2013, Number 2
<< Back Next >>
Rev Cubana Med Gen Integr 2013; 29 (2)
Clinical characteristics and frequency of chronic complications in people with newly diagnosed Type 2 Diabetes Mellitus
Valdés RE, Camps AMC
Language: Spanish
References: 40
Page:
PDF size: 102.88 Kb.
ABSTRACT
Background: clinical characterization of people with diabetes mellitus is essential to
carry out its comprehensive evaluation and indicate an individualized medical
treatment.
Objective: to identify the clinical characteristics and the frequency of chronic
complications in people with newly diagnosed Type 2 Diabetes Mellitus in Granma
Province.
Methods: a descriptive cross-sectional study was conducted in patients with Type 2
Diabetes Mellitus who were admitted to The Diabetes Care Center in Bayamo, Granma,
from January 2011 to July 2012. The universe was composed of the 683 patients who
were admitted to this institution during this period of time. The sample was
represented by the 150 Type 2 diabetics who have been suffering from this disease for
less than 6 months.
Results: the mean age was 49, 2 years. The diabetics who had family antecedents of
Diabetes Mellitus (60, 6 %), the ones who were overweight and obese (90 %) and the
hypertensive ones (62 %), predominated in the study. At the moment of the diagnosis,
43 cases (28,7 %) presented the following chronic complications: 9 had diabetic
retinopathy (6 %), 16 had diabetic polyneuropathy (10, 6 %), 11 had ischemic heart
disease (7,3 %), 4 suffered from stroke (2,6 %) and 13 presented peripheral arterial
disease (8,6 %). 7 patients were diagnosed with more than one complication.
Conclusions: type 2 Diabetes Mellitus frequently occurs in people over 45 years, with
family antecedents of diabetes mellitus associated to obesity and hypertension.
Chronic complications of diabetes are present in a high percent of cases at the moment
of the initial diagnosis of the disease.
REFERENCES
DeFronzo RA. From the triumvirate to the ominous octet: A new paradigm for the treatment of type 2 diabetes mellitus. Diabetes. 2009; 58:773-94.
DNE. Anuario Estadístico de Salud 2006. La Habana: MINSAP-DNE; 2006.
DNE. Anuario Estadístico de Salud 2009. La Habana: MINSAP-DNE; 2009.
DeFronzo RA. Insulin resistance, lipotoxicity, type 2 diabetes and atherosclerosis: the missing links. The Claude Bernard Lecture 2009. Diabetologia. 2010; 53:1270-87.
American Diabetes Association. Standards of Medical Care in Diabetes -2009. Diabetes Care. 2009; 32(suppl 1): S13-61.
World Health Organization (WHO). Definition and classification of diabetes mellitus and complications. Report of WHO consultation. Part 1: Diagnosis and classification of Diabetes mellitus. World Health Organization. Department of Noncommunicable Disease Surveillance. Génova, 1999.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL. The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of High Blood Pressure. The JNC 7 Report. JAMA. 2003; 289:2560-72.
World Health Organization (WHO). Expert Committee Phycal Status. The use and interpretation of anthropometry. Geneva. WHO Technical Report Serie No 854; 1995.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of The National Cholesterol Education Program (NCEP), Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001; 285:2486-97.
Schettler G. and Nüssel E. Cholesterol CHOP-PAP. Arb Med Loz Med Präv Med. 1975; 10:25.
Schettler G and Nüssel E. Triglycerides liquicolor GPO-PAP. Arb Med Loz Med Präv Med. 1975;10:25.
Trinder P. Determination of glucose in blood using glucose oxidase with on alternative oxigen acceptor. Clin Biochem. 1996; 13(2):24-7
Primer consenso cubano de dislipoproteinemias: Guía para la prevención, detección, diagnóstico y tratamiento. Rev Cubana Endocrinol. 2006; 17 (4): 1-31.
L´Esperance FA. Diabetic retinopathy. Ophtalmic Laser Fotocoagulation, photoradiation and sugery. Diabetic Retinopathy In: L' Esperance FA (Jr). St Louis- Toronto-Londres. Ed.Mosby 1983:275-85.
Dyck PJ, Karness JL, Daube JR,Obrien PH, Service FJ. Clinical and neuropathologic criteria for the diagnosis and staging of diabetic polineuropathy. Brain 1985;108: 861- 80.
Escobar F. Pie diabético y factores de riesgo. Av Diabetol 1995;5:71-76.
Ito H, Harano Y, Suzuky M, Hattori y, Takeuchi M, Inada H, et al. Risk factor analyses for macrovascular complication in nonobese NIDDM patients multiclinal study for diabetic macroangiopathy. Diabetes 1996;45 (Suppl 3):519-23.
Scherag A, Dina C, Hinney A, Vatin V, Scherag S, Vogel CI, et-al. Two new Loci for body-weight regulation identified in a joint analysis of genome-wide association studies for early-onset extreme obesity in French and german study groups. PLoS Genet. 2010; 6:e1000916.
