Skip to main content
Top
Published in: International Journal of Diabetes in Developing Countries 2/2016

01-06-2016 | Original Article

Prevalence of type 2 diabetes–associated complications in Pakistan

Authors: Asima Zia, Attya Bhatti, Fazal Jalil, Xingbin Wang, Peter John, Aysha Karim Kiani, Jamal Zafar, M. Ilyas Kamboh

Published in: International Journal of Diabetes in Developing Countries | Issue 2/2016

Login to get access

Abstract

The prevalence of type 2 diabetes (T2DM) is rapidly increasing in Pakistan. Various micro- and macro-vascular complications are associated with disease progression which increases the economic burden not only on patients but also on country. The aim of the present study was to determine the prevalence of micro- and macro-vascular complications among T2DM patients in Pakistan. A cross-sectional study was carried out on 692 T2DM patients during July 2011 to December 2012. The participants recruited in this study were clinically diagnosed by certified diabetologist and endocrinologists in the Pakistan Institute of Medical Sciences (PIMS) and Kahuta Research Laboratory (KRL) hospital of Islamabad. Demographic and clinical data was collected under supervision of a diabetologist and endocrinologist using a specially designed questionnaire. Clinical variables were statistically analyzed using SPSS version 16.0 and Graphpad prism 5 version 5.01. Of the 678 T2DM patients, 432 (63.62 %) were females with mean age of 51.81 ± 11.43. Out of total patients, 0.56 % were diagnosed with retinopathy, 0.84 % with nephropathy, 0.28 % with neuropathy, 28.17 % with ischemic heart diseases, 8.45 % with stroke, and 5.35 % with peripheral vascular disease. Overall, 55.77 % of T2DM patients were hypertensive and 0.56 % experienced impotence. Significant association of hypertension (P = 0.0072), ischemic heart disease (IHD; P = 0.0001), and peripheral vascular disease (PVD; P = 0.014) was observed at gender level in the study subjects. This study indicates high prevalence of macro-vascular complications along with high triglyceride level and hypertension among T2DM patients. A study with larger sample set is suggested to explore the relation of genetic and environmental factors on disease progression and sub-population variations.
Literature
1.
go back to reference Morris AP, Voight BF, Teslovich TM, Ferreira T, Segre AV, et al. Large-scale association analysis provides insights into the genetic architecture and pathophysiology of type 2 diabetes. Nature genetics. 2012;44:981–90.CrossRefPubMedPubMedCentral Morris AP, Voight BF, Teslovich TM, Ferreira T, Segre AV, et al. Large-scale association analysis provides insights into the genetic architecture and pathophysiology of type 2 diabetes. Nature genetics. 2012;44:981–90.CrossRefPubMedPubMedCentral
2.
go back to reference Ahlqvist E, Ahluwalia TS, Groop L. Genetics of type 2 diabetes. Clinical chemistry. 2011;57:241–54.CrossRefPubMed Ahlqvist E, Ahluwalia TS, Groop L. Genetics of type 2 diabetes. Clinical chemistry. 2011;57:241–54.CrossRefPubMed
3.
go back to reference Billings LK, Florez JC. The genetics of type 2 diabetes: what have we learned from GWAS? Annals of the New York Academy of Sciences. 2010;1212:59–77.CrossRefPubMedPubMedCentral Billings LK, Florez JC. The genetics of type 2 diabetes: what have we learned from GWAS? Annals of the New York Academy of Sciences. 2010;1212:59–77.CrossRefPubMedPubMedCentral
4.
