Background:
In Egypt, data on the prevalence of chronic diabetic complications, which are
essential for the adjustment of policies and practices related to diabetes care, are scarce. Therefore, the
aim of this study was to determine the frequency of chronic complications of diabetes; namely neuropathy,
Diabetic Kidney Disease (DKD), retinopathy and Peripheral Arterial Disease (PAD) in
newly-diagnosed versus known type 2 diabetic patients.
Subjects & Methods:
This is a cross-sectional study that is based on a previous household survey conducted
on a representative sample of the population of Alexandria, Egypt. This study included 506
consecutive subjects with type 2 diabetes; 323 patients with previously known T2DM and 183 patients
with newly diagnosed T2DM (discovered during the survey). For each participant, a focused history
was taken. Comprehensive clinical examination was done including fundus examination, foot examination
and assessment of ankle brachial index. Laboratory tests included HbAlc, lipids profile, serum
creatinine and Urinary Albumin Creatinine Ratio (UACR).
Results:
Peripheral neuropathy was detected in 20% of the studied patients; 29.4% of known patients
and 3.3% of newly diagnosed patients (p<0.001). Diabetic kidney disease was detected in 33.2% of the
studied patients; 46.1% of known patients and 10.4% of newly diagnosed patients (p<0.001). Diabetic
retinopathy was detected in 34.6% of the studied patients; 48.3% of known patients and 10.4% of newly
diagnosed patients (p<0.001). Peripheral arterial disease was detected in 32.6% of the studied patients;
45.5% of known patients and 9.8% of newly diagnosed patients (p<0.001). In patients with known diabetes,
the presence of any of the studied complications (neuropathy, diabetic kidney disease, retinopathy or
PAD) was significantly associated with the presence of all other complications (p< 0.001). In patients
with newly-diagnosed diabetes, the presence of diabetic kidney disease was significantly associated
with the presence of retinopathy (p<0.001), with no significant association with PAD (p=0.357).
Conclusion:
The present study confirms that a considerable proportion of people with T2DM have microvascular
complications and/or PAD at the time of, and possibly years before, diagnosis. Having
shown that, it is strongly recommended to apply appropriate screening strategies for subjects with diabetes
at the time of diagnosis. Finally, these results should be considered as a call for action for the
health care planners and providers in our region to plan for early screening for diabetes and its complications
to reduce the disease burden in our community.
Exercise Ameliorates Diabetic Kidney Disease in Type 2 Diabetic Fatty Rats
