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Prevalence and risk factors of chronic complications of type 2 diabetic inpatients in Hubei Province of central China: results from a multiple-hospital study

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Abstract

The aims of this study are to investigate the prevalence of chronic complications in hospitalized patients with type 2 diabetes mellitus (T2DM) in Hubei Province of central China and identify its risk factors. The retrospective study was conducted in eight hospitals from four cities in Hubei Province from January 1, 2013 to December 31, 2014. All participants’ medical records were collected, and the demographic characteristics, clinical features, metabolic parameters, and the occurrence of chronic complications associated to T2DM were analyzed. The risk factors of T2DM-associated chronic complications were identified using multivariate logistic stepwise regression analysis. A total of 3469 subjects with T2DM were enrolled. Among the subjects included, 28.9 % developed diabetic retinopathy, 39.2 % developed diabetic nephropathy, 53.0 % developed diabetic neuropathy, 25.8 % developed coronary heart disease (CHD), 17.4 % developed cerebral vascular diseases (CVD), and 10.4 % developed vascular disease of the lower extremities. The prevalence of chronic complications varied significantly among the four cities (P < 0.01). Multivariate logistic regression analysis showed that systolic blood pressure >125 mmHg and diabetes duration >5 years were common risk factors for microvascular (nephropathy and retinopathy) and macrovascular (CHD and CVD) complications. Meanwhile, family history of diabetes was risk factor for retinopathy, HbA1c >7.0 % was risk factor for retinopathy and CHD, LDL-C level >3.12 mmol/L was risk factor for nephropathy and CHD, triglyceride level >1.7 mmol/L was risk factor for nephropathy and CVD, and age at admission >45 years was risk factor for CHD and CVD. Chronic complications are highly prevalent in inpatients with T2DM in Hubei Province of central China. Future efforts directed at blood glucose control and management of hypertension and lipid disorders are required to prevent and reduce the occurrence of chronic complications of T2DM.

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References

  1. 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;15:539–53.

    Article  CAS  PubMed  Google Scholar 

  2. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380:219–29.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Xu Y, Wang L, He J, Bi Y, Li M, Wang T, et al. Prevalence and control of diabetes in Chinese adults. JAMA. 2013;310:948–59.

    Article  CAS  PubMed  Google Scholar 

  4. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2012;33:S64–71.

    Article  Google Scholar 

  5. Pinhas-Hamiel O, Zeitler P. Acute and chronic complications of type 2 diabetes mellitus in children and adolescents. Lancet. 2007;369:1823–31.

    Article  PubMed  Google Scholar 

  6. Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiol Rev. 2013;93:137–88.

    Article  CAS  PubMed  Google Scholar 

  7. American Diabetes Association. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36:1033–46.

    Article  PubMed Central  Google Scholar 

  8. Bertoldi AD, Kanavos P, França GV, Carraro A, Tejada CA, Hallal PC, et al. Epidemiology, management, complications and costs associated with type 2 diabetes in Brazil: a comprehensive literature review. Glob Health. 2013;9:62.

    Article  Google Scholar 

  9. Wang W, Fu CW, Pan CY, Chen W, Zhan S, Luan R, et al. How do type 2 diabetes mellitus-related chronic complications impact direct medical cost in four major cities of urban China? Value Health. 2009;12:923–9.

    Article  PubMed  Google Scholar 

  10. Botas P, Delgado E, Castaño G, Díaz de Greñu C, Prieto J, Díaz-Cadórniga FJ. Comparison of the diagnostic criteria for diabetes mellitus, WHO-1985, ADA-1997 and WHO-1999 in the adult population of Asturias (Spain). Diabet Med. 2003;20:904–8.

    Article  CAS  PubMed  Google Scholar 

  11. Bartoli E, Fra GP, Carnevale Schianca GP. The oral glucose tolerance test (OGTT) revisited. Eur J Int Med. 2011;22:8–12.

    Article  CAS  Google Scholar 

  12. Selvin E, Steffes MW, Zhu H, Matsushita K, Wagenknecht L, Pankow J, et al. Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. N Engl J Med. 2010;362:800–11.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Chen L, Magliano DJ, Zimmet PZ. The worldwide epidemiology of type 2 diabetes mellitus—present and future perspectives. Nat Rev Endocrinol. 2011;8:228–36.

    Article  PubMed  Google Scholar 

  14. Li R, Lu W, Jiang QW, Li YY, Zhao GM, Shi L, et al. Increasing prevalence of type 2 diabetes in Chinese adults in Shanghai. Diabetes Care. 2012;35:1028–30.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Gao WG, Dong YH, Pang ZC, Nan HR, Zhang L, Wang SJ, et al. Increasing trend in the prevalence of type 2 diabetes and pre-diabetes in the Chinese rural and urban population in Qingdao, China. Diabet Med. 2009;26:1220–7.

    Article  CAS  PubMed  Google Scholar 

  16. Hu EA, Pan A, Malik V, Sun Q. White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ. 2012;344:e1454.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Gill JM, Cooper AR. Physical activity and prevention of type 2 diabetes mellitus. Sports Med. 2008;38:807–24.

    Article  PubMed  Google Scholar 

  18. Ng SW, Norton EC, Popkin BM. Why have physical activity levels declined among Chinese adults? Findings from the 1991–2006 China Health and Nutrition Surveys. Soc Sci Med. 2009;68:1305–14.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Popkin BM. Nutrition in transition: the changing global nutrition challenge. Asia Pac J Clin Nutr. 2001;10:S13–8.