go back to reference Cervin C, Lyssenko V, Bakhtadze E, Lindholm E, Nilsson P, et al. Genetic similarities between latent autoimmune diabetes in adults, type 1 diabetes, and type 2 diabetes. Diabetes. 2008;57:1433–7.CrossRefPubMed Cervin C, Lyssenko V, Bakhtadze E, Lindholm E, Nilsson P, et al. Genetic similarities between latent autoimmune diabetes in adults, type 1 diabetes, and type 2 diabetes. Diabetes. 2008;57:1433–7.CrossRefPubMed
5.
go back to reference Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet. 2005;365:1333–46.CrossRefPubMed Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet. 2005;365:1333–46.CrossRefPubMed
6.
go back to reference Alonso-Magdalena P, Quesada I, Nadal A. Endocrine disruptors in the etiology of type 2 diabetes mellitus. Nature reviews Endocrinology. 2011;7:346–53.CrossRefPubMed Alonso-Magdalena P, Quesada I, Nadal A. Endocrine disruptors in the etiology of type 2 diabetes mellitus. Nature reviews Endocrinology. 2011;7:346–53.CrossRefPubMed
7.
go back to reference DeFronzo RA. Pathogenesis of type 2 diabetes mellitus. The Medical clinics of North America. 2004;88:787–835. ix.CrossRefPubMed DeFronzo RA. Pathogenesis of type 2 diabetes mellitus. The Medical clinics of North America. 2004;88:787–835. ix.CrossRefPubMed
8.
go back to reference Dey L, Attele AS, Yuan CS. Alternative therapies for type 2 diabetes. Altern Med Rev. 2002;7:45–58.PubMed Dey L, Attele AS, Yuan CS. Alternative therapies for type 2 diabetes. Altern Med Rev. 2002;7:45–58.PubMed
9.
go back to reference Chen L, Magliano DJ, Zimmet PZ. The worldwide epidemiology of type 2 diabetes mellitus–present and future perspectives. Nature reviews Endocrinology. 2012;8:228–36.CrossRef Chen L, Magliano DJ, Zimmet PZ. The worldwide epidemiology of type 2 diabetes mellitus–present and future perspectives. Nature reviews Endocrinology. 2012;8:228–36.CrossRef
10.
go back to reference Jain S, Saraf S. Type 2 diabetes mellitus—Its global prevalence and therapeutic strategies. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2010;4:48–56.CrossRef Jain S, Saraf S. Type 2 diabetes mellitus—Its global prevalence and therapeutic strategies. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2010;4:48–56.CrossRef
12.
go back to reference Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. The New England journal of medicine. 2001;345:790–7.CrossRefPubMed Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. The New England journal of medicine. 2001;345:790–7.CrossRefPubMed
13.
14.
go back to reference (2011) National diabetes fact sheet. 2011 ed: National estimates and general information on diabetes and prediabetes in the United States. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011. (2011) National diabetes fact sheet. 2011 ed: National estimates and general information on diabetes and prediabetes in the United States. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.
15.
go back to reference (2012) International Diabetes Federation. 2012 ed: Brussels, Belgium: International Diabetes Federation. (2012) International Diabetes Federation. 2012 ed: Brussels, Belgium: International Diabetes Federation.
16.
go back to reference Orchard TJ, Dorman JS, Maser RE, Becker DJ, Drash AL, et al. Prevalence of Complications in IDDM by Sex and Duration: Pittsburgh Epidemiology of Diabetes Complications Study II. Diabetes. 1990;39:1116–24.CrossRefPubMed Orchard TJ, Dorman JS, Maser RE, Becker DJ, Drash AL, et al. Prevalence of Complications in IDDM by Sex and Duration: Pittsburgh Epidemiology of Diabetes Complications Study II. Diabetes. 1990;39:1116–24.CrossRefPubMed
17.
go back to reference Information ND (2011) Diagnosis of Diabetes and Prediabetes. Information ND (2011) Diagnosis of Diabetes and Prediabetes.
