Late Diabetic Complications in Diabetologic Outpatient Department – Results.
|Year of publication||2014|
|Description||Background: Diabetes mellitus (DM) occurs often in the domain of multi-morbidity especially in type 2 (T2DM) as one of the signs of Reaven's metabolic syndrom. Diabetic retino-, nephro- and neuropathy (incl. diabetic foot syndrom-DFS) belong to main late diabetic complications (LDC). Purpose: An analysis of occurrence and charactertistics of LDC observed and treated in one outpatient dept. for diabetology. Patients and Methods: During the year 2013 authors treated 1,904 diabetic out-patients altogether. Out of this number of the diabetics there were 876 men and 1,028 women of the average age (68.5 ±11.4 y. vs. 72.0 ±11.4 y.). All the patients have been long-term treated in the outpatient dept. for diabetes (DIASTOP). They have been non-selectively enrolled from the catchment area of Brno city where 25 000 inhabitants live. Out of this number of the diabetics there were type1 -72 persons (5.8%) and type2 -1832 persons (96.2%). We analyzed in the set: age, duration of diabetes, kind of therapy, obesity, presence of late diabetic micro-vascular complications and compared the results between male and female genders. Results: The DM duration in patients of our set was 7.7±6.4 y. Methods of treatment in T2DM group were diet only (MNT) 26.8%; oral antidiabetic drugs (OAD) altogether 55.4%; mere insulin or analogues 7.8% and combination of insulin with OAD 5.2%. In T2DM therapy among OAD or in monotherapy either in combination metformin in 36.2%; sulphonylurea in 35.5%; DPP-4 inhibitors in 12.6%; pioglitazone 1% and incretine mimetics in 1.1%. The presence of late complications such as diabetic retino-, nephro- and neuropathy (diabetic foot syndrome-DFS) was among the men in comparison to women higher: 77 vs.74 (5.4%:7.2%); 189 vs.158 (21.6%:15.4%) and 45 vs 18 (5: 2%). All the mentioned complications (except retinopathy) incl. DFS, were statistically significant (p< 0.01) in the male subset in comparison to the females. Among the diabetic males we found amputation in the low extremities 4- times (0.5%); in the female set amputation as a terminal solution once (0.1%). Obesity (BMI?30) men in comparison to women 54.2% vs. 44.7%; morbid obesity (BMI?40) 4.8% vs. 6.4%. Overweight was similar 30.9% vs. 29.3% for both genders groups. Normal weight (BMI?25) was less frequently in men vs. women 8.8% vs. 11.2%. Average waist circumference in both groups was also significantly higher in comparison to standard range 118 (men) vs. 100 (women) centimeter. Conclusions: A diabetic patient faces a long-term threat of developing late complications. The risk of the development of LDC we found essentially higher among male diabetics. Obesity in our patient’s set was more important problem in the men’s subset. Moreover, any improvement of long-term compensation DM and delaying or slowing down the development of LDC, or further risks, is essential in each age.|