, K.P.C. Medical College, Jadavpur, Kolkata, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20170103

Keywords:

Adults, Diagnosis, General health check-up, Type 2 diabetes

Abstract

Background: Diabetes is one of the most important public health problems. There is paucity of Indian data as to which conditions leads to diagnosis of T2DM. The present study endeavors to throw some light on the problem.

Methods: A cross-sectional and retrospective study including 321 subjects, performed at a tertiary care hospital in eastern India. Descriptive statistical analysis has been carried out in the present study. Results on continuous measurements are presented on Mean±SD (min-max) and results on categorical measurements are presented in number (%). Significance is assessed at 5 % level of significance pooled chi-square/Fischer’s exact test used to explore association between study variables.

Results: A total of 321 patients (male: female - 2.61: 1) diagnosed with diabetes over a period of 24 months were included. Mean age at diagnosis being 45.54±10.8 years respectively. Out of these, only 23.05 % presented with osmotic and other symptoms (foot ulcer, weight loss etc.) suggestive of diabetes. A substantial 43.52% of total patients were diagnosed during general healthcare check-up (35.2% in OPD and 8.32% during perioperative evaluation). Remaining patients diagnosed with diabetes included 8.28% patients admitted with acute coronary syndrome, 13.4% with infections of different types and 11.75% with other non-related diseases. Among diagnosed diabetics, 50.47% had HTN and 41.12% had IHD. Diabetic Males have higher prevalence of IHD (48.28%) than females (22.47%), p <0.001. Prevalence of HTN is higher among diabetic females (48.28%) than males (22.47%), p <0.046. The prevalence of HTN and IHD steadily increased with the increasing age group, p<0.001.

Conclusions: The results of this study suggest that a very low percentage of the patients present with symptoms suggestive of diabetes. Hence, it is prudent to evaluate adult patients coming in contact with healthcare system for diabetes by simple inexpensive test.

Metrics

Metrics Loading ...

References

International diabetes federation. Available at http://www.diabetesatlas.org. Accessed on 12 July 2016.

Public Health Agency of Canada. Diabetes in Canada: facts and figures from a public health perspective. Ottawa; 2011.

Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 47 years before clinical diagnosis. Diab Care. 1992;15:815-9.

Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. Diab Care. 1997;20(4):537-44.

Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344(18):1343-50.

Knowler WC, Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle interventions or metformin. N Engl J Med. 2002;346(6):393-403.

UK prospective diabetes study (UKPDS) group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. Lancet. 1998;352(9131):837-53.

Kahn SE. The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of Type 2 diabetes. Diabetologia. 2003;46:3-19.

Stolar M. Glycemic control and complications in type 2 diabetes mellitus. Am J Med. 2010;123:3-11.

Ruigomez A, Rodriguez LA. Presence of diabetes related complication at the time of NIDDM diagnosis: an important prognostic factor. Eur J Epidemiol. 1998;14(5):439-45.

UK prospective diabetes study. VIII. study design, progress and performance. Diabetologia. 1991;34(12):877-90.

Meisinger C, Thorand B, Schneider A, Stieber J, Doring A, Lowel H. Sex differences in risk factors for incident type 2 diabetes mellitus: the monica Augsburg cohort study. Arch Intern Med. 2002;162(1):82-9.

Njolstad I, Arnesen E, Larsen PG. Sex differences in risk factors for clinical diabetes mellitus in a general population: a 12-year follow-up of the Finnmark Study. Am J Epidemiol. 1998;147(1):49-58.

Karastergiou K, Fried SK, Xie H, Lee MJ, Divoux A, Rosencrantz MA, et al. Distinct developmental signatures of human abdominal and gluteal subcutaneous adipose tissue depots. J Clin Endocrinol Metab. 2013;98(1):362-71.

Logue J, Walker JJ, Colhoun HM, Leese GP, Lindsay RS, Mcknight JA, et al. Do men develop type 2 diabetes at lower body mass indices than women? Diabetologia. 2011;54(12):3003-6.