Díaz-Perera G., Concepción Quero F., Quintana Setién C., Alemañy Pérez E. Factores de riesgo y enfermedades consecuentes de la aterosclerosis en pacientes diabéticos. Rev haban C. méd . 2010. 9(3): 313-320.
Pérez J.L., Regueira J.L., Hernández R. Caracterización de la diabetes mellitus en un área de salud. Rev Cubana Med Gen Integr. 2002, 18(4): 251-253. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864- 21252002000400003&lng=es .
Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006;444: 840-6.
Hernandez-Mijares A, Sola-Izquierdo E, Ballester-Mecho F, Mari-Herrero MT, Gilabert-Moles JV, Gimeno-Clemente N, et al. Obesity and overweight prevalences in rural and urban populations in East Spain and its association with undiagnosed hypertension and Diabetes Mellitus: a cross-sectional population-based survey. BMC Res Notes. 2009;2:151
Thaler JP, Schwartz MW. Minireview: Inflammation and obesity pathogenesis: the hypothalamus heats up. Endocrinology 2010;151: 4109_4115.
Valdés E, Bencosme N. Características clínicas y frecuencia de complicaciones crónicas en un grupo de personas con diabetes mellitus tipo 2 en la provincia Granma. Multimed. 2009; 13(3-4). Disponible en:http://www.cpicm.grm.sld.cu/index.php?option=com_remository&Itemid=85 .
González R.M., Perich P., Arranz C. Heterogeneidad de los trastornos metabólicos de las etapas iniciales de la diabetes mellitus 2. Rev Cub. End. 2009; 20(1): Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561- 29532009000100003&lng=es .
Tirosh A, Shai I, Afek A, Dubnov-Raz G, Ayalon N, Gordon B, et-al. Adolescent BMI trajectory and risk of diabetes versus coronary disease. N Engl J Med. 2011; 364:1315-25.
Valdés E, Bencosme N. Frecuencia de la hipertensión arterial y su relación con algunas variables clínicas en pacientes con diabetes mellitus tipo 2. Rev Cubana de Endocrinol. 2009;20(3):1561-2953.
Chuang SY, Chou P, Hsu PF, Cheng HM, Tsai ST, Lin IF, et al. Presence and progression of abdominal obesity are predictors of future high blood pressure and hypertension. Am J Hypertens. 2006; 19:788-95.
Kim SH, Reaven GM. Insulin resistance and hyperinsulinemia: you can't have one without the other. Diabetes Care. 2008; 31(7):1433-8.
Avogaro A, Fadini GP, Gallo A, Pagnin E, de Kreutzenberg S. Endothelial dysfunction in type 2 diabetes mellitus. Nutr Metab Cardiovasc Dis 2006; 16(Suppl. 1):S39_S45pmid:16530129.
Rahmouni K, Mark AL, Haynes WG, Sigmund CD. Adipose depot-specific modulation of angiotensinogen gene expression in diet-induced obesity. Am J Physiol Endocrinol Metab. 2004; 286:E891-5.
Hypertension in Diabetes Study (HDS): Prevalence of Hypertensión in newly presenting type diabetes patients and association risk factors for Cardiovascular and Diabetic complications.J.Hypertens.1993,mar,11(3):309 _ 317.
Sereday M, Damiano M, Lapertosa S. Complicaciones crónicas en personas con diabetes mellitus tipo 2 de reciente diagnóstico. Endocrinol Nutr. 2008; 55:64-8.
Licea M.E., Figueredo E., Perich P.A., Cabrera E. Frecuencia y características clínicas de la nefropatìa incipiente en personas con diabetes mellitus tipo 2 de diagnóstico reciente. Rev Cubana Endocrinol. 2003, Abril. 14(1): Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561- 29532003000100003&lng=es .
Festa A, Williams K, D'Agostino R, Wagenknecht LE, Haffner SM. The natural course of Beta Cell function in nondiabetic and diabetic individuals in the Insulin Resistance Atherosclerosis Study (IRAS). The Insulin Resistance Atherosclerosis Study Diabetes. 2006; 55:1114-20.
Prentki M, Nolan CN. Islet Beta cell failure in type 2 diabetes. J Clin Invest. 2006;116:1802-12.
Bansilal S, Farkouh ME, Fuster V. Role of insulin resistance and hyperglycemia in the development of atherosclerosis. Am J Cardiol. 2007; 99:6B-14B.
Licea ME, Roldós D, Cobas MI, Domínguez E. Neuropatía periférica de los miembros inferiores en diabéticos tipo 2 de diagnóstico reciente. Av Diabetol. 2006;22:149-6.
Licea ME, Fernández H, Cabrera-Rode E, Maciques JE. Frecuencia y características clínicas de la retinopatía diabética en un grupo de personas con diabetes tipo 2 de diagnóstico reciente. Rev Cubana Endocrinol. 2003.14(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561- 29532003000200002&lng=es&nrm=iso&tlng=es .
Arteagoitia JM, Larrañaga MI, Rodríguez JL, Fernández I, Pinies JA. Incidence, prevalence and coronary heart disease risk level in known type 2 diabetes: a sentinel practice network study in the Basque Country, Spain. Diabetologia. 2003; 46: 899- 909.