Khalid, Mohd Khairul Ashraf
(2018)
Vascular complications in type 2 diabetes mellitus patients and their association with hypertension and dyslipidemia.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: Type 2 diabetes mellitus (T2DM) is a common non communicable
disease among population of Marang district. T2DM is a chronic disease which may
progress to vascular complications. Hypertension and dyslipidemia are two common
co morbidities in T2DM.
Objective: This study aimed to study the occurence of vascular complications and
their asscoiated factors among T2DM patients in Marang from 2010 to 2016.
Methodology: This is a cross sectional design using secondary data of registered
T2DM patients from January 2010 to December 2016 in National Diabetic Registry
(NDR) database, Non Communicable Disease Unit, District Health Office Marang,
Terengganu. All registered T2DM cases with no missing data variable were included
For trend analysis, and 500 samples were randomly selected to describe the type of
vascular complication and determine the association between hypertension and
dyslipidemia with vascular complication.
Result: Six thousand four hundred and eighty seven T2DM cases had been
registered in NDR Marang from 2010 to 2016. The T2DM patient‘s age ranged from
23 to 93 years old. There were more female 362(72.4%) as compared to male
patients 138(27.6%). Majority of the T2DM patients were Malay 478(95.6%).
Majority of the patients were overweight group (BMI ≥25kg/m²) 185(37%). The
mean HbA1c of the T2DM patients was 8.6(2.29). Majority, 431(86.2%) of the
T2DM patients did not achieve good glycaemic control target of HbA1c less than
6.3% . Hypertension present in 340(68%) whereas 357(71.4%) has dyslipidaemia.
One hundred and eighteen(23%) had vascular complications,either nephropathy,
retinopathy, ischemic heart disease (IHD), cerebrovascular disease, diabetic foot
ulcer and amputations as single or multiple complications.
The most common vascular complications was nephropathy 59(11.8%) followed by
retinopathy 47(9.6%). The highest detection of nephropathy were 116 in 2010
which then fluctuate before reducing back in 2016. Retinopathy complication
remained high since the year 2010 to 2016. The highest case of retinopathy detected
were 91 case in 2015 and the lowest detected were 61 case in 2013. IHD reducing
from 2010 to 2013 but increase steadily again by 2014. Diabetic foot ulcer,
amputation and cerebro vascular disease remain at lower frequency through out 2010
to 2016. Presence of hypertension(AdjOR 1.750, 95%CI(1.062, 2.886) p-value
0.028) and dyslipidemia(AdjOR 1.858, 95%CI: 1.092, 3.160; p-value 0.022 ) was
found to be significantly associated with the presence of vascular complication
Conclusion: Vascular complications especially nephropathy and retinopathy still
pose a public health problem among T2DM patients in Marang. Presence of
hypertension and dylipidemia increase the risk of vascular complication.
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