[Prevalence of micro and macroangiopatic chronic complications and their risk factors in the care of out patients with type 2 diabetes mellitus].
BACKGROUND
Type 2 diabetes (DM2) has been related to the development of macroangiopatic [coronary heart disease (CHD), peripheral vascular disease (PVD) and stroke] and microangiopatic [retinopathy, nephropathy, and distal sensory neuropathy (DSN)] complications. The aims of this study were to analyze prevalence of complications in DM2 patients and to estimate their associated risk factors.


METHODS
Cross-sectional study, including 927 out patients with DM2 from three medical centers in Rio Grande do Sul: Hospital de Clinicas de Porto Alegre (n = 475), Grupo Hospitalar Conceicao (n = 229) and Hospital Sao Vicente de Paula (n = 223). Of the patients 42% were male, mean age was 59 +/- 10 years and the median known duration of DM2 was 11 (5-43) years. Retinopathy was identified by direct fundoscopy; CHD by WHO questionnaire and/or abnormal ECG and/or perfusion abnormalities on myocardial scintigraphy; DSN by compatible symptoms and absent sensation on 10 g monofilament and/or tune fork; PVD by the presence of claudication and absent foot pulses; stroke by presence of sequels and history; and nephropathy by the urinary albumin excretion rate (>20 microg/min). Hypertension was defined by blood pressure (>140/90 mmHg) and/or use of antihypertensive drugs. Body mass index (BMI, kg/m2) and waist-to-hip ratio (WHR) were calculated.


RESULTS
CHD was present in 36% and PVD in 33% of the patients. Among the microvascular, 37% had nephropathy (12% with macroalbuminuria); 48% retinopathy (15% proliferative retinopathy). DSN was present in 36%. Seventy three percent of the patients presented arterial hypertension. Cholesterol levels were >200 mg/dl in 64% and BMI > 30 kg/m2 in 36%. Twenty two percent of patients were smokers and 21% ex-smokers.


CONCLUSIONS
Diabetic complications are frequent among out patients referring to general hospitals. Almost all patients presented at least one risk factor for cardiovascular disease, justifying the efforts for identification and adequate control.
Scheffel
Rafael Selbach
RS
Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS.
Bortolanza
Desirê
D
Weber
Cristiane Seganfredo
CS
Costa
Luciana Abarno da
LA
Canani
Luís Henrique
LH
Santos
Kátia Gonçalves dos
KG
Crispim
Daisy
D
Roisenberg
Israel
I
Lisbôa
Hugo Roberto Kurtz
HR
Tres
Glaucia Sarturi
GS
Tschiedel
Balduíno
B
Gross
Jorge Luiz
JL
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000209:etiology; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000209:etiology; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000209:etiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D049629:Waist-Hip Ratio