Chronic Complications of Diabetes in Iraq: Experience from Southern Iraq

2009 ◽  
Vol 2 ◽  
pp. CMED.S3657 ◽  
Author(s):  
Abbas Ali Mansour
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Erectile Dysfunction ◽  
Peripheral Neuropathy ◽  
Ischemic Heart Disease ◽  
Vascular Disease ◽  
Diabetic Foot ◽  
Peripheral Vascular ◽  
Chronic Complications ◽  
Southern Iraq

Background The aim of this study is to evaluate the prevalence of chronic complications in type 2 diabetic patients in Basrah (Southern Iraq). Methods This was a longitudinal descriptive study for patients with diabetes registered in Al-Faiha Diabetes and Endocrine Centre in Basrah (Southern Iraq) for the period from April 2003 to end of February 2009. Results Out of 4,926 patients enrolled, 51.0% were women, mean age was 55.0 ± 13.1 years and 67.6% were overweight or obese. Those with duration of diabetes more than 5 years constituted 50.6% and only 25.3% were on insulin. Mean Hemoglobin A1C was 9.3 ± 2.0. The prevalence of the 16 complications studied were as follows: Hypertension in 31.0%, peripheral neuropathy in 13.8%, ischemic heart disease in 7.8%, proteinuria in 6.6%, cereberovascular accident in 4.6%, interdigital fungal infection in 4.3%, heart failure in 3.4%, and erectile dysfunction in 6.0%. In this study 2.8% of patients died of cardiovascular causes, 2.7% developed diabetic foot, 2.4% had non-alcoholic fatty liver, 0.7% had amputation, 0.4% developed ophthalmoplegia, 0.2% had peripheral vascular disease, and 0.04% developed mucormycosis. The chronic complications which were more seen in those with diabetes more than 5 years were hypertension, peripheral neuropathy, ischemic heart disease, proteinuria, cereberovascular accident, heart failure, erectile dysfunction, cardiovascular death, diabetic foot, amputation and peripheral vascular disease. Conclusion This study provided the baseline for chronic complications of diabetes in Iraq. Screening for early complications is recommended.

scholarly journals Pattern of Cardiovascular Diseases in Diabetic population - a seven year study in a tertiary care hospital of Bangladesh

2020 ◽  
Vol 8 (2) ◽  
pp. 96-101
Author(s):  
SM Rezaul Irfan ◽  
Samira Humaira Habib ◽  
Shabnam Jahan Hoque ◽  
AKM Mohibullah
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Observational Study ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Diabetic Patients ◽  
Peripheral Vascular ◽  
Different Types ◽  
Diabetic Population

Background: Cardiac involvement in diabetes covers a wide spectrum, ranging from asymptomatic silent ischemia to clinically evident heart failure. The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. Up to 80% of diabetic patients die of macrovascular complications, including coronary artery disease (CAD), stroke, and peripheral vascular disease (PVD). CVD is the single-most important contributor, and is responsible for 17% of total mortality. Because of the growing numbers of diabetic patients and the increased mortality after their first cardiovascular event, it is critical to identify and treat risk factors early and aggressively in these patients. Methodology: This is a retrospective observational study carried out in the Department of Cardiology BIRDEM General Hospital Dhaka Bangladesh from 2011 to2017. Total 5598 patients who were admitted to the institute between 2011 to 2017 was studied and evaluated to see the pattern of cardiovascular diseases in diabetic population. Results: Among total 5598 patients, 50.02% were male and 49.98% were female. Majority of them were Diabetic and Hypertensive. Most of the patient having cardiovascular disease belongs to age 50-70 years. IHD was found among 1810(32.33%) patients with slightly male predominance. Different types of Cardiomyopathy were found among 330(5.8%) study population. Heart failure of different forms were present among 632 (11.28%) of patients. Different types of Arrhythmia were found among 159 (2.8%) of admitted patient. Rheumatic Vulvular Heart disease were found 64 (1.1%) of individual. Congenital Heart disease were found among 51 with ASD 36 (70.58%) followed by VSD 15 (29.42%) and PAD in 105 (1.8%). Conclusion: This study reflects the higher incidence of Ischemic Heart Disease and higher association of Hypertensive Heart Disease in Diabetic population mostly affecting the 50-70 year age groups. This observational study also shows that the duration of hospital stay has gradually declined over the course of seven years. The incidence of Cardiomyopathy, Peripheral Vascular Disease and Heart Failure could be different in Diabetic population if wide range multicenter prospective approach would have been applied. Bangladesh Crit Care J September 2020; 8(2): 96-101

Pathophysiology of the Diabetic Foot

2018 ◽  
Author(s):  
Paul J Kim
Keyword(s):  
Peripheral Neuropathy ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Diabetic Foot ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Peripheral Vascular ◽  
Associated Conditions

