Yaprak B, Keskin L
Department of Internal Medicine, Turgut Ozal University, Malatya Training and Research Hospital, Malatya, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Feb;27(4):1601-1608. doi: 10.26355/eurrev_202302_31403.
The incidence of microvascular complications such as diabetic retinopathy, diabetic nephropathy and diabetic neuropathy has increased in newly diagnosed diabetes patients. The aim of this study was to determine the factors affecting the incidence of microvascular complications in newly diagnosed patients with type 2 diabetes.
This study was conducted on 97 newly diagnosed type 2 DM patients who applied to Malatya Training and Research Hospital Endocrinology outpatient clinic between September 2021 and July 2022. The patient files were reviewed retrospectively and their age, height, weight, body mass index (BMI), fasting/postprandial blood glucose measurements, serum HDL cholesterol, LDL cholesterol, total cholesterol, triglyceride, HbA1c levels, glomerular filtration rate (GFR) and complications of retinopathy, nephropathy, and neuropathy were recorded. Mann-Whitney U, t-test, Kruskal-Wallis, Binary logistic regression analysis, and Chi-square analysis were used to analyze the data.
The mean age of the patients included in the study was 47.40±7.78 (min: 23 - max: 62). Non-proliferative retinopathy was observed in 74.2% of patients, proliferative retinopathy in 25.8%, diffuse neuropathy in 49.5% and mononeuropathy was detected in 9.3% of them. Fasting blood glucose, postprandial blood glucose and HbA1c values were found to be higher in patients with proliferative retinopathy than in patients without retinopathy. Fasting blood glucose, postprandial blood glucose and HbA1c values were found to be higher in patients with neuropathy than in patients without neuropathy. In addition, patients with mononeuropathy had statistically significantly higher HbA1c values than patients with diffuse-type neuropathy. It was found that the urine protein values of patients with mononeuropathy were significantly higher than those without neuropathy and those with diffuse neuropathy. Each 0.677-unit increase in HbA1c increases the risk of proliferative retinopathy 1.98-fold, and every 1.018-unit increase increases the risk of neuropathy 2.76-fold. Proliferative retinopathy and mononeuropathy rates were discovered to be higher in patients with a family history.
Microvascular complications are common in newly diagnosed T2DM patients and an increase in HbA1c is a significant risk factor. Every newly diagnosed T2DM patient should be screened for microvascular complications.
糖尿病视网膜病变、糖尿病肾病和糖尿病神经病变等微血管并发症在新诊断的糖尿病患者中的发生率有所上升。本研究的目的是确定影响新诊断的2型糖尿病患者微血管并发症发生率的因素。
本研究对2021年9月至2022年7月期间到马拉蒂亚培训与研究医院内分泌门诊就诊的97例新诊断的2型糖尿病患者进行。回顾性查阅患者病历，记录他们的年龄、身高、体重、体重指数（BMI）、空腹/餐后血糖测量值、血清高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、总胆固醇、甘油三酯、糖化血红蛋白（HbA1c）水平、肾小球滤过率（GFR）以及视网膜病变、肾病和神经病变的并发症情况。采用曼-惠特尼U检验、t检验、克鲁斯卡尔-沃利斯检验、二元逻辑回归分析和卡方分析对数据进行分析。
纳入研究的患者平均年龄为47.40±7.78岁（最小：23岁 - 最大：62岁）。74.2%的患者出现非增殖性视网膜病变，25.8%出现增殖性视网膜病变，49.5%出现弥漫性神经病变，9.3%出现单神经病变。发现增殖性视网膜病变患者的空腹血糖、餐后血糖和HbA1c值高于无视网膜病变的患者。神经病变患者的空腹血糖、餐后血糖和HbA1c值高于无神经病变的患者。此外，单神经病变患者的HbA1c值在统计学上显著高于弥漫性神经病变患者。发现单神经病变患者的尿蛋白值显著高于无神经病变和弥漫性神经病变的患者。HbA1c每增加0.677个单位，增殖性视网膜病变的风险增加1.98倍，每增加1.018个单位，神经病变的风险增加2.76倍。发现有家族史的患者增殖性视网膜病变和单神经病变的发生率更高。
微血管并发症在新诊断的2型糖尿病患者中很常见，HbA1c升高是一个重要危险因素。每一位新诊断的2型糖尿病患者都应筛查微血管并发症。
