GLYCEMIC CONTROL, HYPERTENSION AND CHRONIC COMPLICATIONS IN TYPE 2 DIABETIC SUBJECTS ATTENDING A TERTIARY CARE CENTRE

Authors

  • Abdul Basit
  • Muhammad Zafar Iqbal Hydrie
  • Rubina Hakeem
  • Mohammad Yakoob Ahmedani
  • Mohiuddin Waseem

Abstract

Background: This study was carried out to assess the association of glycemic control and hypertension with chronic complications in type 2 diabetic subjects attending a tertiary care centre in Karachi, Pakistan. Methods: This was a cross sectional analytical study. First visit of type 2 diabetic subjects to the outpatient department of Baqai Institute of Diabetology and Endocrinology, from September 1996 to December 2001, were analyzed for this study. Socio-demographic attributes and clinical profiles were obtained from the computerized records of these patients retrospectively. Odds ratio with 95% confidence interval were reported for independent variables associated with outcome variables. Results: Records of 2199 subjects (48.5% males, 51.5% females) were analyzed. Mean age of the male and female subjects was 52.2 and 50.6 years respectively. Hypertriglyceridemia [OR: 1.74; 95% CI (1.18-2.57)] and diabetic foot ulcers [OR: 2.32; 95% CI (1.14-4.01)] were significantly associated with poor glycemic control according to HbA1c. Whereas hypertriglyceridemia [OR: 2.39; 95% CI (1.42 -4.03)] and hypertension [OR: 1.65; 95% CI (1.13-2.41)] were significantly associated with poor glycemic control according to FPG. Obesity [OR: 1.44; 95% CI(1.18-1.75)], Retinopathy [OR: 1.95; 95% CI(1.49-2.53)], nephropathy [OR: 1.99; 95% CI(1.45-2.75)],neuropathy [OR:1.40; 95% CI(1.15-1.71)] and presence of coronary arterial disease [OR:1.33; 95% CI(1.02-1.72) were found to be significantly associated with systolic blood pressure. Obesity [OR:2.07; 95% CI(1.69-2.54)], hyperglycemia [OR: 1.40; 95% CI(1.04-1.90)] and nephropathy [OR: 1.92; 95% CI(1.39 -2.64)] had significant association with high diastolic blood pressure. Conclusion: In conclusion this study shows the association of chronic complications with glycemic control and hypertension amongst type 2 diabetics in Karachi. This information needs to be verified by multicentred large scale studies in order to be helpful in planning healthcare and treatment strategies.

Keywords:     diabetes, complications, microvascular, macrovascular, Pakistan, hypertension,             glycemic control.

References

King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025-prevalence, numerical estimates and projection. Diabetes Care 1998; 21: 1414-31.

Fujimoto WY. The growing prevalence of non insulin dependent diabetes in migrant Asian population and its implications for Asia. Diab Res Clin Pract 1991; 15:167-84.

Shera AS, Rafique G, Khwaja IA, Ara J, Baqai S, King H. Pakistan national diabetes survey: prevalence of glucose intolerance and associated factors in Shikarpur, Sindh Province. Diabet Med 1995;12:1116-21.

Shera AS, Rafique G, Ahmed KI, Baqai S, Khan IA, King H. Pakistan National Diabetes Survey prevalence of glucose intolerance and associated factors in North West at Frontier Province (NWFP) of Pakistan [see comments]. J Pak Med Assoc 1999; 49:206-211.

Shera AS, Rafique G, Khawaja IA, Baqai S, King H. Pakistan National Diabetes Survey: prevalence of glucose intolerance and associated factors in Baluchistan province. Diabetes Res Clin Pract 1999; 44:49-58.

Basit A, Hydrie MZI, Ahmed K, Hakeem R. Prevalence of Diabetes, Impaired Fasting Glucose and associated risk factors in a rural area of Baluchistan province according to new ADA Criteria. J Pak Med Assoc 2002; 52:351-60.

Haider Z, Obaidullah S, Ud D, Zubair M, Saleem M. Prevalence of coronary heart disease in Pakistani patients suffering from maturity onset diabetes mellitus. J Trop Med Hyg 1978;81:98-02.

Haider Z, Obaidullah S, Maqbool K. Hypertension in Pakistani patients with diabetes mellitus. J Trop.Med Hyg 1980; 83:251-3.

