Clinical Characteristics Of Newly Diagnosed Type 2 Diabetes Mellitus And Its Glycemic Control In One Year Follow-up

Objective: The aim is to analyze the clinical characteristics of newly diagnosed early-onset and late-onset diabetes mellitus admitted during Jan 1, 2005 to Jan 1, 2007 in the author's hospital and to study glycemic control, medical compliance after one year since discharge.Methods: 246 cases were enrolled and divided into two groups, EOD group (early-onset diabetes mellitus, <40 years old) and LOD group (late-onset diabetes mellitus,≥40 years old). An independent-sample t test study was carried out to analyze the clinical characteristics, including blood pressure, body mass index (BMI), waist circumstance, fasting blood glucose level (FBG), HbA1c, and serum lipid profiles etc. Insulin resistance (IR)and beta cell function were assessed by HOMA-IR index and C peptide respectively. After one year discharging from the hospital, through telephone communication, or face-to-face discussion, or a combination of both ways, we recorded the level of followed-up FBG, post-meal blood glucose (PBG), and HbA1c. One-way ANOVA study was carried out to analyze the relationship between the treatment compliance and body weight, FBG, PBG, HbA1c, etc. The systolic blood pressure (SBP) <140mmHg and diastolic blood pressure (DBP)≥90mmHg were defined as isolated increased diastolic pressure (i-IDP). BMI> 25Kg/m2 was defined as overweight. Male waist circumference> 90cm or female waist circumference > 80cm were defined as abdominal obesity.Results: Waist circumference, diastolic blood pressure (DBP),BW, HbA1c, C peptide and family history were higher in EOD than LOD group (P<0.05). The levels of TC, LDL-c, and HDL-c levels were lower in EOD than LOD group (P<0.05). Compared to admission, FBG, PBG, and HbA1c were significantly decreased one year later (P<0.05). Lower C peptide on admission was significantly associated with worse glycemic control of one-year follow-up. There was no difference in glycemic control between insulin therapy and oral hypoglycemic agents. The BW of insulin therapy group was higher than oral hypoglycemic group. After one year there was no difference in blood sugar control between EOD and LOD. The BW of EOD was still higher than the LOD (P <0.05). After one year, 48 percent of EOD stop using insulin treatment, and LOD was 19 percent. The glycemic control was also significantly related to the treatment compliance (P<0.05) and the level of education (P<0.05).Conclusion: EOD had lager waist circumstance, higher DBP, HbA1c, higher C peptide, higher rate of T2DM family history than LOD group. Family history, i-IDP may relate to EOD. After one year, there was no difference in glycemic control or treatment options between EOD and LOD group. It showed no difference between oral and insulin treatment for newly diagnosed T2DM. Poorβ-cell function may relate to poor glycemic control. The higher level of education was related to more favorable treatment compliance and better glycemic control. Not trusting the hospital and health care providers was the main reason for missing the questionnaire.