scholarly journals Distal Symmetric and Cardiovascular Autonomic Neuropathies in Brazilian Individuals with Type 2 Diabetes Followed in a Primary Health Care Unit: A Cross-Sectional Study

2020 ◽  
Vol 17 (9) ◽  
pp. 3232
Author(s):  
Mozania Reis de Matos ◽  
Daniele Pereira Santos-Bezerra ◽  
Cristiane das Graças Dias Cavalcante ◽  
Jacira Xavier de Carvalho ◽  
Juliana Leite ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Epidemiological Data ◽  
Cross Sectional Study ◽  
Diabetes Duration ◽  
Prevalence Rates ◽  
Sectional Study ◽  
Disability Score ◽  
Cross Sectional

The paucity of epidemiological data regarding diabetes complications in Brazil motivated us to evaluate the prevalence rates of distal symmetric polyneuropathy (DSP) and of cardiovascular autonomic neuropathy (CAN) in individuals with type 2 diabetes (T2D) followed in a primary care unit. A total of 551 individuals (59.3% women, 65 years old; diabetes duration of 10 years; HbA1c of 7.2%, medians) were included in this cross-sectional study. DSP was diagnosed by sum of the Neuropathy Symptoms Score (NSS) and Modified Neuropathy Disability Score (NDS) and by the Semmes–Weinstein monofilament. CAN was diagnosed by cardiovascular autonomic reflex tests combined with spectral analysis of heart rate variability. The prevalence rates of DSP were 6.3% and 14.3%, as evaluated by the sum of NSS and NDS and by the Semmes–Weinstein monofilament, respectively. Those with DSP diagnosed by monofilament presented longer diabetes duration, worse glycemic control and a higher stature. The prevalence rates of incipient and definitive CAN were 12.5% and 10%, respectively. Individuals with definitive CAN presented a higher frequency of hypercholesterolemia and of arterial hypertension. The higher prevalence rate of DSP with the use of the monofilament suggests that it may be a more appropriate tool to diagnose DSP in the primary care setting in Brazil.

scholarly journals Anaemia among primary care patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD): a multicentred cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e025125 ◽  
Author(s):  
Iliza Idris ◽  
Hizlinda Tohid ◽  
Noor Azimah Muhammad ◽  
Mohd Radzniwan A Rashid ◽  
Azainorsuzila Mohd Ahad ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Chronic Kidney Disease ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ckd Stage

ObjectivesThis study aimed to determine the prevalence of anaemia among patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) at primary care settings and its associated factors.Design, setting and participantsThis cross-sectional study involved 808 adult patients with T2DM and CKD who were recruited via systematic sampling from 20 public primary care clinics in Peninsular Malaysia. Their sociodemographic, clinical and biomedical profiles were collected through interviews, examination of medical records and blood testing.ResultsThe prevalence of anaemia was 31.7% (256/808). The anaemia was mainly mild (61.5%) and normocytic normochromic (58.7%). About 88.7% of the patients with anaemia were not known to have anaemia prior to the study. Among 36 patients with documented history of anaemia, 80.6% were still anaemic, and only a half received iron therapy. Multivariate regression analysis showed that women (adjusted odd ratio (AOR): 1.57, 95% CI: 1.12 to 2.21, p=0.009) and those with older age (AOR: 1.04, 95% CI: 1.01 to 1.06, p<0.001), CKD stage 3a (AOR: 2.47; 95% CI: 1.25 to 4.87, p=0.009), CKD stage 3b (AOR: 4.36; 95% CI: 2.14 to 8.85, p<0.001), CKD stage 4 (AOR: 10.12; 95% CI: 4.36 to 23.47, p<0.001), CKD stage 5 (AOR: 10.80; 95% CI: 3.32 to 35.11, p<0.001) and foot complication (AOR 3.12, 95% CI: 1.51 to 6.46, p=0.002) were more likely to have anaemia. Having higher body mass index (AOR 0.95, 95% CI: 0.92 to 0.99, p=0.012) and higher diastolic blood pressure (AOR 0.97, 95% CI: 0.95 to 0.99, p<0.001) were associated with lower odds to have anaemia.ConclusionAnaemia among patients with T2DM and CKD in primary care was common, and the majority was unrecognised. Inadequate treatment of anaemia was also prevalent. Therefore, screening of anaemia should be incorporated into the routine assessment of diabetic complications particularly for those with significant associated factors. It is hoped that such strategy could lead to early treatment and hence improve their overall care.Trial registration numberNMRR-15-660-24324.

scholarly journals Renal Function but Not Asymmetric Dimethylarginine Is Independently Associated with Retinopathy in Type 2 Diabetes

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Katarzyna Krzyzanowska ◽  
Friedrich Mittermayer ◽  
Gerit H. Schernthaner ◽  
Simon Brunner ◽  
Johanna M. Brix ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Asymmetric Dimethylarginine ◽  
Independent Predictor ◽  
Macrovascular Disease ◽  
Cross Sectional Study ◽  
Multivariate Model ◽  
Diabetes Duration ◽  
Sectional Study ◽  
Cross Sectional

