Morbidity in relation to stage of diabetic nephropathy in type-2 diabetic patients.
OBJECTIVE
Type-2 diabetic patients have excessive cardiovascular mortality, primarily related to diabetic nephropathy. The extent of the morbidity due to nephropathy in type-2 diabetes mellitus has not been fully quantified in Nigeria. This study aims to quantify the prevalence of micro- and macrovascular complications in hospitalized type-2 diabetic patients with nephropathy.


METHODS
Over a three-year period, 465 type-2 diabetic patients were examined for nephropathy and diabetic associated diseases while on hospital admission.


RESULTS
One-hundred-ninety-one patients (41.1%) had signs of different stages of diabetic nephropathy. There is a predominance of the male sex in the nephropathic groups. Disease duration is lowest in the non-nephropathic group (6.5+/-7.1 years) but varies between 9.4+/-4.1 years and 11.7+/-3.5 years in the nephropathic groups. Hypertension, left ventricular hypertrophy, stroke, and myocardial infarction were less common in the non-nephropathic group, p<0.05, but showed an upward trend with progression of nephropathy. Although foot amputation was uncommon, the total percentage of patients with diabetic foot increased with progression of nephropathy (17% in non-nephropathic group versus 67% in patients with chronic renal insufficiency). The overall prevalence of diabetic retinopathy increased with progression of nephropathy, especially the occurrence of proliferative retinopathy.


CONCLUSIONS
A high morbidity was already present even in patients without nephropathy that increased in the course of the development of nephropathy. The study identifies patients with diabetic nephropathy as a high-risk group for excess cardiovascular morbidity in Nigeria. Thus, it is imperative to aggressively prevent or slow down progression of diabetic nephropathy.
Alebiosu
Christopher Olutayo
CO
Department of Medicine, Olabisi Onabanjo University Teaching Hospital, Ibadan, Oyo State, Nigeria. dralechristo@infoweb.abs.net
Odusan
Olatunde
O
Jaiyesimi
Alfred
A
D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009549:Nigeria / Q000453:epidemiology; D012720:Severity of Illness Index