Microvascular and macrovascular complications in a cohort of patients with type 2 diabetes mellitus

Sandra Herranz-Antolin; Visitacion Alvarez-de Frutos; Miguel Torralba; Andrea Biedma-Mendez

doi:10.1530/endoabs.63.P126

Objective: To assess the prevalence of complications In a cohort of patients with type 2 diabetes mellitus (T2DM).

Material and methods: Prospective cohort study. 465 patients with T2DM who were not followed-up at an endocrinology clinic were included. The follow-up was carried out during 26 weeks. The prevalence of complications was evaluated throughout the study. This study was approved by the Ethics and Clinical Research Committee of the University Hospital of Guadalajara (Spain).

Results: Mean age was 63.4±12.5 years and 61.5% were males. Time of evolution of T2DM was ≥5 years in the 69.9%. Initial HbA1c was 8.3%±1.8 and the HbA1c at the 26th week of the follow-up was 6.6%±0.9 (difference of mean 1.7; 95% CI 1.4–1.9; P < 0.0001). The 80.6% of patients had hypertension (HT), 83.1% had dyslipidemia (DL), 61.5% had obesity and the 16.8% were smokers. 25.1% of patients had diabetic nephropathy (DN), 21.9% had ocular disease (OD) (retinopathy and/or macular edema) and the 6.9% had diabetic foot or amputation. Regarding to macrovascular disease (MD), the 4.9% had cerebral vasculopathy, 7.7% had peripheral arterial disease and 19.8% had coronary disease. The factors that were independently associated with the presence of complications are shown in Table 1.

Table 1 Associated factors with DN, OD and MD in the multivariate logistic regression analysis.
	OR			95% CI			P
	DN	OD	MD	DN	OD	MD	DN	OD	MD
Age (years)	1	1.1	1.1	0.9–1.1	0.9–1.2	1–1.2	0.104	0.074	0.002
Male	2.8	1.1	4.1	1.4–5.8	0.5–2.2	1.9–8.8	0.0004	0.809	<0.0001
Time of evolution ≥ 5 years	1.7	3.7	0.9	0.8–3.7	1.4–9.7	0.4–2.2	0.208	0.008	0.883
Initial HbA1c (%)	1.7	0.7	1.2	1.1–2.7	0.4–1.1	0.8–1.7	0.029	0.124	0.474
HbA1c in the previous two years (%)	2	1.9	0.9	1.2–3.4	1.1–3.1	0.6–1.4	0.006	0.014	0.568
HT	2.5	0.7	2.1	1.1–6.3	0.4–1.1	0.8–5.9	0.043	0.124	0.144
DL	1.3	1.1	15.7	0.5–2.9	0.5–2.6	3.4–72.5	0.597	0.808	<0.0001
Smoking	1.3	0.9	1.4	0.5–3.3	0.4–2.6	0.5–3.8	0.524	0.986	0.502
Obesity	1.8	–	–	0.9–3.7	–	–	0.088	–	–
OD	3.1	–	0.8	1.5–6.5	–	0.3–1.9	0.002	–	0.628
MD	1	0.8	–	0.–2.2	0.3–1.7	–	0.95	0.51	–
DN	–	2.4	1.5	–	1.1–5.1	0.7–3.2	–	0.021	0.336

Conclusions: • The prevalence of cardiovascular risk factors is high in the cohort of patients and microvascular complications are more frequent than macrovascular ones.

• Poor metabolic control of T2DM is associated with the presence of microvascular complications among other factors. However, it is not associated with the presence of macrovascular disease.

Endocrine Abstracts

P126