Khan AJ. Prevalence of diabetic retinopathy in Pakistani subjects. A pilot study. J Pak.Med Assoc 1991; 41:49-50.

Haider Z, Obaidullah S. Clinical diabetes mellitus in Pakistan. J Trop.Med Hyg 1981; 84:155-8.

Khan MA, Baseer A. Magnitude of lipoprotein (a) in diabetes mellitus. J Pak.Med Assoc 1998;48:11-13.

Hashim R, Khan FA, Khan DA, Shaukat A. Prevalence of macrovascular complications in diabetics of WAH, District Rawalpindi. J Pak Med Assoc 1999; 49:8-11.

Hanif R, Sattar A, Qayum I. FBG and TC/HDL ratios in type 2 diabetes mellitus. J Ayub Med Coll Abbottabad 2001;13(2):42-4.

Klein R. Hyperglycemia and microvascular and macrovascular disease in diabetes. Diabetes Care 1995;18:258-68.

UKPDS Group. Risk factors for coronary artery disease in non-insulin dependent diabetes (UKPDS 23). BMJ 1998;316:823-8.

UKPDS Group. Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-53.

UKPDS Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998;352:854-65.

UKPDS Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes (UKPDS 38). BMJ 1998;317:703-13.

NGSP Steering Committee. Implementation of the National Glycohemoglobin Standardization Program (NGSP). Diabetes 46(Suppl 1), 151A. 1997.

European Atherosclerosis Society. Strategies for the prevention of coronary heart disease:a policy statement of the European Atherosclerosis Society. Eur Heart J 1987;8:77-88.

NCEP. Executive Summary of the Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001; 285:2486-97.

World Health Organization, Regional Office for the Western Pacific, International Association for the Study of Obesity. International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment. Melbourne, Health Communications Australia, 2000.

MacCuish AC. Early detection and screening for diabetic retinopathy. Eye 1993;7( Pt 2):254-9.

Watts GF, Jasik M, Cooper ME. The implications of the detection of proteinuria and microalbuminuria in insulin and non-insulin dependent diabetes. Aust N Z J Med 1995;25:157-61.

Deckert T, Borch-Johnsen K, Grenfell A. Epidemiology and National History of Diabetic Nephropathy. In: In Pickup CJ, Williams G, editors. Textbook of Chronic Complications of Diabetes. 1 ed. Oxford: Blackwell Scientific Publications, 1994:139-45.

Valk GD, Nauta JJ, Strijers RL, Bertelsmann FW. Clinical examination versus neurophysiological examination in the diagnosis of diabetic polyneuropathy. Diabet Med 1992;9:716-21.

Liniger C, Albeanu A, Bloise D, Assal JP. The tuning fork revisited. Diabet Med 1990;7:859-64.

NIH-NHLBI (National Institute of Health.National Heart LaBI. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA 2003;289 (Vol 19):2560-72.

Hussain MS, Haque SS, Farzana A, Mahtab H, Kibriya MG. Long Term Vascular Complications in Type-II Diabetes, BIRDEM DCCS. Diabetes in Asia 2001, Compendium of Abstracts 2001 (18th-19th Feb):182-183. Diabetes in Asia 2001, Compendium of Abstracts 2001 (18th-19th Feb), 182-183. 2001.

Raheja BS, Kapur A, Bhoraskar A, Sathe SR, Jorgensen LN, Moorthi SR, et al. DiabCare Asia--India Study: diabetes care in India--current status. J Assoc Physicians India 2001; 49:717-22.

Ramachandran A, Snehalatha C, Satyavani K, Latha E, Sasikala R, Vijay V. Prevalence of vascular complications and their risk factors in type 2 diabetes. J Assoc Physicians India 1999;47:1152-56

Downloads

How to Cite

Basit, A., Hydrie, M. Z. I., Hakeem, R., Ahmedani, M. Y., & Waseem, M. (2005). GLYCEMIC CONTROL, HYPERTENSION AND CHRONIC COMPLICATIONS IN TYPE 2 DIABETIC SUBJECTS ATTENDING A TERTIARY CARE CENTRE. Journal of Ayub Medical College Abbottabad, 17(2). Retrieved from https://jamc.ayubmed.edu.pk/jamc/index.php/jamc/article/view/4170

Issue

Vol. 17 No. 2 (2005): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.