[Chronic diabetic complications and treatments in Chinese diabetic patients]

To investigate the prevalence of diabetes complications and the control of blood glucose, lipids and treatments in Chinese diabetic patients.

In 1994-1996, 626 Chinese diabetics were investigated for their diabetic complications, the control of blood glucose, lipids and their treatments by a multi-disciplinary team which included diabetic specialists, ophthalmologists, neurologists, nephrologists, dieticians, cardiologists, and others.

Of these patients, 49.6% had hypertension, 46.5% neuropathy, 37.0% retinopathy, 25.4% ischemic heart disease (including 2.3% with myocardial infarction), 22.8% proteinuria (including microalbuminuria), 12.3% cerebral infarction and 1.0% amputation. 16% had preproliferative and proliferative retinopathy, and 10.5% maculopathy. 28 patients (44 eyes) were blind, but only 29% of them were checked by ophthalmologists before this screening. 36% of these patients with antihypertensive agents had their blood pressure controlled. 60% patients with hypertension were not taking any antihypertensive agent, one-third hypertensive patients had their blood pressure uncontrolled even if they had been treated with antihypertensive agents. Hyperglycemia was controlled unsatisfactorily in half of the patients. Over one-fourth of the patients had severe hyperglycemia. 24%, 48% and 59% of the patients had hypercholesterolemia, hypertriglyceridemia and low HDL level respectively. 21.9% kept on diabetic diet and about one-fourth had their diet uncontrolled, including 14% who had never controlled their diet even if their hyperglycemia was severe and 20% newly diagnosed diabetic patients untreated. One hundred twenty-seven newly diagnosed patients with duration less than 1 month were investigated for their diabetic complications. 19.6%, 17.8% and 42.5% of them had retinopathy, proteinuria and neuropathy. Eight patients had preproliferative and 1 had proliferative retinopathy. Three patients (5 eyes) had maculopathy. 33% of these newly diagnosed patients had hypertension, 7 severe hypertension, including 3 patients with antihypertensive therapy.

Diabetes was found late in the Chinese patients and diabetic complications had occurred in some patients by the time the disease was diagnosed. Hypertension was common in the Chinese diabetics. Over half of the diabetics had their blood glucose and blood pressure uncontrolled. Most of the diabetic patients had not controlled their diet. Macrovascular diseases and abnormal lipids metabolism were common. The risks of diabetic complications such as smoking, obesity and hypertension were not controlled and the awareness of these risks was low in the Chinese diabetics.