18.
go back to reference WHO (2003) Screening for Type 2 Diabetes. Report of a World Health Organization and International Diabetes Federation meeting. WHO (2003) Screening for Type 2 Diabetes. Report of a World Health Organization and International Diabetes Federation meeting.
19.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA : the journal of the American Medical Association. 2003;289:2560–71.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA : the journal of the American Medical Association. 2003;289:2560–71.CrossRefPubMed
20.
go back to reference Krause T, Lovibond K, Caulfield M, McCormack T, Williams B (2011) Management of hypertension: summary of NICE guidance. Krause T, Lovibond K, Caulfield M, McCormack T, Williams B (2011) Management of hypertension: summary of NICE guidance.
21.
go back to reference Groop L, Pociot F (2013) Genetics of diabetes - Are we missing the genes or the disease? Mol Cell Endocrinol. Groop L, Pociot F (2013) Genetics of diabetes - Are we missing the genes or the disease? Mol Cell Endocrinol.
22.
go back to reference Shera AS, Jawad F, Maqsood A. Prevalence of diabetes in Pakistan. Diabetes research and clinical practice. 2007;76:219–22.CrossRefPubMed Shera AS, Jawad F, Maqsood A. Prevalence of diabetes in Pakistan. Diabetes research and clinical practice. 2007;76:219–22.CrossRefPubMed
23.
go back to reference Lipscombe LL, Hux JE. Trends in diabetes prevalence, incidence, and mortality in Ontario, Canada 1995-2005: a population-based study. Lancet. 2007;369:750–6.CrossRefPubMed Lipscombe LL, Hux JE. Trends in diabetes prevalence, incidence, and mortality in Ontario, Canada 1995-2005: a population-based study. Lancet. 2007;369:750–6.CrossRefPubMed
24.
go back to reference Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375:2215–22.CrossRefPubMed Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375:2215–22.CrossRefPubMed
25.
go back to reference Logue J, Walker JJ, Colhoun HM, Leese GP, Lindsay RS, et al. Do men develop type 2 diabetes at lower body mass indices than women? Diabetologia. 2011;54:3003–6.CrossRefPubMedPubMedCentral Logue J, Walker JJ, Colhoun HM, Leese GP, Lindsay RS, et al. Do men develop type 2 diabetes at lower body mass indices than women? Diabetologia. 2011;54:3003–6.CrossRefPubMedPubMedCentral
26.
go back to reference Choi YJ, Kim HC, Kim HM, Park SW, Kim J, et al. Prevalence and management of diabetes in Korean adults: Korea National Health and Nutrition Examination Surveys 1998-2005. Diabetes Care. 2009;32:2016–20.CrossRefPubMedPubMedCentral Choi YJ, Kim HC, Kim HM, Park SW, Kim J, et al. Prevalence and management of diabetes in Korean adults: Korea National Health and Nutrition Examination Surveys 1998-2005. Diabetes Care. 2009;32:2016–20.CrossRefPubMedPubMedCentral
27.
go back to reference Tirosh A, Shai I, Bitzur R, Kochba I, Tekes-Manova D, et al. Changes in triglyceride levels over time and risk of type 2 diabetes in young men. Diabetes Care. 2008;31:2032–7.CrossRefPubMedPubMedCentral Tirosh A, Shai I, Bitzur R, Kochba I, Tekes-Manova D, et al. Changes in triglyceride levels over time and risk of type 2 diabetes in young men. Diabetes Care. 2008;31:2032–7.CrossRefPubMedPubMedCentral
28.
go back to reference Crawford AG, Cote C, Couto J, Daskiran M, Gunnarsson C, et al. Prevalence of obesity, type II diabetes mellitus, hyperlipidemia, and hypertension in the United States: findings from the GE Centricity Electronic Medical Record database. Population health management. 2010;13:151–61.CrossRefPubMed Crawford AG, Cote C, Couto J, Daskiran M, Gunnarsson C, et al. Prevalence of obesity, type II diabetes mellitus, hyperlipidemia, and hypertension in the United States: findings from the GE Centricity Electronic Medical Record database. Population health management. 2010;13:151–61.CrossRefPubMed