    Article  PubMed  Google Scholar 

  20. Wang Y, Ji J, Liu YJ, Deng X, He QQ. Passive smoking and risk of type 2 diabetes: a meta-analysis of prospective cohort studies. PLoS One. 2013;8:e69915.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Kim KS, Kim SK, Sung KM, Cho YW, Park SW. Management of type 2 diabetes mellitus in older adults. Diabetes Metab J. 2012;36:336–44.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ginter E, Simko V. Type 2 diabetes mellitus, pandemic in 21st century. Adv Exp Med Biol. 2012;771:42–50.

    PubMed  Google Scholar 

  23. Stolar M. Glycemic control and complications in type 2 diabetes mellitus. Am J Med. 2010;123:S3–11.

    Article  CAS  PubMed  Google Scholar 

  24. Liu Z, Fu C, Wang W, Xu B. Prevalence of chronic complications of type 2 diabetes mellitus in outpatients—a cross-sectional hospital based survey in urban China. Health Qual Life Outcomes. 2010;8:62.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Lin Y, Xu Y, Chen G, Lai X, Huang B, Chen Z, et al. Diabetes and its chronic complications in the She ethnic minority group of China. Diabetes Technol Ther. 2012;14:430–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Lu B, Song X, Dong X, Yang Y, Zhang Z, Wen J, et al. High prevalence of chronic kidney disease in population-based patients diagnosed with type 2 diabetes in downtown Shanghai. J Diabetes Complicat. 2008;22:96–103.

    Article  PubMed  Google Scholar 

  27. Ramachandran A, Snehalatha C, Satyavani K, Latha E, Sasikala R, Vijay V. Prevalence of vascular complications and their risk factors in type 2 diabetes. J Assoc Physicians India. 1999;47:1152–6.

    CAS  PubMed  Google Scholar 

  28. Pradeepa R, Anjana RM, Unnikrishnan R, Ganesan A, Mohan V, Rema M. Risk factors for microvascular complications of diabetes among South Indian subjects with type 2 diabetes—the Chennai Urban Rural Epidemiology Study (CURES) eye study-5. Diabetes Technol Ther. 2010;12:755–61.

    Article  CAS  PubMed  Google Scholar 

  29. Spijkerman AM, Dekker JM, Nijpels G, Jager A, Kostense PJ, van Hinsbergh VW, et al. Impact of diabetes duration and cardiovascular risk factors on mortality in type 2 diabetes: the Hoorn Study. Eur J Clin Investig. 2002;32:924–30.

    Article  CAS  Google Scholar 

  30. Bi Y, Wang T, Xu M, Xu Y, Li M, Lu J, et al. Advanced research on risk factors of type 2 diabetes. Diabetes Metab Res Rev. 2012;28:32–9.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to sincerely thank the participation of the eight hospitals from Jingzhou, Wuhan, Yichang, and Xiangyang. Thanks also go to all subjects joining in this project.

Author contributions

Peng Yun conceived and designed the study; Hu Xiao, Ai-Ming Du, Hui-Fang Zhang, Yuan Tian, and Fang-Xi Xiao conducted the study. Peng Yun and Hu Xiao collected the data and performed analysis of data. Peng Yun and Ai-Ming Du prepared the first draft of the manuscript. All authors read and approved the final version of the manuscript.

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    Authors and Affiliations

    1. Department of Endocrinology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei Province, 434000, China

      Hu Xiao

    2. Department of Endocrinology, The Central Hospital of Jingzhou City, Jingzhou, Hubei Province, 434001, China

      Ai-Ming Du

    3. Department of Internal Medicine, School of Clinical Medicine, Yangtze University, Jingzhou, Hubei Province, 434023, China

      Peng Yun

    4. Department of Endocrinology, The First People’s Hospital of Yichang City, Yichang, Hubei Province, 443000, China

      Hui-Fang Zhang

    5. Department of Endocrinology, The Central Hospital of Xiangyang City, Xiangyang, Hubei Province, 441021, China

      Yuan Tian

    6. Department of Endocrinology, The First People’s Hospital of Wuhan City, Wuhan, Hubei Province, 430022, China

      Fang-Xi Xiao

    Authors
    1. Hu Xiao
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    Corresponding author

    Correspondence to Peng Yun.

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    Funding

    This study was funded by the Youth Science and Technology Talent Fund of Hubei Provincial Department of Health (grant number QJX2012-59).

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

    Informed consent

    Informed consent was obtained from all individual participants included in the study.

    Conflict of interest

    Author Hu Xiao declares that he has no conflict of interest.

    Author Ai-Ming Du declares that he has no conflict of interest.

    Author Peng Yun declares that he has no conflict of interest.

    Author Hui-Fang Zhang declares that she has no conflict of interest.

    Author Yuan Tian declares that he has no conflict of interest.

    Author Fang-Xi Xiao declares that she has no conflict of interest.

    Additional information

    Hu Xiao and Ai-Ming Du contributed equally to this work.

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    Cite this article

    Xiao, H., Du, AM., Yun, P. et al. Prevalence and risk factors of chronic complications of type 2 diabetic inpatients in Hubei Province of central China: results from a multiple-hospital study. Int J Diabetes Dev Ctries 36, 242–247 (2016). https://doi.org/10.1007/s13410-015-0452-7

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    • DOI: https://doi.org/10.1007/s13410-015-0452-7

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