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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2010

Open Access 01-12-2010 | Research

Prevalence of chronic complications of type 2 diabetes mellitus in outpatients - a cross-sectional hospital based survey in urban China

Authors: Zhaolan Liu, Chaowei Fu, Weibing Wang, Biao Xu

Published in: Health and Quality of Life Outcomes | Issue 1/2010

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Abstract

Background

Chronic complications are the major outcome of type 2 diabetes mellitus progress, which reduce the quality of life of patients, incur heavy burdens to the health care system, and increase diabetic mortality. The aims of this study were to describe the prevalence of chronic complications among urban Chinese type 2 diabetic outpatients; and to analyze the associations between chronic complications and patients' demographics, diabetic related clinical characteristics.

Methods

This cross-sectional hospital-based study was carried out in 4 major Chinese cities: - Shanghai, Chengdu, Beijing and Guangzhou. The survey was conducted from March to July in 2007 among 1,524 type 2 diabetic outpatients. The subjects were interviewed face-to-face by trained interviewers using a questionnaire to capture information on demographics, disease presentations and complications. All the subjects were invited to have a HbA1c test free of charge by the standardized method with Bio-Rad Variant II.

Results

Of the 1,524 study subjects, 637 (41.8%) were male, and the mean age was 63.3 ± 10.2 years. At least one chronic complication was diagnosed in 792 individuals (52.0%) of the study subjects; 509 (33.4%) presented with macrovascular complications and 528 (34.7%) with microvascular complications. The prevalence of cardiovascular and cerebrovascular conditions, neuropathy, nephropathy, ocular lesions and foot disease were 30.1%, 6.8%, 17.8%, 10.7%, 14.8% and 0.8%, respectively. The prevalence of chronic complications varied between cities, and significantly increased with age and duration of diagnosed diabetes. The mean of HbA1c in diabetic patients with chronic complications was 8.2% ± 1.6% and 63.0% of the subjects with type 2 diabetes related complications had a poor glycemic control with the HbA1c > 7.5%.

