Prevalence of target organ disease and its relation with HbA1c at the point of detection of type 2 diabetes mellitus – A cross sectional study from a tertiary care hospital in Odisha
DOI:
https://doi.org/10.51248/.v43i5.2915Keywords:
Diabetes, HbA1c, Target organ disease [TOD], Diabetic complicationsAbstract
Introduction and Aim: HbA1c is not only a valid indicator of chronic hyperglycaemia but also coincides with the increased risk of diabetic complications in the long term. This study focuses on the prevalence of target organ disease (TOD) and its relation with HbA1c at the point of detecting Type 2 Diabetes Mellitus(T2DM).
Materials and Methods: This is a single-centre cross-sectional study done in the Department of General medicine at IMS and SUM Hospital, Odisha, between November 2020 and June 2022, including all newly diagnosed Type-2 Diabetes Mellitus patients aged > 30 years. Besides all the biochemical parameters, the demographic profile was noted in an excel sheet, and later on, using SPSS version 26, the data was analysed categorically.
Results: 148 newly diagnosed Type 2 DM patients were enrolled in the study with male predominance (54.72%). The mean age was found as 52.49±9.40 years. There were 29 (19.5%) cases of diabetic retinopathy, 39 (26.3%) diabetic neuropathy, 32(21.6%) diabetic nephropathy and 23(15.54%) left ventricular diastolic dysfunction, with a minimal number of RWMA [7 (4.72%)], Concentric left ventricular hypertrophy [9 (6.08%)] and Ischemic DCM [1(0.67%)] found as complications of newly diagnosed Diabetes mellitus patients. The prevalence of coronary artery disease (CAD) is higher in our study than in other diabetic complications, i.e., 40 (27.02%).A statistically significant (p<0.05) correlation exists between newly diagnosed Diabetes patients with higher HbA1C and serum creatinine, serum urea, microalbuminuria, and positive monofilament test.
Conclusion: This study underscores the significance of assessing target organ damage (TOD) prevalence for Type 2 Diabetes Mellitus (T2DM) detection, highlighting the utility of HbA1c testing. HbA1c, a rapid and precise diagnostic tool, holds promise, especially in resource-limited settings, aiding in timely T2DM diagnosis and improved patient care amid the global diabetes epidemic.
References
Khan, M. A., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., Al Kaabi, J. Epidemiology of type 2 diabetes–global burden of disease and forecasted trends. Journal of Epidemiology and Global Health. 2020;10(1):107-111.
Ivelina, M., Maria, M., Mariela, H.S., Veronika, P, Rumen, N., Markova, T., et al., Type and frequency of genetic variants for cardiovascular risk in patients with type 2 diabetes mellitus. Biomedicine. 2021 Sep 7;41(2):382-389.
Sherwani, S. I., Khan, H. A., Ekhzaimy, A., Masood, A., Sakharkar, M. K. Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomarker Insights. 2016;11: BMI-S38440.
Hahr, A. J., Molitch, M. E. Management of diabetes mellitus in patients with chronic kidney disease. Clinical Diabetes and Endocrinology. 2015;1(1):1-9.
Buse, J. B., ACCORD Study Group. Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: design and methods. The American Journal of Cardiology. 2007;99(12): S21-S33.
Papazoglou, A. S., Kartas, A., Moysidis, D. V., Tsagkaris, C., Papadakos, S. P., Bekiaridou, A., et al., Glycemic control and atrial fibrillation: an intricate relationship, yet under investigation. Cardiovascular Diabetology. 2022;21(1):39.
Ooi, S.W., Yeh, S.T., Chang, Y.H., Li, C.Y., Chen, H. F. Low mean HbA1c does not increase all-cause and cardiovascular mortality in patients with diabetes: Effect-modifications by anemia and chronic kidney disease stages. Plos One. 2022;17(8): e0272137.
Song, B. M., Lee, J. H., Woo, H. D., Cho, M. J., Kim, S. S. Association between haemoglobin A1c and all-cause and cause-specific mortality in middle-aged and older Koreans: a prospective cohort study. Nutrition and Metabolism. 2022;19(1):46.
Hsu, C. C., Chang, H. Y., Huang, M. C., Hwang, S. J., Yang, Y. C., Lee, Y. S., et al., HbA1c variability is associated with microalbuminuria development in type 2 diabetes: a 7-year prospective cohort study. Diabetologia. 2012;55:3163-3172.
