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ORIGINAL ARTICLE
Year : 2012  |  Volume : 3  |  Issue : 1  |  Page : 3

Association of chronic complications of type 2 diabetes with the biochemical and physical estimations in subjects attending single visit screening for complications


1 Diabetes Association of Sri Lanka, National Diabetes Centre No. 50, Sarana Mawatha, Rajagiriya, Sri Lanka
2 Faculty of Medicine, University of Colombo, Kynsey Road, Colombo 8, Sri Lanka

Correspondence Address:
M A Wijesuriya
Diabetes Association of Sri Lanka, National Diabetes Centre No. 50, Sarana Mawatha, Rajagiriya, Sri Lanka

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Source of Support: None, Conflict of Interest: None


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The objective of the study was to determine the association of chronic complications of type 2 diabetes with the biochemical and physical estimations in subjects attending single visit screening for complications. A retrospective analytical study was conducted by reviewing the clinical records of the patients with type 2 diabetes who attended the National Diabetes Centre of Sri Lanka from January 2005 to December 2010. Odds ratio (OR) with 95% confidence interval (CI) was calculated to examine the association of chronic complications with the biochemical and physical estimations. A total of 12517 type 2 diabetic patients aged 20 years or above were included in the study. Microvascular complications were present in 7102 (56.7%) subjects. Retinopathy was present in 2654(21.2%), neuropathy in 3509(28%), nephropathy in 4173(33.3%) subjects, whereas, 2626(21.0%) had more than one complication. Retinopathy was significantly associated with poor glycemic control [high HbA1c (OR:2.42;CI:2.09-2.79) and high fasting blood glucose (OR:1.48;CI:1.30-1.68)] and high systolic (OR:2.00;CI:1.83-2.18) and diastolic blood pressure (OR:1.66;CI:1.52-1.82). Neuropathy was also significantly associated with poor glycemic control [high HbA1c (OR: 1.30; CI: 1.17-1.45)] and high systolic (OR:2.01;CI:1.86-2.18) and diastolic blood pressure (OR:1.45;CI:1.33-1.57). Nephropathy was significantly associated with poor glycemic control [high HbA1c (OR:1.96;CI:1.75-2.19) and high fasting blood glucose (OR:1.88;CI:1.68-2.11)], high systolic blood pressure (OR:1.53;CI:1.41-1.65) and diastolic blood pressure (OR:1.52;CI:1.40-1.65), and high body mass index (OR:1.20;CI:1.11-1.29). Macrovascular complications were present in 785 (6.3%) subjects; ischemic heart disease in 676 (5.4%), cerebrovascular accidents in 99 (0.8%) and peripheral vascular disease in 14 (0.1%) subjects. Ischemic heart disease was significantly associated with high systolic (OR:1.79;CI:1.53-2.09) and diastolic blood pressure (OR:1.20;CI:1.02-1.41), and low HDL (OR:1.17;CI:1.01-1.37). Cerebrovascular accidents were significantly associated with high systolic (OR:2.77;CI:1.84-4.17) and diastolic blood pressure (OR:1.56;CI:1.04-2.33). This study shows that chronic complications of type 2 diabetes in Sri Lanka are related to multiple risk factors; microvascular complications are associated with poor glycemic control, high blood pressure and abnormal lipids, macrovascular complications with high blood pressure and abnormal lipids. It is important to diagnose and manage hypertension and dyslipidemia concomitantly with achieving the glycemic control in order to prevent diabetic complications.


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