title: Clinical profile of long-term survivors and nonsurvivors with type 2 diabetes.
abstract: OBJECTIVE
  To compare clinical profile of long-term survivors and nonsurvivors with type 2 diabetes (T2DM).
  
  
  METHODS
  After conducting a retrospective survey of >200,000 case records, we identified T2DM survivors (>40 years of duration) and age at diagnosis and sex-matched T2DM nonsurvivors. Prevalence of complications and causes of death were analyzed. Retinopathy was diagnosed by retinal photography. Microalbuminuria and macroalbuminuria, peripheral vascular disease based on ankle-brachial index <0.9, coronary artery disease based on history of myocardial infarction or coronary revascularization, and neuropathy based on vibration perception threshold >20 V were compared in both groups.
  
  
  RESULTS
  The mean duration of diabetes of survivors (n = 238) was 43.7 ± 3.9 years, and that of the nonsurvivors (n = 307), at time of death, was 22.4 ± 11.0 years (P < 0.001). Nonsurvivors had significantly higher systolic and diastolic blood pressures, plasma glucose, HbA1c, serum cholesterol, LDL cholesterol, and triglycerides and lower HDL cholesterol compared with long-term survivors (P < 0.001 for all parameters except systolic blood pressure, which was P = 0.027). Myocardial infarction (46.4%) and renal failure (16.6%) were the most common causes of death. Prevalence of most complications was higher among survivors because of longer duration and older age, as follows, for survivors versus nonsurvivors: retinopathy, 76 vs. 62%; microalbuminuria, 39.1 vs. 27.3%; macroalbuminuria, 8.4 vs. 23.7%; neuropathy, 86.5 vs. 63.5%; peripheral vascular disease, 23.1 vs. 11.4%; and coronary artery disease, 44.5 vs. 40.7%.
  
  
  CONCLUSIONS
  Long-term survivors with T2DM had better glycemic and blood pressure control and more favorable lipid profiles.
authors.affiliation: Madras Diabetes Research Foundation, Madras, India. drmohans@diabetes.ind.in
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
authors.forename: Coimbatore Subramanian
authors.initials: CS
authors.lastname: Shanthi Rani
authors.forename: Anandakumar
authors.initials: A
authors.lastname: Amutha
authors.forename: Sravan
authors.initials: S
authors.lastname: Dhulipala
authors.forename: Ranjit Mohan
authors.initials: RM
authors.lastname: Anjana
authors.forename: Balasubramanian
authors.initials: B
authors.lastname: Parathasarathy
authors.forename: Ranjit
authors.initials: R
authors.lastname: Unnikrishnan
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000150:complications; D002423:Cause of Death; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000401:mortality; D048909:Diabetes Complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D003929:Diabetic Neuropathies / Q000401:mortality; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007194:India / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D015995:Prevalence; D051437:Renal Insufficiency / Q000401:mortality; D012189:Retrospective Studies; D017741:Survivors
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human
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