COMPLICATION PROFILE OF NEWLY DETECTED DIABETES MELLITUS AND ITS RELATION TO METABOLIC SYNDROME Jagadesh M ,SURYA NARAYANA J, JAYAPRAKASH, NRRAU DEPARTMENT OF MEDICINE , KMC MANIPAL , MANIPAL UNIVERISTY INSERT LOGO HERE AIM RESULTS DISCUSSION To determine the commonly occurring complications among newly detected diabetics and morbidity at presentation. To determine the prevalence of obesity, family history and metabolic syndrome in type 2 diabetics at detection. To determine the correlation of metabolic syndrome to complication profile. COMPLICATION PROFILE MICROVASCULAR Nephropathy : 43 ( 28.7%) Microalbuminuria : 30 ( 20% ) Peripheral neuropathy : 32 ( 21.3%) Retinopathy : 14 ( 9.3%) MACROVASCULAR IHD : 16 ( 10.7%) Stroke : 8 ( 5.3%) PVD : 3 ( 2 %) DKA : 2 ( 1.3%) SKIN INFECTIONS,TB.UTI : 25 ( 16.7%). STUDY PARTICIPANTS (N=106) WITH METABOLIC SYNDROME HAD NO SIGNIFICANT CORRELATION TO ANY COMPLICATION PROFILE AT DIAGNOSIS THAN THOSE WITH PARTICIPANTS WITHOUT METABOLIC SYNDROME [ P > 0.1]. As compared with previous studies , higher incidence of microvascular complications were seen in all the studies , but incidence of nephropathy ( 29%) was higher as compared to other [ Gaurav et al – 18%] , [ Ranganayakulu et al – 14%] [ Subramanyam – 24 % ] A cross sectional study on 548 patients with DM revealed metabolic syndrome and the aggregation of its components were significantly associated with macro- and microvascular complications in Type 2 DM patients. In contrast this study revealed presence of metabolic syndrome had no significant correlation to complication profile at diagnosis , but this study was conducted on newly detected diabetes mellitus compared to other studies which were done patients already diagnosed to have diabetes mellitus. MATERIALS AND METHODS THE STUDY UNDERTAKEN WAS A CROSS – SECTIONAL STUDY INCLUSION CRITERIA Age > 35 years Diagnosed to have diabetes mellitus within the last 3 months and not on treatment. Proved to have Diabetes Mellitus as per ADA guidelines. EXCLUSION CRITERIA Secondary diabetes Type 1 Diabetes mellitus ALL PATIENTS UNDERWENT THE FOLLOWING BMI,waist circumference and waist hip ratio. Blood tests – FBS , PPBS , FLP , GLYHb , RFT , Urine protein i) if negative – microalbuminuria ii ) if positive - macroalbuminuria Ophthalmological evaluation : Fundoscopic examination Neuropathy : clinical examination. ECG , ECHO , Chest Xray TMT , Angiography , CT Brain , Doppler ( if indicated) SAMPLE SIZE:141 which was calculated using P(1-P)*Z2/D2 95%CONFIDENCE INTERVAL Correlation between metabolic syndrome and complication profile was done using odds ratio. Figur 5 CONCLUSIONS Figure 6 Significant proportion of patients had diabetes related microvascular and macrovascular complications on diagnosis. Microvascular complications were more common than macrovascular complications. Nephropathy was found to be common , a proportion of patients were in microalbuminuric phase , which is reversible if detected early. Waist Hip ratio is a better marker than BMI for identifying population at high risk. Presence of metabolic syndrome had no significant correlation to complication profile at diagnosis. Figure 7 REFERENCES ADA .Diagnosis and classification of diabetes mellitus .Diabetic care 2010 : 33 suppl 1 : 362. Obesity in Asia collaboration – Diabetes care , Vol 30 , numbers Dec 2007 Aggregation of features of the metabolic syndrome is associated with increased prevalence of chronic complications in Type 2 diabetes. Diabet med 2004 Mar;21(3):252-5. A B CONCLUSIONS TOTAL NUMBER OF SUBJECTS : 150 DEMOGRAPHY a) Males : 98 ( 65% ) Females : 52 ( 35% ) Mean Age : 50.2 yrs (males 49.4, females 51.9) CLINICAL PROFILE Family History :49 ( 32.7%) Classical symptoms : 46 ( 30.7%) Abnormal BMI :76( 50.6%) Abnormal Waist Hip ratio :120 ( 80%) Males :73(74.5%) Females :47(90.4%) Abnormal waist circumference :69( 46%) Males :32(32.7%) Females :37(71.2%) Metabolic syndrome :106( 70.6%) Males : 64(65.3%) Females : 42(80.8%) Mean Gly Hb : 9.2 TABLES WITH METABOLIC SYNDROME WITHOUT METABOLIC SYNDROME ODDS RATIO CONFIDENCE INTERVAL P VALUE Nephropathy 30 13 0.94 0.43 – 2.03 0.87 P.neuropathy 23 9 1.07 0.45 – 2.56 Retinopathy 11 3 1.58 0.41 – 5.97 0.49 IHD 12 4 1.27 0.38 – 4.19 0.68 Stroke 6 2 1.26 0.24 – 6.41 0.78 PVD 1 0.82 0.07 – 9.30