Norbu Tshering, Dorjey Yeshey, Tshering Sangay, Dorji Namkha, Dhakal Guru Prasad
Department of Internal Medicine Trashigang General Hospital Trashigang Bhutan.
Department of Obstetrics and Gynaecology Phuntsholing General Hospital Chukha Bhutan.
Health Sci Rep. 2024 Nov 13;7(11):e70202. doi: 10.1002/hsr2.70202. eCollection 2024 Nov.
Globally, diabetes mellitus is a major public health concern affecting 10.5% of the population. Nearly 90% of these people have Type 2 diabetes mellitus (T2DM). In Bhutan, T2DM is prevalent in 5.6% of the population, and around 60% are unaware of their diagnosis of diabetes. There is no baseline information on the rate and the risk factors for complications of diabetes in Bhutan. The study assessed the clinical profile and the risk factors for complications of T2DM at the Jigme Dorji Wangchuk (JDW) National Referral Hospital, Bhutan.
A descriptive cross-sectional study was conducted at the JDW National Referral Hospital, Bhutan, from January to December 2019. Patients with T2DM attending diabetic clinics were included in the study. Demographic variables and metabolic profiles were recorded using a standard pro forma. Descriptive statistics were used to express the results. The association of clinical profiles with the microvascular complication was assessed using multivariate logistic analysis with statistical significance at < 0.05.
There were 292 patients with T2DM during the study period. The rate of microvascular complication is around 25% in T2DM. Among the complications, diabetic retinopathy occurred in over 51%, followed by neuropathy (29.7%) and nephropathy (18.9%). Over 1/3rd of patients had a duration of diabetes over 10 years with a mean duration of 6.3 (5.4) years, and around 44% (127/292) of them had poor glycemic control (HbA1C ≥ 7%). The age ≥ 60 years and the duration of diabetes ≥ 10 years were independent risk factors for microvascular complications in T2DM patients. Regular exercise prevents retinopathy (OR 0.4, 95%CI 0.2-0.9, = 0.026).
There is a microvascular complication in 1 in 4 of type 2 diabetic patients. Age over 60 years and a duration of diabetes of more than 10 years are independent risk factors for microvascular complications, and regular exercise is preventive for microvascular complications.
在全球范围内，糖尿病是一个主要的公共卫生问题，影响着10.5%的人口。其中近90%的人患有2型糖尿病（T2DM）。在不丹，T2DM在5.6%的人口中普遍存在，约60%的人未意识到自己患有糖尿病。不丹没有关于糖尿病并发症发生率及危险因素的基线信息。本研究评估了不丹吉格梅·多杰·旺楚克（JDW）国家转诊医院T2DM的临床特征及并发症危险因素。
2019年1月至12月在不丹JDW国家转诊医院进行了一项描述性横断面研究。纳入在糖尿病门诊就诊的T2DM患者。使用标准表格记录人口统计学变量和代谢谱。采用描述性统计来表达结果。使用多因素逻辑分析评估临床特征与微血管并发症的关联，统计学显著性设定为<0.05。
研究期间有292例T2DM患者。T2DM患者微血管并发症发生率约为25%。在并发症中，糖尿病视网膜病变发生率超过51%，其次是神经病变（29.7%）和肾病（18.9%）。超过1/3的患者糖尿病病程超过10年，平均病程为6.3（5.4）年，其中约44%（127/292）血糖控制不佳（糖化血红蛋白≥7%）。年龄≥60岁和糖尿病病程≥10年是T2DM患者微血管并发症的独立危险因素。规律运动可预防视网膜病变（比值比0.4，95%置信区间0.2 - 0.9，P = 0.026）。
四分之一的2型糖尿病患者存在微血管并发症。年龄超过60岁和糖尿病病程超过10年是微血管并发症的独立危险因素，规律运动可预防微血管并发症。