Conclusions

Chronic complications are highly prevalent among type 2 diabetic outpatients, the glycemic control of diabetic patients with chronic complications was poor, and future efforts should be directed at intensive blood glucose control, strengthening early diagnosis and improving case management to prevent and minimize the occurrence of complications.
Appendix
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Literature
1.
International Diabetes Federation: Diabetes Atlas. 2nd edition. Brussels: Gan D, Ed. Belgium; 2003.
2.
Thomas JS: Disability in Diabetes[A]. National Diabetes Data Group. Diabetes in America[M]. Bethesda 2nd edition. 1995. NIH Publication NO.9521468
3.
Roglic G, Unwin N, Bennett PH, Mathers C, Tuomilehto J, Nag S, Connolly V, King H: The burden of mortality attributable to diabetes: realistic estimates for the year 2000. Diabetes Care 2005,28(9):2130–2135. 10.2337/diacare.28.9.2130PubMedCrossRef
4.
Shaw JE, Sicree RA, Zimmet PZ: Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010,87(1):4–14. 10.1016/j.diabres.2009.10.007PubMedCrossRef
5.
King H, Aubert RE, Herman WH: Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care 1998,21(9):1414–1431. 10.2337/diacare.21.9.1414PubMedCrossRef
6.
Yang W, Lu J, Weng J, Jia W, Ji L, Xiao J, Shan Z, Liu J, Tian H, Ji Q, Zhu D, Ge J, Lin L, Chen L, Guo X, Zhao Z, Li Q, Zhou Z, Shan G, He J, China National Diabetes and Metabolic Disorders Study Group: Prevalence of diabetes among men and women in China. N Engl J Med 2010,362(12):1090–1101. 10.1056/NEJMoa0908292PubMedCrossRef
7.
Lee ET, Keen H, Bennett PH, Fuller JH, Lu M: Follow-up of the WHO Multinational Study of Vascular Disease in Diabetes: general description and morbidity. Diabetologia 2001,44(Suppl 2(2)):S3–13. 10.1007/PL00002936PubMedCrossRef
8.
LeRoith D, Fonseca V, Vinik A: Metabolic memory in diabetes--focus on insulin. Diabetes Metab Res Rev 2005,21(2):85–90. 10.1002/dmrr.530PubMedCrossRef
9.
Turner RC, Holman RR: Lessons from UK prospective diabetes study. Diabetes Res Clin Pract 1995,28(Suppl(7)):S151–157. 10.1016/0168-8227(95)01105-MPubMedCrossRef
10.
Wang W, Fu CW, Pan CY, Chen W, Zhan S, Luan R, Tan A, Liu Z, Xu B: How do type 2 diabetes mellitus-related chronic complications impact direct medical cost in four major cities of urban China? Value Health 2009,12(6):923–929. 10.1111/j.1524-4733.2009.00561.xPubMedCrossRef
11.
Liu ZL, Fu CW, Luan RS, Zhan SY, Chen WQ, Wang WB, Xu B: The impact of complication on quality of life among diabetic patients in urban China. Chin J Epidemiol 2008,29(10):1029–1033.
12.
Solli O, Stavem K, Sonbo Kristiansen I: Health-related quality of life in diabetes: The associations of complications with EQ-5D scores. Health and Quality of Life Outcomes 2010,8(1):18. 10.1186/1477-7525-8-18PubMedCentralPubMedCrossRef
13.
Linda SG, William HH, Smith PJ: Mortality in Non-Insulin-Dependent Diabetes[A]. National Diabetes Data Group. Diabetes in America. Bethesda 2nd edition. 1995. NIH Publication NO.9521468
14.
Stefansson E, Bek T, Porta M, Larsen N, Kristinsson J, Agardh E: Screening and prevention of diabetic blindness. Acta Ophthalmol Scand 2000,78(4):374–385. 10.1034/j.1600-0420.2000.078004374.xPubMedCrossRef
15.
Reiber GE, Boyko EJ, Smith DG: Lower extremity foot ulcers and amputations in diabetes[A]. National Diabetes Data Group. Diabetes in America. Bethesda 2nd edition. 1995. NIH Publication NO.9521468
16.
17.
Alberti KG, Zimmet PZ: Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998,15(7):539–553. Publisher Full Text 10.1002/(SICI)1096-9136(199807)15:7%3C539::AID-DIA668%3C3.0.CO;2-SPubMedCrossRef
18.
The Asian-Pacific Type 2 Diabetes Policy Group: Type 2 Diabetes Practical Targets and Treatments. 3rd edition. Sydney: Health Communications Australia Pty Ltd and In Vivo Communications Pty Ltd; 2002.
19.
National Diabetes Prevention and Control Cooperative Group: Chinese guidelines for type 2 diabetes. Beijing: Beijing Science and Technology Press; 2007.
20.
Ribu L, Hanestad BR, Moum T, Birkeland K, Rustoen T: A comparison of the health-related quality of life in patients with diabetic foot ulcers, with a diabetes group and a nondiabetes group from the general population. Qual Life Res 2007,16(2):179–189. 10.1007/s11136-006-0031-yPubMedCrossRef
21.
Economic costs of diabetes in the U.S. In 2007 Diabetes Care 2008,31(3):596–615. 10.2337/dc08-9017
22.
Zou XM, Lu JM, Pan CY: The prevalence and clinical risk factors of microangopathy in type 2 diabetes mellitus. Acad J PLA Postgrad Med Sch 2000,21(3):211–214.
23.
