Background: India is one of the epicentres of the global diabetes mellitus pandemic. Rapid socioeconomic development and demographic changes, along with increased susceptibility for Indian individuals, have led to the explosive increase in the prevalence of diabetes mellitus in India over the past four decades. Available data also suggest that the susceptibility of Asian Indian people to the complications of diabetes mellitus differs from that of white populations.
Objective: The objectives of this study are to evaluate the patients with type II diabetes mellitus clinically as well as with relevant investigations to see spectrum of various complications of the disease.
Design: A prospective cross sectional study carried out in 200 patients diagnosed of diabetes mellitus admitted into the wards of the medicine department, Osmania General Hospital, Hyderabad.
Duration: September 2016 to November 2017.
Setting: Department of Medicine, Osmania General Hospital, Hyderabad.
Participants: 200 patients diagnosed of diabetes mellitus admitted in Osmania General Hospital, Hyderabad.
Methods: All subjects were interviewed, examined and investigated according to the proforma which was predesigned and pretested. Waist circumference was measured using a non stretchable fibre measure tape. Blood pressure measurement: It was recorded with the subject in lying down position in the right arm with a mercury manometer to nearest of 2 mmHg. Weight was measured by platform scale. Body mass index was calculated using the formula: BMI= weight (kg)/height (m2). Examination of diabetic peripheral neuropathy was done by foot sensitivity testing with Semmes Weinstein monofilament, deep tendon reflex. For diabetic autonomic neuropathy, parasympathetic tests and sympathetic test were performed. Nerve conduction study, CT, MRI and carotid Doppler if required were done accordingly. Examination of diabetic retinopathy was done by direct opthalmoscopic examination of the fundus. Ischemic heart disease was assessed by electrocardiogram and echocardiography. Categorical variables were presented in number and percentage (%) and continuous variables were presented as mean ± SD and median. Qualitative variables were correlated using Chi-Square test /Fisher’s exact test.
Results: Peak incidence of complications was seen in the age group of 63 - 70 years. Most (69%) of the patients presenting with complications of diabetes mellitus had the disease for 1- 10 years. 19% of the patients had a positive family history of the disease. 11% patients presented with acute complications of diabetes mellitus, 56% had macrovascular complications while 58% had microvascular complications. 32% patients had more than 1 complication. Microvascular and macrovascular complications coexisted in 20% patients. Ischemic heart disease was the most common complication followed by retinopathy. Retinopathy (60%) and ischemic heart disease (99%) were seen even patients who were newly diagnosed. Neuropathy was most common (37%) when duration of diabetes was greater than 10 years.
Conclusion: The microvascular and macrovascular complications of diabetes mellitus account for most of the morbidity and mortality associated with the disease. All the associated diabetic complications observed need to be addressed with appropriate prevention and control strategies.
Impact Factor
2022: 6.012
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