Prevalence of diabetic micro vascular complications at a tertiary care unit of Karachi, Pakistan

Abro, Mujeeb Ur Rehman; Zafar, Awn Bin; Fawwad, Asher; Mustafa, Nida; Tahir, Bilal; Riaz, Musarrat; Basit, Abdul

doi:10.1007/s13410-018-0683-5

Cited by 10 publications

(8 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, 56.9% of the total number of respondents were obese (BMI> 25 kg/m 2 ). There were statistically significantly more obese respondents with unregulated HbA1c values>7.1% compared to obese respondents with HbA1c<7.0% (34.9%) and only in the case of retinopathy it was shown that of the total number of respondents with BMI>25 kg/m 2 , 41.8% of them have this microvascular complication, which is in line with the results of other scientific studies showing that obesity and poor glycemic control are significant risk factors for microvascular complications including diabetic foot ulcer ( 21 - 23 ).…”

Section: Discussionsupporting

confidence: 87%

Correlation Between Extracutaneous Microvascular Complications and Diabetic Foot Ulcers in Patients with Type 2 Diabetes Mellitus

Balaban

Bijelic²,

Miličević

et al. 2020

Med Arch

View full text Add to dashboard Cite

Background: Diabetes is a metabolic disease that is taking an epidemic proportion around the world. The occurrence of microvascular complications and diabetic foot ulcer is associated with an increased mortality and morbidity incidence, which is the most serious complication of this disease, which significantly reduce the quality of patient life. Objective. The aim of the study was to determine the correlation of extracutaneous microvascular complications with diabetic foot ulcer in patients with type 2 diabetes. Method. The study was prospective, and included 160 patients with type 2 diabetes. It was conducted at the University Clinical Center of the Republic of Srpska in the period from January 2016 until December 2019. The respondents were adults, of both sexes, suffering from type 2 diabetes, in whom complications of this disease are present. Glycemic control was established based on a target HbA1c value of 7%. Results. Of the 160 patients in the study, 53.8% were men and 46.2% were women. The average age of the patients was 70.11%±10.05 years. Extracutaneous microvascular complications were present in 85 patients (53.1%); of which 30.2% had well-regulated glycemia (HbA1c≤7.0%), while 61.5% (p<0.001) had unregulated glycemia (HbA1c≥7.0). Polyneuropathy was present in 23.3% of patients with HbA1c≤7.0%, while 41.0% of patients had HbA1c≥7.0% (p<0.043). Nephropathy with HbA1c≤7.0% was present in 36.8% of cases compared to patients with HbA1c≥7.0 in whom the prevalence was 36.8% (p<0.004). Out of total, 25.6% had retinopathy with HbA1c≤7.0%, while in 41.9% of patients with HbA1c≥7.0% (p <0.067). Diabetic ulcer foot was present in 13 patients with HbA1c≥7 (11.1%) compared to patients with HbA1c≤7.0% where there was no occurrence of this complication 0.0% (p<0.021). At the same time, 5.6% of patients had a diabetic foot ulcer with polyneuropathy (p=0.010), 4.4% had neuropathy (p=0.058) and 5.6% had retinopathy (p=0.014). Conclusion: The high incidence of extracutaneous microvascular complications and diabetic foot ulcer in patients with type 2 diabetes requires a multidisciplinary approach of medical professionals that includes prevention of risk factors and good regulation of glycemia.

show abstract

Section: Discussionsupporting

confidence: 87%

Correlation Between Extracutaneous Microvascular Complications and Diabetic Foot Ulcers in Patients with Type 2 Diabetes Mellitus

Balaban

Bijelic²,

Miličević

et al. 2020

Med Arch

View full text Add to dashboard Cite

show abstract

“…In our study, patients with diabetes duration over 20 years had statistically significantly more often poor glycemic control, with a mean HbA1c value of 8.89±1.43%, compared to those with a diagnosis of diabetes for less than 20 years. This is confirmed by other scientific studies indicating that the previously confirmed diagnosis of diabetes and insufficient glycemic control, combined with hypertension and hyperlipidemia, are a risk factor for the increased incidence of micro/macrovascular complications in patients with long-standing disease (14,19,20).…”

Section: Discussionsupporting

confidence: 82%

“…Our study has shown that type 2 diabetic patients who are obese (BMI >25 kg/m²) and who have some chronic microvascular complications have statistically significantly more often unregulated glycemic values (HbA1c ≥7.1%) with scientific studies highlighting obesity as a significant risk factor for microvascular complications (9,13,14). In our study, there was no statistically significant difference in gender compared to glycemic control, which is confirmed by other studies, although, on the other hand, some studies report that glycemic control is worse in women due to differences in glucose homeostasis, response to treatment and certain psychological factors (15,16,17).…”

Section: Discussionmentioning

confidence: 68%

The Association of Obesity and Microvascular Complications with Glycemic Control in Patients with Type 2 Diabetes Mellitus

