A study of prevalence and association of risk factors for diabetic vasculopathy in an urban area of Gujarat

Solanki, Jayesh Dalpatbhai; Makwana, Amit H; Mehta, Hemant B; Gokhale, Pradnya A; Shah, Chinmay J

doi:10.4103/2249-4863.123906

Cited by 13 publications

(17 citation statements)

References 34 publications

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“…Earlier study [21] factor for peripheral vasculopathy in this study. Solanki et al [42] has shown significant association between hyperlipidemia with peripheral vasculopathy which is in agreement with our study. ACR (Odd ratio 1.01, 95% CI: 1.00 -1.01, P = 0.004) found to risk factors for peripheral vasculopathy in this study.…”

Section: Risk Factors For Early Neuropathy and Vasculopathysupporting

confidence: 94%

Peripheral Neuropathy and Vasculopathy; Frequency and Associated Risk Factors in Newly Diagnosed Treatment Naive Type 2 Diabetes

Naqvi¹,

Talib²,

Akhter³

et al. 2018

OJEMD

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Background: The prevalence of diabetes in Pakistan is 11.45%. The reported prevalence of diabetic foot ulceration in Pakistan is between 4% and 10%, with the amputation rate of 8%-21%. Peripheral neuropathy and vasculopathy are main underlying cause of diabetic foot ulcers. Methodology: It was a cross-sectional non-interventional cohort study where all newly diagnosed treatment naïve type 2 diabetic patients were enrolled. Peripheral neuropathy and vasculopathy were detected by Michigan neuropathy screening instrument (MNSI) and ankle brachial index (ABI) respectively. Risk factors for peripheral neuropathy and vasculopathy were determined by univariate and multivariate logistic regression analysis. Statistical significance was considered with P value of < 0.05. Result: Fifty seven patients (37.7%) had early neuropathy with MNSI score of 3.3 ± 0.4. Thirty seven patients (20.6%) had vasculopathy with ABI score of 0.76 ± 0.11. Age (Odd ratio 1.07 (1.02-1.11), p 0.003), duration of symptoms (Odd ratio 1.11 95% CI: 1.05-1.17, p ≤ 0.001), high HbA1C % (Odd ratio 1.94 95% CI: 1.54-2.45, P ≤ 0.001), albumin creatinine ratio (Odd ratio 1.01, 95% CI: 1.00-1.01, P ≤ 0.001) and cholesterol level (Odd ratio 1.01 95% CI: 1.01-1.02, p = 0.001) were found as risk factors for early neuropathy and vasculopathy. Conclusion: Peripheral neuropathy and vasculopathy are frequently reported complications among newly diagnosed treatment naïve patients of type 2 DM. Age, duration of symptoms prior to diagnosis, metabolic parameters like raised HbA1C, hyperlipidemia and spot random albumin creatinine ratio are found to be risk factors for both peripheral neuropathy and vasculopathy.

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Section: Risk Factors For Early Neuropathy and Vasculopathysupporting

confidence: 94%

Peripheral Neuropathy and Vasculopathy; Frequency and Associated Risk Factors in Newly Diagnosed Treatment Naive Type 2 Diabetes

Naqvi¹,

Talib²,

Akhter³

et al. 2018

OJEMD

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“… 14 In previous studies, in Type 2 diabetics of our region, we found poor glycemic control and high prevalence of many preventable risk factor. 15 We also found that Type 2 diabetics have more ectopic fat on expense of skeletal muscle that persists even after matching by weight or BMI, both quantitatively and qualitatively. 16 With this propensity, it seems quite worthful to know body composition and body fat, in particular, both quantitatively and qualitatively in not only high-risk obese subjects but also in Type 2 diabetics with respect to current glycemic control.…”