29.
go back to reference Messerli F, Ventura HO, Glade LB, Sundgaard-Riise K, Dunn FG, Frohlich ED. Essential hypertension in the elderly: haemodynamics, intravascular volume, plasma renin activity, and circulating catecholamine levels. The Lancet. 1983;322. Messerli F, Ventura HO, Glade LB, Sundgaard-Riise K, Dunn FG, Frohlich ED. Essential hypertension in the elderly: haemodynamics, intravascular volume, plasma renin activity, and circulating catecholamine levels. The Lancet. 1983;322.
30.
go back to reference Hayat AS, Khan AH, Baloch GH, Shaikh N. Frequency and pattern of retinopathy in newly diagnosed type 2 diabetic patients at tertiary care settings in Abbottabad. Journal of Ayub Medical College, Abbottabad : JAMC. 2012;24:87–9.PubMed Hayat AS, Khan AH, Baloch GH, Shaikh N. Frequency and pattern of retinopathy in newly diagnosed type 2 diabetic patients at tertiary care settings in Abbottabad. Journal of Ayub Medical College, Abbottabad : JAMC. 2012;24:87–9.PubMed
31.
go back to reference Ali A, Iqbal F, Taj A, Iqbal Z, Amin MJ, et al. Prevalence of microvascular complications in newly diagnosed patients with type 2 diabetes. Pakistan journal of medical sciences. 2013;29:899–902.PubMedPubMedCentral Ali A, Iqbal F, Taj A, Iqbal Z, Amin MJ, et al. Prevalence of microvascular complications in newly diagnosed patients with type 2 diabetes. Pakistan journal of medical sciences. 2013;29:899–902.PubMedPubMedCentral
32.
go back to reference Shera AS, Jawad F, Maqsood A, Jamal S, Azfar M, et al. Prevalence of chronic complications and associated factors in type 2 diabetes. JPMA The Journal of the Pakistan Medical Association. 2004;54:54–9.PubMed Shera AS, Jawad F, Maqsood A, Jamal S, Azfar M, et al. Prevalence of chronic complications and associated factors in type 2 diabetes. JPMA The Journal of the Pakistan Medical Association. 2004;54:54–9.PubMed
33.
go back to reference Wahab S, Mahmood N, Shaikh Z, Kazmi WH. Frequency of retinopathy in newly diagnosed type 2 diabetes patients. JPMA The Journal of the Pakistan Medical Association. 2008;58:557–61.PubMed Wahab S, Mahmood N, Shaikh Z, Kazmi WH. Frequency of retinopathy in newly diagnosed type 2 diabetes patients. JPMA The Journal of the Pakistan Medical Association. 2008;58:557–61.PubMed
34.
go back to reference Iqbal T. Frequency of Retinopathy in newly diagnosed Type 2 Diabetes Mellitus. RMJ. 2009;34:167–9. Iqbal T. Frequency of Retinopathy in newly diagnosed Type 2 Diabetes Mellitus. RMJ. 2009;34:167–9.
35.
go back to reference Hussain FA, Mohammad; Ahmad, Munir (2011) The prevalence of diabetic retinopathy in Faisalabad, Pakistan: a population-based study. Turk J Med Sci 41. Hussain FA, Mohammad; Ahmad, Munir (2011) The prevalence of diabetic retinopathy in Faisalabad, Pakistan: a population-based study. Turk J Med Sci 41.
36.
go back to reference Knuiman MW, Welborn TA, McCann VJ, Stanton KG, Constable IJ. Prevalence of diabetic complications in relation to risk factors. Diabetes. 1986;35:1332–9.CrossRefPubMed Knuiman MW, Welborn TA, McCann VJ, Stanton KG, Constable IJ. Prevalence of diabetic complications in relation to risk factors. Diabetes. 1986;35:1332–9.CrossRefPubMed
37.
