Profile and analysis of diabetes chronic complications in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital, Jakarta

  • Tri J.E. Tarigan Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta
  • Em Yunir Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta
  • Imam Subekti Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta
  • Laurentius A. Pramono Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta
  • Diah Martina Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta
Keywords: diabetes chronic complications, diabetic neuropathy, macrovascular, microvascular, type 2 diabetes
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Abstract

Background: Chronic complications of diabetes mellitus have a significant role in increasing morbidity, mortality, disability, and health cost. In the outpatient setting, the availability of data regarding to the chronic complications of type 2 diabetes is useful for evaluation of prevention, education, and patientâs treatment. This study aimed to describe the characteristic of type 2 diabetes chronic complications in outpatient diabetes clinic.

Methods: A cross-sectional study was done using 155 patients in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital (RSCM), Jakarta in 2010. Secondary data were used from medical record based on history taking, physical examination, diabetic foot assessment, laboratory, neurologic, cardiology, opthalmology, ankle brachial index, and electrography of the patients. Characteristic profiles of the subjects, prevalence of the chronic complications, and its association with diabetes risk factors, such as glycemic control using HbA1c, fasting blood glucose, duration of diabetes, and LDL cholesterol were analyzed using chi square test.

Results: Among 155 subjects participated in the study, most of them were women (59%) and elderly (46%). The prevalence of diabetes chronic complications was 69% from all subjects. These chronic complications included microangiopathy, macroangiopathy and mixed complications, with prevalence of 56%, 7% and 27% respectively. Microangiopathy included nephropathy (2%), retinopathy (7%), neuropathy (38%) and mixed complications (53%). Macroangiopathy included coronary heart disease (46%), peripheral arterial disease (19%), stroke (18%), and mixed complication (17%). From the analysis, we found significant association between duration of diabetes and diabetic neuropathy (p = 0.003).

Conclusion: Prevalence of diabetes chronic complications in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital, mainly dominated by microvascular-related complications including nephropathy, retinopathy, neuropathy and mixed complications. There was statistical significance between diabetes duration and diabetic neuropathy.

References

  1. Olveira-Fuster G, Olvera-Márquez P, Carral-Sanlaureano F, González-Romero S, Aquilar-Diosdado M, Soriquer-Escofet F. Excess hospitalizations, hospital days, and inpatient costs among people with diabetes in Andalusia Spain. Diabetes Care. 2004;27(8):1904-9. http://dx.doi.org/10.2337/diacare.27.8.1904

  2. 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):1-9. http://dx.doi.org/10.1186/1477-7525-8-62

  3. Karki P, Bhandary S, Korean M, Braind K. Diabetes and its macrovascular and microvascular manifestations among Micronesian populations. J Nepal Med Assoc. 2003;42:337-40.

  4. Schoolwalk.diabetes.org [Internet]. American Diabetes Association [cited Nov 2010]. Available from: http://schoolwalk.diabetes.org/

  5. Badan Penelitian dan Pengembangan Kesehatan. Riset Kesehatan Dasar; Laporan Nasional 2007. Departemen Kesehatan Republik Indonesia, 2008; 156-60. Indonesian.

  6. Clarke PM, Glasziou P, Patel A, Chalmers J, Woodward M, Harrap SB, et al. Event rates, hospital utilization, and costs associated with major complications of diabetes: a multicountry comparative analysis. PLoS Med. 2010;7(2):e1000236. http://dx.doi.org/10.1371/journal.pmed.1000236

  7. Grover S, Avasthi A, Bhansali A, Chakrabarti S, Kulhara P. Cost of ambulatory care of diabetes mellitus: a study from north India. Postgrad Med J. 2005;81(956):391-5. http://dx.doi.org/10.1136/pgmj.2004.024299

  8. Donner TW. Tight control of hyperglycemia in type 2 diabetes mellitus. Insulin. 2006;1(4):166-72. http://dx.doi.org/10.1016/S1557-0843(06)80037-0

  9. Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB, et al. American Association of Clinical Endocrinologists and American Diabetes Association Consensus statement on inpatient glycemic control. Diabetes Care. 2009;32(6):1119-31. http://dx.doi.org/10.2337/dc09-9029

