Abstract
Vascular complication results in serious physical damages which may lead to the death of Type 2 diabetes mellitus patients. Studying the determinant factors of changes in blood glucose level and duration of time to the development of vascular complications helps to save the lives of citizens. A retrospective cohort study was conducted among type 2 diabetes mellitus (T2DM) patients enrolled between December 2011 and December 2012 at Felege Hiwot Referral Hospital. A total of 159 T2DM patients were included in the study. Joint modelling of longitudinal and survival analysis was employed to identify predictors of Blood Glucose Change and Vascular Complication of Type 2 Diabetes Mellitus Patients. The prevalence of vascular complication in Type 2 diabetes patients was 23.3%. Half of these patients developed an avascular complication after 24 months from the onset of the follow-up. The significant predictors of shorter time to development of vascular complication were positive proteinuria (adjusted hazard ratio (AHR) = 1.62, CI: 1.08–2.41), increase in the level of serum creatinine (AHR = 4.12, CI: 1.94–8.74), cholesterol ≥ 200 mg/dl (AHR = 1.54, CI: 1.01–2.35), and log (fasting blood glucose) (AHR = 1.453, CI: 1.004–2.104). The predictors of progression of fasting blood glucose were duration of treatment (CL: − 0.015, − 0.0001), hypertension (CL: 0.018, 0.098), baseline fasting blood glucose level 126–139 and 140-199 mg/dl (CI: − 0.40, − 0.31) and (CI: − 0.24, − 0.17), respectively. Male T2DM patients, patients with more visits to the hospital and patients who required one oral agent had a relatively lower progression of blood sugar level. Type 2 diabetes mellitus patients having higher cholesterol level, positive proteinuria, higher fasting blood sugar and a lesser number of hospital visits had a higher risk of developing a complication.
Highlights
IntroductionDiabetes mellitus is a metabolic disorder of multiple etiologies characterized by chronic hyperglycemia with disturbance in carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action or b oth[1]
Abbreviations ADA America Diabetes Association AHR Adjusted hazard ratio AIC Akaike information criteria ANOVA Analysis of variance BD Bahir Dar BIC Bayesian information criteria BP Blood pressure CL Confidence interval CHD Coronary heart disease df Degree of freedom fasting blood sugar (FBS) Fasting blood glucose FHRH Felege Hiwot Referral Hospital LUC Lower confidence limit OPD Outpatient department PAD Peripheral arterial disease
Diabetes mellitus is a metabolic disorder of multiple etiologies characterized by chronic hyperglycemia with disturbance in carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action or b oth[1]
Summary
Diabetes mellitus is a metabolic disorder of multiple etiologies characterized by chronic hyperglycemia with disturbance in carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action or b oth[1]. IDF reported that the worldwide prevalence of diabetes was estimated to be 8.8% (7.2–11.3%) in 2017 affecting 424.9 (346.4–545.4) million adults aged 20–79, including 212.4 million who are undiagnosed. There were approximately 4.0 (3.2–5.0) million people estimated to have died due to diabetes worldwide in the same year. It is projected that by 2045 there will be 628.6 (477–808.7) million people living with diabetes. In the African region with 69.2%, undiagnosed diabetes has a prevalence of 3.3%2 whereas in Ethiopia the number is estimated at[1] to 10 million in 2 0153
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