Pan C, Lu J, Tian H, Yao C, Jiang C, Deng X, Liu Y, He S, Yin L, Kong X, et al.: Prevalence of vascular complications in newly diagnosed type 2 diabetic patients. Chin J Endocrinol Metab 1997,13(4):201–205.
24.
Chen Y, Teng X, Lu S, Liu W: Survey on prevalence of complication in type 2 diabetic outpatients and its related factors. Shandong Med J 2007,47(17):137–138.
25.
Liu Y, Lu J, Pan C, Tian H, Lu X, Kong X, Yao C, Deng X, Wang Z, Wang S: Prevalence of microalbuminuria in newly diagnosed non-insulin dependent diabetic subjects and its related factors. Med J Chin PLA 1996,21(9):270–272.
26.
Tang L, Chen X, Chen H, Zhao L, Hu S: The financing burden of treatment of diabetesII and Its symptom in urban China. Chinese Health Economics 2003,22(12):21–23.
27.
Prevalence of small vessel and large vessel disease in diabetic patients from 14 centres. The World Health Organisation Multinational Study of Vascular Disease in Diabetics. Diabetes Drafting Group Diabetologia 1985,28(Suppl):615–640.
28.
Phillips P, Wilson D, Beilby J, Taylor A, Rosenfeld E, Hill W, Parsons J: Diabetes complications and risk factors in an Australian population. How well are they managed? Int J Epidemiol 1998,27(5):853–859. 10.1093/ije/27.5.853PubMedCrossRef
29.
Zhang B, Xiang HD, Mao WB, Guo XH, Wang JC, Jia WP, Yu M, Li QF, Fu ZY, Cao WH, Qian RL: Epidemiological survey of chronic vascular complications of type 2 diabetic in-patients in four municipalities. Acta Academiae Medicinae Sinicae 2002,24(5):452–456.PubMed
30.
Morgan CL, Currie CJ, Stott NC, Smithers M, Butler CC, Peters JR: The prevalence of multiple diabetes-related complications. Diabet Med 2000,17(2):146–151. 10.1046/j.1464-5491.2000.00222.xPubMedCrossRef
31.
Shi W, LI X, LI J: The morbidity of chronic diabetic complication with logistic analysis of related potential factor. Chin J Epidemiol 2004,25(1):60–64.
32.
Bruce SG, Young TK: Prevalence and Risk Factors for Neuropathy in a Canadian First Nation Community. Diabetes Care 2008, 28: 28.
33.
Gregg EW, Gu Q, Williams D, de Rekeneire N, Cheng YJ, Geiss L, Engelgau M: Prevalence of lower extremity diseases associated with normal glucose levels, impaired fasting glucose, and diabetes among U.S. adults aged 40 or older. Diabetes Res Clin Pract 2007,77(3):485–488. 10.1016/j.diabres.2007.01.005PubMedCrossRef
34.
Wandell PE, Gafvels C: Patients with type 2 diabetes aged 35–64 years at four primary health care centres in Stockholm County, Sweden. Prevalence and complications in relation to gender and socio-economic status. Diabetes Res Clin Pract 2004,63(3):195–203. 10.1016/j.diabres.2003.08.011PubMedCrossRef
35.
McNeely MJ, Boyko EJ: Diabetes-related comorbidities in Asian Americans: results of a national health survey. J Diabetes Complications 2005,19(2):101–106. 10.1016/j.jdiacomp.2004.08.003PubMedCrossRef
36.
Romon I, Fosse S, Eschwege E, Simon D, Weill A, Varroud-Vial M, Detournay B, Fagot-Campagna A: Prevalence of macrovascular complications and cardiovascular risk factors in people treated for diabetes and living in France: the ENTRED study 2001. Diabetes Metab 2008,34(2):140–147. 10.1016/j.diabet.2007.11.002PubMedCrossRef
37.
Zhou J: The North-South Differences in China. Teaching Reference of Middle School Geography 2003,9(Z2):21–22.
38.
Candrilli SD, Davis KL, Kan HJ, Lucero MA, Rousculp MD: Prevalence and the associated burden of illness of symptoms of diabetic peripheral neuropathy and diabetic retinopathy. J Diabetes Complications 2007,21(5):306–314. 10.1016/j.jdiacomp.2006.08.002PubMedCrossRef
39.
Chen SJ, Liu JH, Shih HC, Chou P, Tsai CY, Tung TH: Prevalence and associated factors of lens opacities among Chinese type 2 diabetics in Kinmen, Taiwan. Acta Diabetologica 2008,45(1):7–13. 10.1007/s00592-007-0012-9PubMedCrossRef
40.
Cyganek K, Mirkiewicz-Sieradzka B, Malecki MT, Wolkow P, Skupien J, Bobrek J, Czogala M, Klupa T, Sieradzki J: Clinical risk factors and the role of VDR gene polymorphisms in diabetic retinopathy in Polish type 2 diabetes patients. Acta Diabetol 2006,43(4):114–119. 10.1007/s00592-006-0225-3PubMedCrossRef
41.
Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR: Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000,321(7258):405–412. 10.1136/bmj.321.7258.405PubMedCentralPubMedCrossRef
Metadata
Title
Prevalence of chronic complications of type 2 diabetes mellitus in outpatients - a cross-sectional hospital based survey in urban China
Authors
Zhaolan Liu
Chaowei Fu
Weibing Wang
Biao Xu
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2010
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-8-62

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