Abstract
Type 2 diabetes (DM2) has been related to the development of macroangiopatic [coronary heart disease (CHD), peripheral vascular disease (PVD) and stroke] and microangiopatic [retinopathy, nephropathy, and distal sensory neuropathy (DSN)] complications. The aims of this study were to analyze prevalence of complications in DM2 patients and to estimate their associated risk factors. Cross-sectional study, including 927 out patients with DM2 from three medical centers in Rio Grande do Sul: Hospital de Clinicas de Porto Alegre (n = 475), Grupo Hospitalar Conceicao (n = 229) and Hospital Sao Vicente de Paula (n = 223). Of the patients 42% were male, mean age was 59 +/- 10 years and the median known duration of DM2 was 11 (5-43) years. Retinopathy was identified by direct fundoscopy; CHD by WHO questionnaire and/or abnormal ECG and/or perfusion abnormalities on myocardial scintigraphy; DSN by compatible symptoms and absent sensation on 10 g monofilament and/or tune fork; PVD by the presence of claudication and absent foot pulses; stroke by presence of sequels and history; and nephropathy by the urinary albumin excretion rate (>20 microg/min). Hypertension was defined by blood pressure (>140/90 mmHg) and/or use of antihypertensive drugs. Body mass index (BMI, kg/m2) and waist-to-hip ratio (WHR) were calculated. CHD was present in 36% and PVD in 33% of the patients. Among the microvascular, 37% had nephropathy (12% with macroalbuminuria); 48% retinopathy (15% proliferative retinopathy). DSN was present in 36%. Seventy three percent of the patients presented arterial hypertension. Cholesterol levels were >200 mg/dl in 64% and BMI > 30 kg/m2 in 36%. Twenty two percent of patients were smokers and 21% ex-smokers. Diabetic complications are frequent among out patients referring to general hospitals. Almost all patients presented at least one risk factor for cardiovascular disease, justifying the efforts for identification and adequate control.
Highlights
CHD was present in 36% and peripheral vascular disease (PVD) in 33% of the patients
Diabetic complications are frequent among out patients referring to general hospitals
Nontraditional risk factors for coronary heart disease incidence among persons with diabetes: the Atherosclerosis Risk in Communities (ARIC) Study
Summary
RAFAEL SELBACH SCHEFFEL, D ESIRÊ BORTOLANZA, CRISTIANE SEGANFREDO WEBER, LUCIANA ABARNO DA COSTA, LUÍS HENRIQUE CANANI, KÁTIA GONÇALVES DOS SANTOS, DAISY CRISPIM, ISRAEL ROISENBERG, HUGO ROBERTO KURTZ LISBÔA, GLAUCIA SARTURI TRES, BALDUÍNO TSCHIEDEL, JORGE LUIZ GROSS* Trabalho realizado no Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre, Porto Alegre, RS. Os objetivos deste estudo foram avaliar a prevalência das complicações crônicas em pacientes com DM do tipo 2 e aferir os seus possíveis fatores de risco. Os objetivos deste estudo foram avaliar a prevalência das complicações crônicas do diabetes em pacientes com DM do tipo 2, em atendimento ambulatorial de três centros médicos do Rio Grande do Sul, e aferir os fatores de risco relacionados com a etiologia destas complicações. MÉTODOS Foi realizado um estudo transversal incluindo 927 pacientes com DM do tipo 2 atendidos ambulatorialmente em três centros médicos do Rio Grande do Sul. Estes centros foram os Serviços de Endocrinologia do Hospital de Clínicas de Porto Alegre (HCPA, n = 475), do Grupo Hospitalar Conceição, em Porto Alegre (GHC, n = 229) e do Hospital São Vicente de Paula, em Passo Fundo (HSVP, n = 223). A avaliação da presença de neuropatia foi realizada através da pesquisa de reflexos tendinosos profundos (patelar e aquileu) e avaliação da sensibilidade vibratória (diapasão de 128 ciclos por segundo no hálux) e tátil (monofilamento de 10 g em três locais dos pés)
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