Title: Clinical Profile of Type 2 Diabetes Mellitus Patients with Diabetic Nephropathy in a Tertiary Care Centre - A Study From Rural Population of Uttar Pradesh
Authors: Vijay Kumar Verma, Ramakant Rawat, Manoj Kumar, Vidya Sagar, Vivek Kumar Verma, Hira Kant Singh, Himanshu Sharma, Sudhir Kumar Yadav
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.75
Abstract
Background: Diabetic nephropathy (DN) is one of the major causes of morbidity and mortality among patients with diabetes worldwide. Data on DN patients in India are scarce.
Objectives: The aim of this study was to determine the clinical profile of patients with DN and its associated factors in Rural India.
Materials and Methods: A cross-sectional observational study was conducted among 130 DN patients in OPD and admitted in Uttar Pradesh rural institute of medical sciences (UPRIMS&R) , Saifai , Etawah from Jan 2016 to July 2017. Patients of type 2 Diabetes as per WHO criteria who had nephropathy were included. A Detailed history was taken and clinical examination was done. Urine routine and microscopic examination and biochemical investigations were done. Patients were subjected to ultrasound of kidneys
Results: The mean age of the patients was 56.50 ± 14.2 years. The mean BMI was 25.9 ± 2.3 kg/m2 and mean systolic and diastolic BP were 136 ± 12.8 and 84 ± 10.5 mmHg, respectively. The mean HbA1c was 9.7 ± 2.9 and mean serum creatinine was 4.2 ± 2.1 mg/dl. Mean duration of diabetes was 9.5 ± 5.6 yrs. All patients were on an antidiabetic treatment plan and the therapeutic regimens were classified as insulin injection only (60%); oral hypoglycemic agent (OHA) only (32.3%); and diet and exercise therapy (7.7%). Almost all of the patients suffered co-morbidity, including retinopathy (83.07 %), cardiovascular disease (35.4 %), and neuropathy (86.15 %)
Conclusion: There is a high prevalence of nephropathy in ambulatory type 2 diabetes patients. Over 20% of type 2 diabetes patients with CKD are at a high or very high risk of adverse cardiovascular outcomes. Hypertension is an important modifiable risk factor for patients with CKD. Risk stratification of patients is important and should be part of routine care to facilitate interventions to mitigate adverse outcomes.
Keywords: Diabetes, Diabetic nephropathy, HbA1c, Rural India.
