Prevalence of Complications and Clinical Audit of Management of Type 2 Diabetes Mellitus: A Prospective Hospital Based Study

Abstract

Introduction: Management of type 2 diabetes mellitus (DM) needs multi factorial risk reduction strategies like weight reduction, blood pressure (BP) control and lipid profile regulation, along with glycaemic control. These strategies should be implemented very early in the course of the disease to prevent both microvascular and macro vascular complications. Aim: To find out the prevalence of diabetic complications and to audit the management of glycaemia, blood pressure and serum lipids in the outpatient diabetes clinic in a hospital located in Western U.P. Materials and Methods: A prospective study conducted in a tertiary referral teaching hospital, on 105 patients with type 2 diabetes mellitus (mean age 52.84 ± 1.02 years) who attended the diabetic clinic during June 2014 to April 2015, who had undergone screening for complications. Main outcome measures: Weight, height, body mass index (BMI), blood pressure, fasting and post prandial blood sugars, glycated hemoglobin, serum lipids and presence of diabetic microvascular as well as macrovascular complications. Mean of various clinical and biochemical parameters were compared in patients with and without complications. Results: The mean age of patients was estimated as 52.84 ± 1.02 years. Fifty six percent of patients were males. Average BMI was 28.61 ± 0.28 kg/m2 . Most of them had abdominal obesity. The average duration of diabetes was 8.39 ± 0.6 years. The average of systolic blood pressure (SBP), diastolic blood pressure (DBP), HbA1C, FBS, PPBS, LDL, HDL and triglyceride were estimated as 129.1 ± 1.49 mm Hg, 84.85 ± 0.94 mm Hg, 6.99 ± 0.08%, 141.33 ± 2.12 mg/dl, 214.51 ± 3.11 mg/dl, 155.66 ± 2.07 mg /dl, 40.07 ± 0.38 mg/dl, 236.53 ± 3.31 mg/dl respectively based on 105 patients. Amongst micro vascular complications; retinopathy, neuropathy and nephropathy were documented in 51.4, 77.14 and 30.47% diabetes patients respectively. The prevalence of coronary artery disease, stroke and gangrene were 42.85, 12.38 and 3.80% respectively. Conclusion: The prevalence and risk of the complications of type 2 DM significantly increased with age of patients, duration of diabetes, fasting blood sugar and LDL levels. The awareness regarding monitoring of target BP and lipid profile is needed beyond the glycaemic control, amongst patients and health care providers.

Keywords

• diabetes care
• management goals
• macrovascular complications
• microvascular complications