The Prevalence Of Diabetic Chronic Complications In Inpatients With Type 2 Diabetes And Related Risk Factors In Tianjin

Objective:To survey the prevalence of its chronic complications and associated risk factors between 1991 and 2000 and between 2001 and 2008 in hospitalized patients with type 2 diabetes in Tianjin.Methods:To retrospectively analyze the clinical and laboratory data of 2223 type 2 diabetic inpatients in the Affiliated Metabolic Diseases Hospital of Tianjin Medical University and the Endocrinology Department of the Third Hospital in Tianjin during Jan 1 1991 to Dec 31 2008. Data were collected according to the unified strategy in the programme of the 10-year retrospective analysis of diabetic chronic complications in Chinese diabetic inpatients launched by Chinese Diabetes Society, Chinese Medical Association in 2001. We investigated and analyzed the prevalence of cerebro-vascular diseases, cardiovascular diseases, lower extremity vascular diseases, eye diseases, nephropathy, neuropathy and their risk factors, and the change of risk factors between group A(1991-2000) and group B(2001-2008). Multivariate logistic regression model was used to identify independent risk factors for related chronic complications. All data was stored and processed by using SPSS software vesrionl3.0. P values<0.05 were considered statistically significant.Results:1. To study 1146 men and 1077 women with type 2 diabetes, mean age (59.0±11.8) years, mean duration (8.4±7.0) years (436 men and 457 women of group A, mean age 60.3±11.8 years, mean duration 8.3±7.0 years; 710 men and 620 women of group B, mean age 58.2±11.7 years, mean duration 8.4±6.9 years); 41.5% of subjects had a family history of diabetes, in which 33.5% of A and 46.9% of B(P< 0.05); 36.3% had a history of smoking (29.5% of A and 41.0% of B)(P<0.05); obesity(BMI≥28kg/m2)19.0%(13.0% of A and 23.0% of B)(P<0.05); hypertension 59.0%(54.8% of A and 54.8% of B)(P<0.05); dyslipidemia 71.8% (70.1% of A group and 70.1% of B group, P<0.05).2. The prevalence of chronic complications of inpatients with type 2 diabetes:① all inpatients:cerebrovascular complications 19.6%, cardiovascular complications 70.9%, lower extremity vascular complications 14.2%, diabetic retinopathy 41.3%, diabetic nephropathy 48.9%, diabetic neuropathy 61.7%;②compare group A with the group of the contemporary national survey:cerebrovascular complications in 20.5% vs.13.2%(P<0.05), cardiovascular complications in 59.8% vs.17.1%(P<0.05), lower extremity vascular complications in 16.3% vs.5.2%(P<0.05), diabetic retinopathy of 39.3% vs.35.7%(P<0.05), diabetic nephropathy 54.4% vs.34.7%(P<0.05), diabetic neuropathy 63.8% vs.60.7%(P>0.05);③compare group A with the group B:cerebro-vascular complications 20.5% vs.19.0%(P>0.05), cardiovascular complications 59.8% vs.78.4%(P<0.05), lower extremity vascular complications 16.3% vs.12.7% (P<0.05), diabetic retinopathy 39.3% vs.42.6%(P>0.05), diabetic nephropathy 54.4% vs.45.1%(P<0.05), diabetic neuropathy 63.8% vs.60.2%(P>0.05).3. The related risk factors of chronic complications in hospitalized patients with type 2 diabetes:①Age and duration were the common risk factors of the chronic complications of inpatients with type 2 diabetes.②Except peripheral neuropathy and lower extremity vascular complications of group A, hypertension is the risk factor of other chronic complications in hospitalized patients with type 2 diabetes; in particular, systolic blood pressure is their common risk factor, and diastolic blood pressure is risk factor of cerebrovascular complications, diabetic nephropathy and cardiovascular complications of group B.③Dyslipidemia is the risk factor of peripheral neuropathy of group A and cerebrovascular complications, lower extremity vascular complicati-ons and diabetic nephropathy of group B.④Body mass index is the risk factor of cardiovascular complication, retinopathy and lower extremity vascular complications, diabetic nephropathy of group B.⑤Glycated hemoglobin Ale is the risk factor of cerebrovascular complication and peripheral neuropathy of group B.⑥Man is the risk factor of cerebrovascular complications of group A, while woman is the risk factor of cardiovascular complications of group A and retinopathy and peripheral neuropathy of group B.⑦Diabetic family history is the risk factor of retinopathy and peripheral neuropathy of group A.4. All patients, about 95% inpatients with type 2 diabetes at least had one kind of chronic complication; more than 60% of patients had more than 3 chronic complications; only 5.2% of patients had no complication.Conclusion:1. The prevalence of chronic complications of inpatients with type 2 diabetes in Tianjin:①The prevalence in 90s years was more than the national level;②compared the years 1991 to 2000 with the years 2001 to 2008, it showed a general decreasing trend, but the prevalence of the silent myocardial ischemia and intermittent claudication increased, which should be paid attention to.2. Age, the duration and the positive family history of type 2 diabetes were the uncontrolled risk factors of chronic complications of inpatients with type 2 diabetes in Tianjin. Hypertension, dyslipidemia, hyperglycemia and unhealthy lifestyle (obesity, smoking, etc.) were the controlled risk factors. In this regard, we should pay attention to the health education on inpatients with type 2 diabetes, and screen and assess their risk factors associated with chronic complications conventionally for early detection, early diagnosis and early treatment, and prevent or delay the occurrence and development of the chronic complications of patients with type 2 diabetes.