Mo, Y., Zhou, J., Ma, X., Zhu, W., Zhang, L., Li, J., et al., Haemoglobin A1c variability as an independent correlate of atherosclerosis and cardiovascular disease in Chinese type 2 diabetes. Diabetes and Vascular Disease Research. 2018;15(5):402-408.
Penno, G., Solini, A., Zoppini, G., Orsi, E., Fondelli, C., Zerbini, G., et al., HemoglobinA1c variability as an independent correlate of cardiovascular disease in patients with type 2 diabetes: a cross-sectional analysis of the Renal Insufficiency and Cardiovascular Events (RIACE) Italian multicenter study. Cardiovascular Diabetology. 2013;12:1-3.
Nicholas, J., Charlton, J., Dregan, A., Gulliford, M. C. Recent HbA1c values and mortality risk in type 2 diabetes. population-based case-control study. PLoS One. 2013;8(7):e68008.
Vihari, J., Sriteja, N., Sahu, S., Das, C., Sahoo, A. K., Swain, B. Revert diabetes. Med India 2023;2:5.
Drivsholm, T., de Fine Olivarius, N., Nielsen, A. B., Siersma, V. Symptoms, signs and complications in newly diagnosed type 2 diabetic patients, and their relationship to glycaemia, blood pressure and weight. Diabetologia. 2005;48:210-214.
Weerasuriya, N., Siribaddana, S., Dissanayake, A., Subasinghe, Z., Wariyapola, D., Fernando, D. J. Long-term complications in newly diagnosed Sri Lankan patients with type 2 diabetes mellitus. QJM: Monthly Journal of the Association of Physicians. 1998;91(6):439-443.
Zoungas, S., Chalmers, J., Ninomiya, T., Li, Q., Cooper, M. E., Colagiuri, S., et al., Association of HbA1c levels with vascular complications and death in patients with type 2 diabetes: evidence of glycaemic thresholds. Diabetologia. 2012;55:636-643.
Mohan, V., Sandeep, S., Deepa, R., Shah, B., Varghese, C. Epidemiology of type 2 diabetes: Indian scenario. Indian Journal of Medical Research. 2007;125(3):217-230.
Chowta, N. K., Pant, P.,Chowta, M. N. Association with age, sex, weight, and creatinine clearance. Indian Journal of Nephrology. 2009;19(2):53-56.
Chiu, W. C., Lai, Y. R., Cheng, B. C., Huang, C. C., Chen, J. F., Lu, C. H. HbA1C variability is strongly associated with development of macroalbuminuria in normal or microalbuminuria in patients with type 2 diabetes mellitus: A six-year follow-up study. BioMed Research International. 2020 Jan 25;2020:7462158.
Mersha, G. A., Alimaw, Y. A., Woredekal, A. T. Prevalence of diabetic retinopathy among diabetic patients in Northwest Ethiopia—A cross sectional hospital based study. Plos one. 2022;17(1):e0262664.
Kizor-Akaraiwe, N. N., Ezegwui, I. R., Oguego, N., Uche, N. J., Asimadu, I. N., & Shiweobi, J. Prevalence, awareness and determinants of diabetic retinopathy in a screening centre in Nigeria. Journal of Community Health. 2016:767-771.
Billah, M. M., Rahim, M. A., Rahman, M. A., Mitra, P., Chowdhury, T. A., Hossan, M. E., et al., Pattern and risk factors of diabetic retinopathy among type 2 diabetic patients: Experience in a tertiary care hospital. Journal of Medicine. 2016;17(1):17-20.
Bondar, A. C., Popa, A. R. Diabetic neuropathy prevalence and its associated risk factors in two representative groups of type 1 and type 2 diabetes mellitus patients from Bihor county. Maedica. 2018;13(3):229-234.
Ismail-Beigi, F., Craven, T., Banerji, M. A., Basile, J., Calles, J., Cohen, R. M., et al., Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial. The Lancet. 2010 Aug 7;376(9739):419-430.
Duckworth, W., Abraira, C., Moritz, T., Reda, D., Emanuele, N., Reaven, P. D., et al., Glucose control and vascular complications in veterans with type 2 diabetes. New England Journal of Medicine. 2009;360(2):129-139.
Eguchi, K., Boden-Albala, B., Jin, Z., Rundek, T., Sacco, R. L., Homma, S., et al., Association between diabetes mellitus and left ventricular hypertrophy in a multiethnic population. The American Journal of Cardiology.2008;101(12):1787-1791.
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