Prevalence of Chronic Complications, Their Risk Factors, and the Cardiovascular Risk Factors among Patients with Type 2 Diabetes Attending the Diabetic Clinic at a Tertiary Care Hospital in Sri Lanka

Arambewela, Maulee Hiromi; Somasundaram, Noel; Jayasekara, Hettiarachchige Buddhi Pradeep Ranjan; Kumbukage, Mahesh; Jayasena, Pulukkutti Mudiyanselage Sarath; Chandrasekara, Chandrasekara Mudalige Priyanka Hemanthi; Fernando, K.; Kusumsiri, Divadalage Priyantha

doi:10.1155/2018/4504287

Cited by 48 publications

(57 citation statements)

References 45 publications

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“…33 Another study also reported that age, disease duration, and HBA1c level were related to microvascular complications of diabetes, while only age was related to macrovascular complication of diabetes, which is in line with our findings as we found that only mortality and retinopathy were associated with higher levels of HbA1C. 34 In our study, females without complication had 12% less risk of mortality than males which could be explained by a longer life expectancy in women than men. 35 In females without complication and with CAD, the risk of mortality was lower than males.…”

Section: Discussionsupporting

confidence: 91%

<p>Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study</p>

Aliyari¹,

Hajizadeh²,

Aminorroaya³

et al. 2020

DMSO

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Background: Increase in the prevalence of type 2 diabetic mellitus (T2DM) as a complex disease, its complications, and spread has become a dominant global health threat in recent decades. Objective: The aim of the current study was to investigate the impact of risk factors and transition probability on the development and progression of the late complications of T2DM. Methods: This study was an open cohort one which was conducted at Isfahan Endocrine and Metabolism Research Center (IEMRC). The data were collected from 1993 to 2018. The sample size consisted of 2519 adults diagnosed with type 2 diabetes. We applied the homogeneous multistate models including no complication, retinopathy alone, coronary artery disease (CAD), microalbuminuria, retinopathy and CAD, and the final absorbing mortality states. Results: Based on our results, time-varying hypertension strongly intensified the hazard of transition to mortality in CAD, no complication, CAD and retinopathy, and retinopathy patients by 4.99, 4.09, 3.42, and 2.65 times, respectively. Hypertension seemed to be a potential factor for the transition of microalbuminuria to no complication in diabetic patients. One-unit increase in LDL increased the hazard ratio of transition from CAD, and retinopathy and CAD to mortality by 1.8% and 2.4%, respectively. Moreover, one level increase in time-varying HbA1c increased the hazard ratio of transition to retinopathy and mortality among no complication diabetic patients by 30% and 67%, respectively. One level increase in time-varying HbA1c also intensified the hazard ratio of transition from retinopathy to mortality by 45%. The same level of increase in time-varying HbA1c also intensified the hazard ratio of transition from CAD alone to CAD and retinopathy, and microalbuminuria to retinopathy by 26% and 50%, respectively. Conclusion: In addition to glycemic control, our study indicates that controlling hypertension and hyperlipidemia is more effective in reducing mortality and the diabetic macro-and microvascular complications.

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Section: Discussionsupporting

confidence: 91%

<p>Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study</p>

Aliyari¹,

Hajizadeh²,

Aminorroaya³

et al. 2020

DMSO

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“…The results obtained after a 24-month follow-up period demonstrated that 93 (54.1%) patients required LEA, with 80 (46.5%) requiring minor amputation and 13 (7.6%) requiring major amputation. The rate of major LEA in this study was considerably lower than the corresponding rate observed in some previous trials [43][44][45]. Furthermore, during the 24-month follow-up period, the risk of LEA was highly associated with newly developed ischemic heart disease, with 49.5% (n = 46) of the patients who underwent LEA developing this disease as compared with 32.9% (n = 26) of the patients who did not undergo LEA (P = 0.028).…”

Section: Discussioncontrasting

confidence: 86%

Long-Term Cilostazol Treatment and Predictive Factors on Outcomes of Endovascular Intervention in Patients with Diabetes Mellitus and Critical Limb Ischemia

