Endocrine Abstracts

Objective: To analyze the demographic and clinical characteristics of the patients treated at the onset of type two diabetes mellitus in our DDH.

Material and method: During 2010–2011 were analyzed 171 patients treated in our DDH, studying the following variables: sex, age, BMI, waist circumference, family diabetes history, microvascular and macrovascular long-term complications, smoking habit, rate of associated hypertension (de novo/ previously known), rate of dyslipidemia (de novo/ previously known), systolic blood pressure (SBP), dyastolic blood pressure (DBP), LDLc, triglycerides(TG), HDLc, HbA1c. According to the HbA1c level the treatment was analyzed, using the paired T-student test to compare basal HbA1c and after 3 months of monitoring (SPSSv18.0).

Results: 121 men (70.8%) and 50 women (29.2%), with an average age of 53.6±12.6 year old were treated in our DDH. They showed a BMI of 31.6±6.2 kg/m2, with a waist circumference of 107.4±13.0 cm. It was described a familial history of 68.4% of DM. At disease onset were observed 22.3% of macrovascular complications and 18.3% of microvascular complications. Smoking habit was identified in 40.9% of patients while previously smokers were 14.6% and non-smokers a 44.4% of them. Associated arterial hypertension was described in a 61.4% of the sample (32% de novo and 68% previously known) and associated dyslipidemia in 72.5% (72.5% de novo, 28.5% previously known). Other figures included an average SBP of 136.7±21 mmHg, DBP of 78.3±13.8 mmHg, LDLc levels of 120±41.8 mg/dl, HDLc levels of 41.7±13.8 mmHg and TG levels of 290±49.4 mmHg. Clasifying the patients depending on the antidiabetic therapy initiated we obtained the following data: Oral antidiabetic monotherapy (n=33, HbA1c 8.6%), double oral antidiabetic therapy (n=52, HbA1c 9.7%), triple oral antidiabetic therapy (n=1, HbA1c 9.2%), basal insulin (n=16, HbA1c 10.7), pre-mixed insulin (n=20, HbA1c 11.7%) and basal-bolus (n=49, HbA1c 12.1%). Basal HbA1c level was 10.6±2.4% and after 3 months of monitoring 6.4±1.1%, obtaining a −4.2% difference, clinically relevant and statistically significant.

Conclusions: Patients at the onset of type 2 diabetes mellitus have a severe cardiovascular risk. It requires a comprehensive treatment and an educative effort in order to optimize the therapy and minimize the existing risk.

It is essential the development of functional units for a comprehensive and an intensive management of the different associated diseases and present risk factors.