Endocrine Abstracts

Introduction and objective: Unsatisfactory glycoregulation is the main cause of the development of diabetic microvascular complications. The gold standard for monitoring glycoregulation is glycated hemoglobin (HbA1c). The aim of the research is to determine the association between glycoregulation, microvascular complications and comorbidities in patients with diabetes in Republika Srpska (RS).

Methods: The study was conducted as a cross-sectional study, with the participation of 1088 patients with diabetes in RS. Anthropometric measurements, blood pressure measurement, serum albumin and creatinine, the ratio of albumin and creatinine in urine (ACR), total cholesterol (C), LDL-C, HDL-C, tryglicerides and HbA1c were performed in all patients. For screening of diabetic retinopathy, a nonmydriatic fundus camera with a field of 45 degrees was used, and for the diagnosis of neuroischemic and polyneuropathic changes in the foot was used neurological hammer, sound fork 128Hz and monofilament test with 10 g with mandatory neurological examination.

Results: The study included 1037 patients with diabetes, T1D4.6 % and T2D95.4 %, 576 women (55.5 %) and 461 (44.5%) of men, with an average age of 64.0 ±10.58. Unsatisfactory glycoregulation (HbA1c ≥ 6.5%) had 61.1% of patients (χ²=4.874, df=1, P=0.027). The duration of diabetes affected the deterioration of glycoregulation, statistically significantly more common in T2D (χ²=62,070, df=2, P=0.000). Patients with diabetes over 10 years (84.60% T1Di 76.10% T2D) had more frequent unsatisfactory glycoregulation (HBa1c≥ 6.5%) Based on the value of BMI, 50.1% of these patients were obese (≥30 kg/m²), and based on waist circumference, abdominal obesity had 75.6% with a higher frequency in T2D compared to T1D (50.1:15.7%). Elevated blood pressure values (≥ 130/80 mmHg) were recorded in 88.61% i.e., 918 of these patients. Patients with unsatisfactory glycoregulation had significantly higher ACR values compared to satisfactory (79.50 mg/g: 39.00 mg/g) (P<0.001). Microalbuminuria was the most common microvascular complication (48.10%), polyneuropathy (42.5%) and retinopathy (25.0%). Polyneuropathy (T2D 43.0%; T1D31.4%) and microalbuminuria (T2D 49.10%; T1D 26.0%) were more common in patients with T2D (χ²=10.217, df =1, P=0.001), while retinopathy (T2D 24.6%; T1D31.4%) was more common in T1D.

Conclusion: Patients with diabetes in RS have a high percentage of unsatisfactory glycoregulation associated with microvascular complications and comorbidities, primarily obesity and hypertension. The results are similar to many studies in developing countries and indicate the need to implement additional measures to improve glycoregulation and reduce microvascular complications and comorbidities.