Background. Asymmetric dimethylarginine (ADMA) is associated with macrovascular disease and possibly with microangiopathy in type 2 diabetes (T2DM). We tested the hypothesis that ADMA is related to diabetic retinopathy (DR) independently of macrovascular disease.Methods. This cross-sectional study included 127 T2DM patients selected to achieve equal distributions of patients with and without macrovascular disease in the groups with and without DR.Results. Patients with DR had increased ADMA, longer diabetes duration, and reduced glomerular filtration rate (GFR). ADMA correlated with GFR (; ), diabetes duration (; ), and age (; ). Logistic regression analysis revealed an association of ADMA with DR. After adjustment for macrovascular disease, this association remained significant (OR 1.48; 95% CI: 1.02–2.15; ). Inclusion of GFR and T2DM duration into the model abolished this significant relationship. GFR remained the only independent predictor for DR. A 10 mL/min/1.73 m2GFR decrease was associated with DR in a multivariate model (OR 1.30; 95% CI: 1.08–1.56; ).Conclusions. These findings indicate an association between ADMA and DR in T2DM independent of macrovascular disease. This relationship is modified by GFR, the only parameter significantly related to DR in multivariate analysis.

scholarly journals Prevalence and coprevalence of chronic comorbid conditions in patients with type 2 diabetes in Catalonia: a population-based cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031281 ◽  
Author(s):  
Manel Mata-Cases ◽  
Josep Franch-Nadal ◽  
Jordi Real ◽  
Marta Cedenilla ◽  
Didac Mauricio
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Primary Care ◽  
Chronic Conditions ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional

ObjectivesTo evaluate the prevalence and coprevalence of several chronic conditions in patients with type 2 diabetes in a Mediterranean region.DesignA cross-sectional study.SettingTwo hundred and eighty-six primary care teams of the Catalonian Health Institute (Catalonia, Spain).ParticipantsWe included patients aged ≥18 years with a diagnosis of type 2 diabetes by 31 December, 2016, who were registered in the Information System for the Development of Research in primary care (SIDIAP) database. We excluded patients with a diagnosis of type 1 diabetes, gestational diabetes mellitus and any other type of diabetes.Primary and secondary outcome measuresWe collected data on diabetes-related comorbidities (ie, chronic complications, associated cardiovascular risk factors and treatment complications). Diagnoses were based on the International Classification of Diseases, 10thRevision codes recorded in the database or, for some entities, on the cut-off points for a particular test result or a specific treatment indicated for that entity. The presence and stage of chronic kidney disease (CKD) were based on the glomerular filtration rate, the CKD Epidemiology Collaboration creatinine equation and the urine albumin-to-creatinine ratio.ResultsA total of 373 185 patients were analysed. 82% of patients exhibited ≥2 comorbidities and 31% exhibited ≥4 comorbidities. The most frequent comorbidities were hypertension (72%), hyperlipidaemia (60%), obesity (45%), CKD (33%), chronic renal failure (CRF)(28%) and cardiovascular disease (23%). The most frequently coprevalent pairs of chronic conditions were the combination of hypertension with hyperlipidaemia (45%), obesity (35%), CKD (28%), CRF (25%) or cardiovascular disease (19%), as well as the combination of hyperlipidaemia with obesity (28%), CKD (21%), CRF (18%) or cardiovascular disease (15%); other common pairs of comorbidities were obesity/CKD, obesity/CRF, hypertension/retinopathy, hypertension/albuminuria, hypertension/urinary tract infection, CVD/CRF and CVD/CKD, which were each present in more than 10% of patients.ConclusionPatients with type 2 diabetes have a high frequency of coprevalence of metabolic risk factors, cardiovascular disease and CKD and thus require an integrated management approach.

scholarly journals Fatores Associados a Tensão Arterial Não Controlada em Pessoas com Diabetes Tipo 2 Seguidas nos Cuidados de Saúde Primários em Portugal

2017 ◽  
Vol 30 (3) ◽  
pp. 197 ◽  
Author(s):  
Inês Rosendo ◽  
Luiz Miguel Santiago ◽  
Margarida Marques
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Regression Analysis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Care Patients

Introduction: Determine whether socio-demographic, habits and risk factors are associated with a better tensional control in type 2 diabetes in primary care patients in order to identify a specific target population for compensatory interventions improving diabetes control and reducing its morbi-mortality.Material and Methods: Cross-sectional study in primary care. Randomized type 2 diabetes patient data collection by their volunteer family doctors, proportionally stratified from the 5 Portuguese continental regions. Variables: blood pressure, age, gender, education, diabetes duration, HbA1c, smoking habits, weight, waist circumference, physical activity and adherence to medication. Bivariate and logistic regression analysis to evaluate each measured variable’s independent association with uncontrolled blood pressure (≥ 140/90).Results: 709 patients were included in the study, 60.2% men, mean age 66.12 ± 10.47 years. In logistic regression analysis, the factors independently associated to uncontrolled BP were lower education (p = 0.014), shorter diabetes duration (p = 0.002), higher waist circumference (p < 0.001), higher pulse pressure (p < 0.001), higher physical activity level (p = 0.043) and being a smoker (p < 0.001).Discussion: The main limitations are the fact that the sample was not totaly random and included only primary care patients, a possible inter-observer bias and being a cross-sectional study, thus not providing information on temporal relation or causality.Conclusion: The sub-group of people with diabetes identified to have worse tensional control should have a different and more intensive approach in primary care. We recommend further longitudinal and population based confirmatory research.

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