go back to reference Ramchandran ASC, Satyavani K, Latha E, Sasikala R, Vijay V. Prevalence of vascular complications and their risk factors in type 2 diabetes. Journal of Assoc Physicians India. 1999;47. Ramchandran ASC, Satyavani K, Latha E, Sasikala R, Vijay V. Prevalence of vascular complications and their risk factors in type 2 diabetes. Journal of Assoc Physicians India. 1999;47.
38.
go back to reference Agrawal RPRM, Beniwal R, Sharma S, Purohit VP, Kochar DK, Kothari RP. Prevalence of micro and macro vascular complications in type 2 diabetes and their risk factors. INT J DIAB DEV COUNTRIES. 2004;24:6. Agrawal RPRM, Beniwal R, Sharma S, Purohit VP, Kochar DK, Kothari RP. Prevalence of micro and macro vascular complications in type 2 diabetes and their risk factors. INT J DIAB DEV COUNTRIES. 2004;24:6.
39.
go back to reference Shafiqur-Rahman IZ. Prevalence of microvascular complications among diabetic patients. Pakistan journal of medical Research. 2004;43:3. Shafiqur-Rahman IZ. Prevalence of microvascular complications among diabetic patients. Pakistan journal of medical Research. 2004;43:3.
40.
go back to reference Khuwaja AK, Rafique G, White F, Azam SI. Macrovascular complications and their associated factors among persons with type 2 diabetes in Karachi, Pakistan–a multi-center study. JPMA The Journal of the Pakistan Medical Association. 2004;54:60–6.PubMed Khuwaja AK, Rafique G, White F, Azam SI. Macrovascular complications and their associated factors among persons with type 2 diabetes in Karachi, Pakistan–a multi-center study. JPMA The Journal of the Pakistan Medical Association. 2004;54:60–6.PubMed
41.
go back to reference Litwak L, Goh SY, Hussein Z, Malek R, Prusty V, et al. Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study. Diabetology & metabolic syndrome. 2013;5:57.CrossRef Litwak L, Goh SY, Hussein Z, Malek R, Prusty V, et al. Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study. Diabetology & metabolic syndrome. 2013;5:57.CrossRef
42.
go back to reference Ahmed I, Aamir A, Anwar E, Ali SS, Ali A. Erectile dysfunction and type 2 diabetes mellitus in northern Pakistan. JPMA The Journal of the Pakistan Medical Association. 2013;63:1486–90.PubMed Ahmed I, Aamir A, Anwar E, Ali SS, Ali A. Erectile dysfunction and type 2 diabetes mellitus in northern Pakistan. JPMA The Journal of the Pakistan Medical Association. 2013;63:1486–90.PubMed
43.
go back to reference Shaikh IAKS, Ujjan ID, Shaikh S. Frequency of Sexual Dysfunctions in Type 2 Diabetic Males. Journal of Liaquat University of Medical and Health Sciences. 2010;9:3. Shaikh IAKS, Ujjan ID, Shaikh S. Frequency of Sexual Dysfunctions in Type 2 Diabetic Males. Journal of Liaquat University of Medical and Health Sciences. 2010;9:3.
44.
go back to reference Haq R (2014) Pakistan Education Atlas 2013: Education survey reveals mixed bag of results. The Express Tribune. Pakistan: Express News. Haq R (2014) Pakistan Education Atlas 2013: Education survey reveals mixed bag of results. The Express Tribune. Pakistan: Express News.
45.
go back to reference UNICEF (2013) Pakistan Statistics. December, 2013 ed: UN. UNICEF (2013) Pakistan Statistics. December, 2013 ed: UN.
Metadata
Title
Prevalence of type 2 diabetes–associated complications in Pakistan
Authors
Asima Zia
Attya Bhatti
Fazal Jalil
Xingbin Wang
Peter John
Aysha Karim Kiani
Jamal Zafar
M. Ilyas Kamboh
Publication date
01-06-2016
Publisher
Springer India
Published in
International Journal of Diabetes in Developing Countries / Issue 2/2016
Print ISSN: 0973-3930
Electronic ISSN: 1998-3832
DOI
https://doi.org/10.1007/s13410-015-0380-6

Other articles of this Issue 2/2016

International Journal of Diabetes in Developing Countries 2/2016 Go to the issue