Lee

Lin

2020

Diabetes Ther

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Introduction: Despite improvements in endovascular interventions and multidisciplinary approaches, improving clinical outcomes and increasing limb salvage have become increasingly challenging. This prospective study investigated the associations of cilostazol treatment with clinical outcomes and predictive factors in patients with diabetes mellitus (DM) and critical limb ischemia (CLI) after endovascular revascularization of the affected angiosome. Methods: In this study, 172 consecutive patients with CLI (Fontaine levels III-IV) received cilostazol treatment after successful endovascular intervention according to the angiosome concept, and their primary patency rates and cardiovascular and amputation events during a 24-month follow-up period were assessed. Result: The 24-month primary patency rate, mortality rate, and amputation rate were better in the patients under long-term cilostazol treatment (P \ 0.001, P = 0.029, and P = 0.014). Weighted multivariate Cox analyses with a propensity scoring-based method showed that long-term cilostazol treatment [hazard ratio (HR) 0.2, 95% confidence interval (CI) 0.11-0.36, P \ 0.001], direct revascularization (DR) (HR 0.46, 95% CI 0.28-0.74, P = 0.002), and supervised exercise (HR 0.4, 95% CI 0.24-0.66, P \ 0.001) were independently associated with primary patency. Patients with lower-extremity amputation (LEA) Digital Features To view digital features for this article go to

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“…Hyperglycaemia and hyperlipidaemia are known risk factors for vascular complications [10,11,14]. However, these associations were not significant in this study.…”

Section: Plos Onecontrasting

confidence: 61%

“…This study aimed to determine the prevalence of vascular complications among these patients and factors independently associated with vascular complications. Similar studies have been conducted in other populations and settings [10][11][12][13][14][15][16][17]. However, the evidence in this particular population and setting could be different from others, and this needs exploration and reporting.…”

Section: Introductionmentioning

confidence: 72%

Prevalence and associated factors of vascular complications among inpatients with type 2 diabetes: A retrospective database study at a tertiary care department, Ningbo, China

Chattopadhyay

et al. 2020

PLoS ONE

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To determine the prevalence of vascular complications among inpatients with type 2 diabetes mellitus (T2DM) and factors independently associated with vascular complications in a tertiary care department in Ningbo, China, the authors conducted a cross-sectional study using an existing computerised medical records database. A total of 3370 adult patients with T2DM were admitted to this tertiary care department for the first time between 2012 and 2017. Patients were categorised as those (1) with at least one vascular complication, (2) with at least one microvascular complication, and (3) with at least one macrovascular complication. Over 5 years, the prevalence of vascular, microvascular, and macrovascular complications among inpatients with T2DM was 73.2%, 57.5%, and 51.4%, respectively. The odds of vascular, microvascular, and macrovascular complications increased with age and were higher in patients with hypertension. The odds of vascular and microvascular complications were higher in single, divorced, or widowed patients, patients with T2DM for a long time, and patients on advanced T2DM therapeutic regimen. The odds of vascular and macrovascular complications were lower in women. The odds of microvascular complications decreased with education. The odds of macrovascular complications were higher in smokers. In conclusion, in the tertiary care department, more than half of inpatients with T2DM had vascular complications, and factors independently associated with vascular complications were identified. The study findings could be used in future interventional studies to prevent and manage vascular complications among these patients.

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Prevalence of Chronic Complications, Their Risk Factors, and the Cardiovascular Risk Factors among Patients with Type 2 Diabetes Attending the Diabetic Clinic at a Tertiary Care Hospital in Sri Lanka

Cited by 48 publications

References 45 publications

<p>Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study</p>

<p>Multistate Models to Predict Development of Late Complications of Type 2 Diabetes in an Open Cohort Study</p>

Long-Term Cilostazol Treatment and Predictive Factors on Outcomes of Endovascular Intervention in Patients with Diabetes Mellitus and Critical Limb Ischemia

Prevalence and associated factors of vascular complications among inpatients with type 2 diabetes: A retrospective database study at a tertiary care department, Ningbo, China

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