Endocrine Abstracts

Background/Aim.: Importance of glucoreglation qality in diabetes complication prevention was proven in numerous clinical studies. Aim of this study is to determine impact of glucoregulation and duration of diabetes on the incidence of chronic complications of diabetes in Republic of Srpska (RS).

Method: Study model included subjects with T1D and T2D who participated in the two-year project in the RS. It was a cross-sectional study with 1088 participants. Specially designed questionnaire included data obtained by objective trial, clinical examination, data on antihyperglycemic treatment, and patient’s record data regarding diabetes and diabetes complications. The quality of glycoregulation was assessed based on glycosylated hemoglobin (HbA1c) values.

Results: Finally, study included 1037 subjects, 4.6% with T1D and 95.4% with T2D, 576 women (55.5%) and 461 (44.5%) men. Poor glycemic control (Hba1c ≧6.5%) was found in 61.1% of subjects (χ²=4.874, df=1, P=0.027) and percentage of this patients increased with longer diabetes duration. Among patients with diabetes, more than 10 years’ duration, poor glucoregulation (HbA1c ≧ 6.5%) was recorded in 84.6% with T1D and 76.1% with T2D; with less than 5 years’ duration was recorded in 58.30% of patients with T1D and 48.0% with T2D. The most common complication was neuroischemic foot (55.8%), statistically significantly more frequently observed in patients with HbA1c ≧ 6.5% (χ²=5.220, df=1); microalbuminuria (49.2%) was reported most frequently in diabetes of 5-10 years’ duration. Polyneuropathy (42,5%) and microalbuminuria were more common in T2D (χ²=10.217, df=1, P=0.001), while retinopathy (25,0%) was more common in T1D. Microvascular complications were statistically significantly more common in patients with unsatisfactory glycoregulation as well as longer duration of diabetes, especially in patients with T2D and disease duration over 10 years.Cardiovascular disease was recorded in 82.0% of T2D patients with HbA1c ≧ 6.5% and in 82.1% of those with HbA1c ≤ 6.5%, with no statistically significant difference with regard to glucoregulation quality.

Conclusion: It can be concluded that 3/5 of diabetes patients in RS (61.1%) have poor glucoregulation. Microvascular complications, have higher incidence in patients with poor glucoregulation Longer T2D duration significantly increases incidence of microvascular complications, especially disease duration of 10 years or more. Cardiovascular complications are present in high percentage regardless of quality of glycemic control. These results are similar to results from developing countries and indicate the need for implementation of additional, interventional measures for improving glucoregulation and reducing chronic complications in patients with diabetes in RS.