Bijelic¹,

Balaban

Miličević

et al. 2020

Med Arch

View full text Add to dashboard Cite

Introduction: According Type 2 diabetes mellitus is a chronic metabolic disease with a high prevalence characterized by elevated blood glycemic values and with progressive development of micro and macrovascular complications. Glycemia control is a very important factor in the process of "delaying" the onset of complications by glycated hemoglobin (HbA1c) analysis. Aim: The aim of the study is to determine the association of obesity, microvascular complications with glycemic control in patients with type 2 diabetes. Methods: The study was prospective, involving 105 patients with type 2 diabetes. It was conducted at the University Clinical Center of the Republic of Srpska from January 2016 to January 2018. The patients were adults, of both sexes, suffering from type 2 diabetes, in whom complications of this disease are present. Glycemic control was evaluated based on a target HbA1c value of 7%. Results: Out of the 105 patients in the study, 45.8% were male, 54.2% female. The mean age of the patients was 68.3%±10.7 years. The mean HbA1c level was 8.32±1.57%. Of the total number of patients, in 25.7% the HbA1c levels were ≤7.0%, while in 74.3% the HbA1c were ≥7.0% (p<0.001). There were 57.1% of obese patients, of whom 37.0% had HbA1c ≤7.0%, and 64.1% had HbA1c ≥7.0% (p<0.014). Depending on the duration of diabetes, the study found that ≥7.0% HbA1c was more present in patients with an diabetes duration over 20 years (24.4%) compared with those who had had the diabetes for less than 20 years (3.8%) (p<0.037). Microvascular complications were present in 58 patients (55.2%), of which 33.3% had normal HbA1c values, while unregulated glycemia had 62.8% (p<0.008). Retinopathy was present in 40.9%, polyneuropathy 37.1% and nephropathy 32.4% from which the unregulated glycemia (HbA1c ≥7.0%) was present in 39.7% of patients compared to normal glycemic values in 11.1 % of respondents (p<0.006). In 88 patients, certain diseases were present: hypertension in 76.2% of patients, cardiovascular disease 58.0% and hyperlipidemia 35.2%. Conclusion: Glycemia control in obese patients with type 2 diabetes mellitus is important especially for the prevention of serious microvascular complications that significantly affect the quality of life of patients.

show abstract

“…The prevalence of peripheral vascular disease (PVD) is 5.3% and that of cerebrovascular disease is 4.5% 14. The prevalence of microvascular complications such as retinopathy, nephropathy, and neuropathy is 15.8%, 31.0%, and 48.7%, respectively 15. Unfortunately, 4% of the diabetic patients are affected by diabetic foot ulcers (DFUs) 16.…”

Section: Background Informationmentioning

confidence: 99%

Current management strategies to target the increasing incidence of diabetes within Pakistan

Basit¹,

Fawwad²,

Siddiqui³

et al. 2018

DMSO

Self Cite

View full text Add to dashboard Cite

According to the recently published National Diabetes Survey of Pakistan (NDSP 2016-2017), the prevalence of diabetes is 26.3%. Hence, Pakistan has around 27.4 million people >20 years of age suffering with diabetes. Compared to previous estimation of having around 7 million diabetic patients based on a survey done in 1994-1998, the figures are disturbingly alarming. The four main strategies to tackle the rising incidence of diabetes in Pakistan are as follows: 1) creating multidisciplinary teams through capacity building of the health care professionals (HCPs), including doctors, dieticians, diabetes educators, diabetes foot assistants, and program managers in standardized evidence-based protocols, enhancing their knowledge and skills in managing diabetes and their related comorbidities; 2) promoting primary prevention and awareness all over Pakistan using screening methods such as Risk Assessment of Pakistani Individuals for Diabetes (RAPID); 3) defining strategies for the management and prevention of diabetes and its complication through forums such as the Pakistan Diabetes Leadership Forum (PDLF); and 4) implementing a nationwide diabetes care program including registration, treatment, and referral protocols. The epidemic of diabetes in an under-resourced and overburdened health care system of Pakistan poses a serious challenge not only for the doctors but also for the multiple stakeholders involved in the community systems. There is a need for promoting and screening the population using RAPID and registering people with diabetes through Diabetes Registry of Pakistan (DROP). Future priority areas and interventional strategies shall include the following: implementing a diabetes health care service model in both rural and urban population using evidence-based clinical guidelines along with lifestyle modifications (LSMs) and prevention policies. Current management strategies and proposed future directions may successfully target the increasing incidence of diabetes.

show abstract

Prevalence of diabetic micro vascular complications at a tertiary care unit of Karachi, Pakistan

Cited by 10 publications

References 22 publications

Correlation Between Extracutaneous Microvascular Complications and Diabetic Foot Ulcers in Patients with Type 2 Diabetes Mellitus

Correlation Between Extracutaneous Microvascular Complications and Diabetic Foot Ulcers in Patients with Type 2 Diabetes Mellitus

The Association of Obesity and Microvascular Complications with Glycemic Control in Patients with Type 2 Diabetes Mellitus

Current management strategies to target the increasing incidence of diabetes within Pakistan

Contact Info

Product

Resources

About