A Study of Microvascular Complications in Patients with Newly Diagnosed Type II Diabetes Mellitus in a Tertiary Care Hospital, Moradabad

Authors

  • Abhishek Singh Post Graduate Student, Department of Medicine, Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India. Author
  • Vishvanayak Professor, Department of Medicine, Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India, Author
  • Hare Krishna Associate Professor, Department of Medicine, Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India. Author

Keywords:

Microvascular complications, type II Diabetes Mellitus

Abstract

Background: Diabetes mellitus is a metabolic syndrome which has reached epidemic levels in both developed and developing parts of the modern world. With rising prevalence of obesity, physical inactivity and other related metabolic syndromes, the incidence and prevalence of type II DM is sharply increasing along with the related complications. Type II diabetes mellitus is related with macrovascular and microvascular complications, latter being usually overt. In fact, in many cases the type II diabetes often reaches clinical attention due to the microvascular complications. The common microvascular complications including diabetic retinopathy, diabetic nephropathy and sensory neurological deficits are a common cause of morbidity associated with type II diabetes. Aim: The frequency of microvascular complications in newly diagnosed cases of Type II diabetes mellitus. Subjects and Methods: More than 200 patients newly diagnosed cases of type II DM were included in the study conducted in Medicine Department of our Institution following approval from IEC and after obtaining written & informed consent. The frequency of the microvascular complications including diabetic retinopathy, diabetic nephropathy and diabetic sensory neuropathy was calculated utilizing various tests and clinical examination along with presence of hypertension and smoking, latter are known factors in increasing the severity of the type II diabetes related morbidities. Appropriate statistical methods and tools were used to find out the statistical significance of various observations. Observations and Results: Significant number of patients in our study were in 41-60yrs age group with male predominance. Majority were obese and more than three-fourth had deranged HbA1c levels of >6.5. Significant number of patients had hypertension and were smokers that showed statistical correlation with increased incidence of microvascular complications in the corresponding subgroup. Significant proportion of patients in our study group were detected with microvascular complications in form of diabetic retinopathy, diabetic nephropathy and sensory neuropathy. Conclusion: Since the incidence of microvascular complications including retinopathy, nephropathy and sensory neuropathy is quite high in newly diagnosed patients of Type II diabetes mellitus, hence clinical & laboratory tests directed to their diagnosis should be included in the screening protocol of such patients. As these tests are inexpensive, hence their inclusion may go a long way in reducing the microvascular complication related morbidity in type II diabetes mellitus patients. 

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References

1. Liu Z, Fu C, Wang W, Xu B. Prevalence of chronic complications of type 2 diabetes mellitus in outpatients - a cross-sectional hospital based survey in urban China. Health Qual Life Outcomes. 2010;8:62.

6. Gross JL, de Azevedo MJ, Silveiro SP, Canani LH, Caramori ML, Zelmanovitz T. Diabetic Nephropathy: Diagnosis, Prevention, and Treatment. Diabetes Care. 2005;28:164–176. Available from: https://dx.doi.org/10.2337/diacare.28.1.164.

7. Grauslund J, Andersen N, Andresen J, Flesner P, Haamann P, Heegaard S, et al. Evidence-based Danish guidelines for screening of diabetic retinopathy. Acta Ophthalmol. 2018;96(8):763–769. Available from: https://doi.org/10.1111/ aos.13936.

8. Kanji JN, Anglin RE, Hunt DL, Panju A. Does this patient with diabetes have large-fiber peripheral neuropathy. JAMA. 2010;303(15):1526–1558. Available from: https://doi.org/10. 1001/jama.2010.428.

9. Raman R, Gupta A, Krishna S, Kulothungan V, Sharma T. Prevalence and risk factors for diabetic microvascular complications in newly diagnosed type II diabetes mellitus. Sankara Nethralaya Diabetic Retinopathy Epidemiology And Molecular Genetic Study (SN-DREAMS, report 27). J Diabetes Complications. 2012;26(2):123–128. Available from: https: //dx.doi.org/10.1016/j.jdiacomp.2012.02.001.

10. Ali A, Iqbal F, Taj A, Iqbal Z, Amin MJ, Iqbal QZ. Prevalence of microvascular complications in newly diagnosed patients with Type 2 diabetes. Pak J Med Sci. 2013;29(4):899–902. Available from: https://dx.doi.org/10.12669/pjms.294.3704.