The clinical manifestations of diabetes are evident in the foot. Peripheral neuropathy, peripheral vascular disease, dermatologic alterations, and musculoskeletal changes place the foot at high risk of ulceration. The diabetic foot ulcer (DFU) is the end result of these pathophysiologic changes, which increases the likelihood of infection, hospitalization, and amputation. There are treatment options available, but DFU imparts a tremendous toll on the patient’s quality of life and healthcare resources. Although there is a growing understanding of the pathophysiologic processes unique to the diabetic foot, much work is still needed. This chapter focuses on the assessment and management of the diabetic foot and its associated conditions.  This review contains 7 figures, 3 tables and 62 references Key Words:: Diabetic foot, Diabetic Foot Ulcer, Peripheral Neuropathy, Peripheral Vascular Disease, Foot Wound, Biomechanics, Deformity, Biomechanical Surgery, Infection

Peripheral Vascular Disease and Erectile Dysfunction as Predictors of Mortality in Heart Failure Patients

2009 ◽  
Vol 6 (7) ◽  
pp. 1999-2007 ◽  
Author(s):  
Kathy Hebert ◽  
Barbara Lopez ◽  
Francisco Yuri Bulcao Macedo ◽  
Conrado Rios Gomes ◽  
Johan Urena ◽  
...  
Keyword(s):  
Heart Failure ◽  
Erectile Dysfunction ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Peripheral Vascular ◽  
Heart Failure Patients ◽  
Predictors Of Mortality

scholarly journals A Study on Carotid Intima-Media Thickness and Ankle Brachial Index In Patients with Various Stages of Chronic Kidney Disease

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 290-296
Author(s):  
Dhileepan T ◽  
Mohamed Azeem S ◽  
Mariraj I ◽  
Jagadeesan M ◽  
Mahendrakumar K ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Heart Disease ◽  
Kidney Disease ◽  
Ischemic Heart Disease ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Ischemic Heart ◽  
Peripheral Vascular

The presence of peripheral vascular disease in chronic kidney disease portends a dismal prognosis due to the increased morbidity and mortality from cardiovascular events. Peripheral vascular disease is asymptomatic in about 40%. The study was designed to identify the prevalence of the peripheral vascular disease in chronic kidney disease, which is a state of accelerated atherosclerosis. A sample of 90 patients of chronic kidney disease attending the outpatient department in medicine and nephrology were assessed for the prevalence of peripheral vascular disease by measuring the Ankle-brachial index and Carotid intima-media thickness. Gender, smoking, hypertension, diabetes and ischemic heart disease profiles of the sample were analyzed for association with peripheral vascular disease. Majority of the patients belonged to the age group 40-50 years. 82 were males, of these 47 were smokers. 6 patients in the sample had symptoms suggestive of peripheral vascular disease. While 21%(n=19) of patients in the sample were diabetics and 21%(n=19) had evidence of ischemic heart disease, hypertension was present in 41%(n=37) of the patients. 50% of the patients belonged to CRF stage 4. The prevalence of the peripheral vascular disease, as determined by ABI<0.9, was 31.1%. CIMT thickness > 0.9mm has a positive correlation with CKD stages and has a statistically significant P value of <0.05. In conclusion, this study revealed that there is an increased prevalence of PVD in smokers, diabetics and in ischemic heart disease compared to those with hypertension.

scholarly journals Cardiovascular disease after renal transplantation.

1996 ◽  
Vol 7 (1) ◽  
pp. 158-165 ◽  
Author(s):  
B L Kasiske ◽  
C Guijarro ◽  
Z A Massy ◽  
M R Wiederkehr ◽  
J Z Ma
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Renal Transplantation ◽  
Ischemic Heart Disease ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Density Lipoprotein ◽  
Ischemic Heart ◽  
Peripheral Vascular

Although cardiovascular disease is a major cause of morbidity and mortality after renal transplantation, its pathogenesis and treatment are poorly understood. We conducted separate analyses of risk factors for ischemic heart disease, cerebral, and peripheral vascular disease after 706 renal transplants, all of which functioned for at least 6 months. We used Cox proportional hazards analysis to examine the effects of multiple pretransplant and posttransplant risk factors and included time-dependent variables measured at 3, 6, and 12 months, and annually to last follow-up at 7.0 +/- 4.2 yr. The independent relative risk (RR) of diabetes was 3.25 for ischemic heart disease, 3.21 for cerebral vascular disease, and 28.18 peripheral vascular disease (P < 0.05). The RR of each acute rejection episode was 1.40 for ischemic heart disease and 1.24 for cerebral vascular disease. Among serum lipid levels, high-density lipoprotein cholesterol was the best predictor of ischemic heart disease (RR = 0.80 for each 10 mg/dL). Posttransplant ischemic heart disease was strongly predictive of cerebral (5.80) and peripheral vascular disease (5.22), whereas ischemic heart disease was predicted by posttransplant cerebral (8.25) and peripheral vascular disease (4.58). Other risk factors for vascular disease included age, gender, cigarette smoking, pretransplant splenectomy, and serum albumin. Hypertension and low-density lipoprotein cholesterol had no effect, perhaps because of aggressive pharmacologic treatment. Thus, the incidence of cardiovascular disease continues to be high after renal transplantation, and multiple risk factors suggest a number of possible strategies for more effective treatment and prevention.

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