Glycemic control, hypertension and chronic complications in type 2 diabetic subjects attending a tertiary care centre

This study was carried out to assess the association of glycemic control and hypertension with chronic complications in type 2 diabetic subjects attending a tertiary care centre in Karachi, Pakistan.

This was a cross sectional analytical study. First visit of type 2 diabetic subjects to the outpatient department of Baqai Institute of Diabetology and Endocrinology, from September 1996 to December 2001, were analyzed for this study. Sociodemographic attributes and clinical profiles were obtained from the computerized records of these patients retrospectively. Odds ratio with 95% confidence interval were reported for independent variables associated with outcome variables.

Records of 2199 subjects (48.5% males, 51.5% females) were analyzed. Mean age of the male and female subjects was 52.2 and 50.6 years respectively. Hypertriglyceridemia [OR: 1.74; 95% CI (1.18-2.57)] and diabetic foot ulcers [OR: 2.32; 95% CI (1.14-4.01)] were significantly associated with poor glycemic control according to HbA1c. Whereas hypertriglyceridemia [OR: 2.39; 95% CI (1.42-4.03)] and hypertension [OR: 1.65; 95% CI (1.13-2.41)] were significantly associated with poor glycemic control according to FPG. Obesity [OR: 1.44; 95% CI (1.18-1.75)], Retinopathy [OR: 1.95; 95% CI (1.49-2.53)], nephropathy [OR: 1.99; 95% CI (1.45-2.75)], neuropathy [OR:1.40; 95% CI (1.15-1.71)] and presence of coronary arterial disease [OR: 1.33; 95% CI (1.02-1.72)] were found to be significantly associated with systolic blood pressure. Obesity [OR:2.07; 95% CI (1.69-2.54)], hyperglycemia [OR: 1.40; 95% CI (1.04-1.90)] and nephropathy [OR: 1.92; 95% CI (1.39-2.64)] had significant association with high diastolic blood pressure.

In conclusion this study shows the association of chronic complications with glycemic control and hypertension amongst type 2 diabetics in Karachi. This information needs to be verified by multicentred large scale studies in order to be helpful in planning healthcare and treatment strategies.