11. Deepa M, Pradeepa, Rema A, Mohan, Deepa, Shanthirani, et al. The Chennai Urban Rural Epidemiology Study (CURES)– study design and methodology (urban component) (CURES-I). J Assoc Physicians India. 2003;51:867–870.

12. Mitra VV, Ram T, Neusha D, Sanghani S, Anusha Y, Tanv N. Incidence of Microvascular Complications in Newly Diagnosed Diabetes Mellitus. JEBMH. 2019;6(42):2760–2764. Available from: https://dx.doi.org/10.18410/jebmh/2019/573.

13. Alrawahi AH, Rizvi SGA, Al-Riyami D, Al-Anqoodi Z. Prevalence and Risk Factors of Diabetic Nephropathy in Omani Type 2 Diabetics in Al-Dakhiliyah Region. Oman Med J. 2012;27(3):212–216. Available from: https://dx.doi.org/10. 5001/omj.2012.48.

14. Gillani AH, Bashir S, Ahmed AB, Usman M, Mustafa A, Iqbal T, et al. Macro and Micro-Vascular Complications and their Risk Factors in Diabetes Mellitus Patients of Southern Punjab, Pakistan. J Pharm Pract Community Med. 2018;4(2):66–71. Available from: https://dx.doi.org/10.5530/jppcm.2018.2.17.

15. Bansal D, Gudala K, Esam HP, Nayakallu R, Vyamusani RV, Bhansali A. Microvascular Complications and Their Associated Risk Factors in Newly Diagnosed Type 2 Diabetes Mellitus Patients. Int J Chronic Dis. 2014;2014:1–7. Available from: https://dx.doi.org/10.1155/2014/201423.

16. Prakash B, Yadav LK. A study of micro vascular complications and associated risk factors in newly diagnosed patients of type 2 diabetes mellitus. Int J Community Med Public Health. 2018;5(6):2338. Available from: https://dx.doi.org/10.18203/

2394-6040.ijcmph20182154.

17. Zoungas S, , Woodward M, Li Q, Cooper ME, Hamet P, et al. Impact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes. Diabetologia. 2014;57(12):2465– 2474. Available from: https://dx.doi.org/10.1007/s00125-014- 3369-7.

18. Albala ET, Elfaki EO, Ali IA, Musa O. HbA 1c Lev els in Newly Diagnosed Diabetic Patients in Omdurman Hospital: A Pilot Study. Saudi J Med. 2018;3(3):78–81. Available from: https://www.researchgate.net/deref/http%3A/ /dx.doi.org/10.21276/sjm.2018.3.3.4.

19. Prakash B, Yadav LK. A study of micro vascular complications and associated risk factors in newly diagnosed patients of type 2 diabetes mellitus. Int J Community Med Public Health. 2018;5(6):2338. Available from: https://dx.doi.org/10.18203/ 2394-6040.ijcmph20182154.

20. Anwer Z, Sharma RK, Garg VK, Kumar N, Kumari A. Hypertension management in diabetic patients. Eur Rev Med Pharmacol Sci. 2011;15(11):1256–1263.

21. Śliwińska Mossoń M, Milnerowicz H. The impact of smoking on the development of diabetes and its complications. Diabetes Vasc Dis Res. 2017;14:265–276. Available from: https://dx. doi.org/10.1177/1479164117701876.

22. Volaco A. Alcohol Consumption and its Relationship to Diabetes Mellitus: Friend or Foe? Int J Endocrinol Metab. 2018;6(1):28–31. Available from: https://dx.doi.org/10.15406/ emij.2018.06.00150.

23. Rahman MA, Mitra P, Rahim MA, Billah MM. Microalbumin uria in Newly Detected Type 2 Diabetic Subjects with Famil ial Predisposition to Hypertension. Eastern Medical College J. 2016;1(2):1–6.

24. Lee KMC, Sum WMR. Prevalence of diabetic retinopathy in patients with newly diagnosed type II diabetes mellitus. Clin Exp Optom. 2011;94(4):371–375. Available from: https://doi. org/10.1111/j.1444-0938.2010.00574.x.

Published

2021-05-10

How to Cite

A Study of Microvascular Complications in Patients with Newly Diagnosed Type II Diabetes Mellitus in a Tertiary Care Hospital, Moradabad . (2021). Academia Journal of Medicine, 4(1), 1-6. https://medjournal.co.in/index.php/ajm/article/view/87