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Category: Volume 4 Issue 04 April 2016
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Title: A Study to Determine the Profile of Type 2 Diabetes Mellitus in Patients Attending Bokaro General Hospital (Bokaro)

Authors: Dr Avnish Kumar Singh, Dr S.K Sinha, Dr Aviral Shah

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i4.56

Abstract

Aims and objective: Prime objective was to determine anthropometric, clinical, biochemical profile of type 2 diabetes mellitus in patients attending Bokaro General Hospital.

Method: A hospital based cross sectional study was conducted during March 2010 to June 2012. The study population comprised diabetic subjects attending endocrinology unit of Bokaro General Hospital. Total 126 patients were taken comprising of old and new cases.After taking and recording detailed history including present complains ,past history including duration of diabetes ,history and duration of hypertension, cardiovascular disease, dyslipidemia; personal history and complete anthropometric and physical examination was carried out.

Result : Out of 126 patients about 4 % were <40 years of age, maximum number of patient belonged to age group 41-60, 64% and only 32.6% patient were in elderly group. Mean age was found to be 56.67±8.38. Majority of females fell in the age group of 41 – 60 years (76.59%). Whereas age distribution was almost equal in men and women in 41-60.In both male and female age group only 2.53% ,6.38% were noted to be <40 years of age respectively. p value = < .001 ,Which is statistically significant. The difference between male and female was found to be highly significant (p<0.001) Around 28.58 % patient were non obese .In our study majority of patient were found to be obese (50%) and 21.42 %were observed to be overweight. Most of our patient were found to be obese (with BMI 25.22±3.73) according to the WHO guidelines and the consensus statement for diagnosis of Obesity, Abdominal obesity and the metabolic syndrome for Asian Indians. (Normal BMI: 18-22.9 kg/m2; Overweight: 22-24.9 kg/m2;Obesity: >25 kg/m2).Most of the patients were obese. Overweight patient constituted 26.65%male and 12.76% female. Almost equal number of diabetic males (27.58%)as well as females(29.78%) were having normal BMI. p value<0.04. The difference between male and female was found to be significant (p<0.04). Male patient having central obesity (55%) exceeded males with normal (45%) abdominal circumference. In females majority of them were having central obesity and only 6% females were having normal abdominal girth. Mean waist circumference among females was 92.03±9.85. In comparison more than 90% of female were found to be having central obesity, whereas about half (55%) of males revealed abdominal obesity .Good number of males (45%) were normal around the waist .only 6.38% female were having normal abdominal girth. p value <.001. The difference between male and female was found to be highly significant (p<0.001).

More than half (55%) of our population were having cholesterol within normal limit.

Around 60 % of diabetic patient revealed normal triglyceride level. Only 41 % diabetic showed raised triglyceride level. Out of 126 patients very few diabetics(15%) were having normal HDl. Majority were having low HDL. LDL was well within control in 86% of patients with 82 out of 126 patients LDL less than/equal to 100 mg/dl. About 69 % of total diabetic were suffering from hypertension. Significant percentage of females were found to be having dyslipidemia (91%), whereas about 79% of males were having abnormal lipid profile. The difference between male and female was found to be significant (p<0.03). In our study it was observed that approximately 70% of patients were having Metabolic syndrome and on comparing between male to female percent it was seen that female patient were predominantly suffering from metabolic syndrome. The difference between male and female was found to be highly significant (p<0.001) Out of 126 patients 15 patients were having hypothyroidismIn present study good glycemic control was achieved in 34.17% of males but only 21.27 % of females revealed good control .Equal number of male and females had glycated haemoglobin between 7-9% More than 51% of females and about 39 % of males showed HbA1C above 9%.p value 0.1. The difference between male and female was found to be not significant (p<0.1).

Out of 126 patients 45.56% males and 44.68% females were having diabetic neuropathy Approximately one third (27%) of males and twenty percent females had retinopathy. The difference between male and female was found to be not significant (p value 0.17).One fourth of males 26% and about one fifth of females had nephropathy. Kidney involvement was seen in only 23% of patients .The difference between male and female

was found to be not significant (p value 0.3).In present study out of 126 patients 17 % patient were suffering from coronary heart disease.

Conclusion

In our hospital study although conducted in small number of patients revealed:

1.      Most of the patients belonged to age group 40-60.

2.      Majority of diabetics were obese, having BMI more than 25 kg/m2

3.      Very few new patients were studied in our study presenting with polydipsia, polyuria as common presentation.

4.      Majority of our patients were having dyslipidemia, and it was seen that dyslipidemia was significantly preponderant in females.

5.      There was dominance of female having metabolic syndrome almost reaching 91% which is much above the findings depicted by other Indian studies, Probably because of limited number of females in our study.

6.      Our study revealed the level of glycemic control was near the target given by ADA in almost one third of patients, which can be attributed to comprehensive care imparted by endocrinology unit.

7.      Neuropathy, Retinopathy and Nephropatahy, were present in one fourth of the patient and it was seen to be significantly associated with duration of diabetes.

Further study with large number of patient is required to substantiate our study.

Significant Findings of the study

1.      Most of the patients belonged to age group 40-60.

2.      Majority of diabetics were obese, having BMI more than 25 kg/m2 .

3.      Very few new patients were studied in our study presenting with polydipsia, polyuria as common presentation.

4.      Majority of our patients were having dyslipidemia, and it was seen that dyslipidemia was significantly preponderant in females..

5.      There was dominance of female having metabolic syndrome almost reaching 91% which is much above the findings depicted by other Indian studies, Probably because of limited number of females in our study.

6.      Our study revealed the level of glycemic control was near the target given by ADA in almost one third of patients, which can be attributed to comprehensive care imparted by endocrinology unit.

7.      Neuropathy, Retinopathy and Nephropatahy, were present in one fourth of the patient and it was seen to be significantly associated with duration of diabetes.

Further study with large number of patient is required to substantiate our study.

Keywords: Profile of Type 2 DM , Metabolic syndrome, hypertension

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Corresponding Author

Dr Avnish Kumar Singh

DNB General Medicine

Bokaro General Hospital