Those able to survive more than 40 years are likely to have better glycemic, BP, lipid control
Those able to survive with type 2 diabetes (T2DM) for more than 40 years are more likely to have better glycemic control, lower blood pressure, and more favorable lipid profiles, according to a study published online April 5 in Diabetes Care.
Viswanathan Mohan, M.D., Ph.D., from the Madras Diabetes Research Foundation in India, and colleagues retrospectively identified T2DM survivors (>40 years duration) from more than 200,000 case records.
Survivors were matched to non-survivors based on age at diagnosis and sex. Retinal photography was used to diagnose retinopathy. Ankle-brachial index 20 V were used to assess peripheral vascular disease and neuropathy.
The researchers found that mean duration of diabetes of survivors (n = 238) was 43.7 years and that of the non-survivors (n = 307), at time of death, was 22.4 years (P < 0.001).
There was significantly higher systolic and diastolic blood pressures, plasma glucose, HbA1c, serum cholesterol, LDL cholesterol, triglycerides, and lower HDL cholesterol in non-survivors compared with long-term survivors.
The most common causes of death were myocardial infarction (46.4 percent) and renal failure (16.6 percent). Survivors had a higher prevalence of most complications because of longer duration and older age, including: retinopathy, 76 percent in survivors versus 62 percent in non-survivors; microalbuminuria, 39.1 percent versus 27.3 percent; macroalbuminuria, 8.4 percent versus 23.7 percent; neuropathy, 86.5 percent versus 63.5 percent; peripheral vascular disease, 23.1 percent versus 11.4 percent; and coronary artery disease, 44.5 percent versus 40.7 percent.
”Long-term survivors with T2DM had better glycemic and blood pressure control and more favorable lipid profiles,” the authors write.
From www.HealthDayNews.com
Abstract
Clinical Profile of Long-Term Survivors and Nonsurvivors With Type 2 Diabetes
Viswanathan Mohan, MD, FRCP, PHD, DSc⇑,
Coimbatore Subramanian Shanthi Rani, PHD,
Amutha Anandakumar, MSC, RD,
Sravan Dhulipala, BS,
Ranjit Mohan Anjana, MD, DIPDIAB (UK),
Balasubramanian Parathasarathy, MD and
Ranjit Unnikrishnan, MD, DIPDIAB (UK)
Madras Diabetes Research Foundation, Madras, India
Dr. Mohan’s Diabetes Specialities Centre, Gopalapuram, Chennai, India
World Health Organization Collaborating Centre for Noncommunicable Diseases Prevention and Control, IDF Centre for Education, Chennai, India
Abstract
OBJECTIVE To compare clinical profile of long-term survivors and nonsurvivors with type 2 diabetes (T2DM).
RESEARCH DESIGN AND METHODS After conducting a retrospective survey of >200,000 case records, we identified T2DM survivors (>40 years of duration) and age at diagnosis and sex-matched T2DM nonsurvivors. Prevalence of complications and causes of death were analyzed. Retinopathy was diagnosed by retinal photography. Microalbuminuria and macroalbuminuria, peripheral vascular disease based on ankle-brachial index 20 V, were compared in both groups.
RESULTS The mean duration of diabetes of survivors (n = 238) was 43.7 ± 3.9 years and that of the nonsurvivors (n = 307), at time of death, was 22.4 ± 11.0 years (P < 0.001). Nonsurvivors had significantly higher systolic and diastolic blood pressures, plasma glucose, HbA1c, serum cholesterol, LDL cholesterol, triglycerides, and lower HDL cholesterol compared with long-term survivors (P < 0.001 for all parameters except systolic blood pressure, which was P = 0.027). Myocardial infarction (46.4%) and renal failure (16.6%) were the most common causes of death. Prevalence of most complications were higher among survivors because of longer duration and older age, as follows, for survivors versus nonsurvivors: retinopathy, 76 vs. 62%; microalbuminuria, 39.1 vs. 27.3%; macroalbuminuria, 8.4 vs. 23.7%; neuropathy, 86.5 vs. 63.5%; peripheral vascular disease, 23.1 vs. 11.4%; and coronary artery disease, 44.5 vs. 40.7%.
CONCLUSIONS Long-term survivors with T2DM had better glycemic and blood pressure control and more favorable lipid profiles.
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