Section: Discussionsupporting

confidence: 57%

Effect of current glycemic control on qualitative body composition in sedentary ambulatory Type 2 diabetics

et al. 2016

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Background:Obesity and Type 2 diabetes mellitus are on rise with cause–effect relationship. Diabetics monitor blood sugar, neglecting qualitative body composition, leaving residual threat of ectopic fat unattended. We tried to correlate glycemic triad with parameters of body composition derived objectively by bioelectrical impedance analysis (BIA).Materials and Methods:A sample of 78 under treatment sedentary Type 2 diabetics of either sex with known glycemic and lipidemic control from our city. Following baseline assessment measurement was done by instrument Omron Karada Scan (Model HBF-510, China) using the principle of tetra poplar BIA to derive parameters of body composition. We tried to correlate glycemic triad with these parameters, both directly as well as after defining them as per established cutoff norms.Results:We found poor glycemic control in the study group (20% for Hb1AC), high body mass index, subcutaneous fat, visceral fat (VF), total body fat (TBF), and lesser mass of skeletal muscle in Type 2 diabetics. However, there were small, insignificant, and inconsistent difference of these parameters while directly correlating with the fasting blood sugar, postprandial blood sugar, and glycosylated hemoglobin. On qualitative assessment, the impact of glycemic control as per standard norms, the risk of high VF, high TBF, low skeletal muscle mass was though high (between 1 and 2) in Type 2 diabetics with poor glycemic control as compared to good glycemics, but each strength lacks statistical significance.Conclusion:BIA reveals that Type 2 diabetics have more ectopic fat on expense of skeletal muscle that do not correlate with current glycemic status, both quantitatively and qualitatively. Measurement of body composition can be included and subjects can be motivated for lifestyle modification strategies while managing metabolic derangements of Type 2 diabetes.

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“…[2] Our previous studies have documented a high prevalence of macrovascular complication such as vasculopathy and ectopic body fat in type 2 diabetics of our region, who usually had poor disease control and high prevalence of risk factors, many of which were modifiable. [67] We tried to inquest the same with regard to CAN as evaluated by HRV in this study.…”

Section: Discussionmentioning

confidence: 99%

Impact of disease control and co-existing risk factors on heart rate variability in Gujarati type 2 diabetics: An observational study

Solanki

Basida

Mehta

et al. 2016

J Family Med Prim Care

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Background:Type 2 diabetes mellitus (T2DM) is a proven threat of cardiac dysautonomia with paucity of studies from India. Poor disease control makes it further worse with co-existence of hypertension in majority. Heart rate variability (HRV) is a validated noninvasive tool to assess cardiac autonomic status.Aim:We studied HRV parameters of type 2 diabetics looking for effects of disease control and other co-existing risk factors.Materials and Methods:Ninety-eight hypertensive and forty normotensive under–treatment, Gujarati type 2 diabetics were evaluated for disease control and risk stratification. Five minutes resting, HRV was measured by Variowin HR, software-based instrument, using standard protocols to record time domain, frequency domain, and Poincare plot HRV parameters. They were compared between subgroups for the difference with P < 0.05 defining statistical significance.Results:All HRV parameters were reduced in type 2 diabetics, having mean age 56 years, mean duration 6 years with poor glycemic but comparatively better pressure control. HRV parameters were significantly not different in good compared to poor glycemics or in subjects with optimum pressure control than those without it. Results did not differ significantly, by the presence of individual cardiovascular risk factor in diabetics except resting heart rate.Conclusion:Our findings of HRV suggest that type 2 diabetics with poor glycemic control do not have a significant difference of cardiac dysautonomia by pressure control, glycemic control, and absence of risk cardiovascular factor. It suggests diabetes as a major cause for cardiac dysautonomia, residual risk despite treatment and need for HRV screening, strict glycemic control, and further studies.

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A study of prevalence and association of risk factors for diabetic vasculopathy in an urban area of Gujarat

Cited by 13 publications

References 34 publications

Peripheral Neuropathy and Vasculopathy; Frequency and Associated Risk Factors in Newly Diagnosed Treatment Naive Type 2 Diabetes

Peripheral Neuropathy and Vasculopathy; Frequency and Associated Risk Factors in Newly Diagnosed Treatment Naive Type 2 Diabetes

Effect of current glycemic control on qualitative body composition in sedentary ambulatory Type 2 diabetics

Impact of disease control and co-existing risk factors on heart rate variability in Gujarati type 2 diabetics: An observational study

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