  10. Home P. Outpatient and inpatient diabetes care delivery. Diabetes Voice. 2006;51(suppl):5-8.

  11. Deepak PJ, Sunitha K, Nagaraj J, Sanjukta A, Bhattacharyya A. Inpatient management of diabetes: survey in a tertiary care centre. Postgrad Med J. 2003;79:585-7. http://dx.doi.org/10.1136/pmj.79.936.585

  12. Van Zyl DG, Rheeder P. Inpatient blood glucose management of diabetic patients in a large secondary hospital. S Afr Fam Pract. 2009;51(2):162-5. http://dx.doi.org/10.1080/20786204.2009.10873834

  13. Zatalia ST, Sanusi H. The role of antioxidants in the pathophysiology, complications, and management of diabetes mellitus. Acta Med Indones. 2013;45(2):141-7.

  14. Soewondo P. New Indonesian Society for Endocrinology (PERKENI) Guidelines for Prevention and Management of Type 2 Diabetes and Its Supporting Evidence. Proceeding Book Jakarta Diabetes Meeting; Jakarta: 2010.

  15. Cheng YJ, Gregg EW, Geiss LS, Imperatore G, Williams DE, Zhang X, et al. Association of A1C and fasting plasma glucose levels with diabetic retinopathy prevalence in the US Population: implications for diabetes diagnostic thresholds. Diabetes Care. 2009;32(11):2027-32. http://dx.doi.org/10.2337/dc09-0440

  16. Wadén J, Forsblom C, Thorn LM, Gordin D, Saraheimo M, Groop PH, et al. A1C variability predicts incident cardiovascular events, microalbuminuria, and overt diabetic nephropathy in patients with type 1 diabetes. Diabetes. 2009;58(11):2649-55. http://dx.doi.org/10.2337/db09-0693

  17. Mataradzija A, Resić H, Rasić S, Kukavica N, , Masnić F. Risk factors for development of cardiovascular complications in patients with chronic renal disease and diabetic nephropathy. Bosnian J Basic Med Sci. 2010;10(suppl):S44-50.

  18. Arsono S. Diabetes sebagai faktor risiko kejadian gagal ginjal terminal [thesis]. Semarang: Universitas Diponegoro; 2005. Indonesian.

  19. Unnikrishnan RI, Rema M, Pradeepa R, Deepa M, Shanthirani CS, Deepa R, et al. Prevalence and risk factors of diabetic nephropathy in an Urban South Indian Population: the Chennai Urban Rural Epidemiology Study (CURES 45). Diabetes Care 2007;30(8):2019-24. http://dx.doi.org/10.2337/dc06-2554

  20. Valensi P. Predicting and preventing cardiovascular risk in patients with diabetes. Eur Endocr Dis. 2007:66-7. DOI: 10.17925/USE.2007.00.1.66

  21. Purnamasari D. Diabetes as risk equivalent to CV disease: what does the guidelines tell us? Proceeding Book, Jakarta Diabetes Meeting, 2010. Indonesian.

  22. Hastuti RT. Faktor-faktor risiko ulkus diabetika pada penderita diabetes melitus [thesis]. Semarang: Universitas Diponegoro; 2008. Indonesian.

  23. Lindsey JB, House JA, Kennedy KF, Marso SP. Diabetes duration is associated with increased thin-cap fibroatheroma detected by intravascular ultrasound with virtual histology. Circ Cardiovasc Interv. 2009;2:543-8. http://dx.doi.org/10.1161/CIRCINTERVENTIONS.109.876672

  24. Kuswardhani RA, Suastika K. Age and homocystein were risk factor for peripheral arterial disease in elderly with type 2 diabetes mellitus. Acta Med Indones. 2010;42(2): 94-9.

  25. Fox CS, Sullivan L, D'Agostino RB Sr, Wilson PW, Framingham Heart Study. The significant effect of diabetes duration on coronary heart disease mortality: the Framingham Heart Study. Diabetes Care. 2004;27(3):704-8. http://dx.doi.org/10.2337/diacare.27.3.704

Published
2015-11-09
How to Cite
1.
Tarigan TJ, Yunir E, Subekti I, Pramono LA, Martina D. Profile and analysis of diabetes chronic complications in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital, Jakarta. Med J Indones [Internet]. 2015Nov.9 [cited 2024Apr.25];24(3):156-62. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/1249
Section
Clinical Research