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Study on Complications of Diabetes Mellitus in Egypt

This study examines various complications of diabetes mellitus in Egypt, including hyperglycemia, hypertension, hyperlipidemia, obesity, hypoglycemia, cardiac issues, retinopathy, neuropathy, and foot complications. It also explores the prevalence of these complications in relation to age, sex, BMI, and glycemic control.

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Study on Complications of Diabetes Mellitus in Egypt

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  1. PREVELANCE OF COMPLICATIONS OF DIABETES MELLITUS IN EGYPTProf Morsi ArabUniversity of Alexandria

  2. Age and Sex ( percent )

  3. Type of Diabetes

  4. BMI Increased BMI and Gender

  5. Comparative prevalences of overweight among diabetic patients at urban and rural Governorates:

  6. Fasting Hyperglycemia - Controlled (< 120 mg/dl ) = 19.8 % -Uncontrolled = 80.2 % • ------------------------------------- Hyperglycemic 121-150 mg/dl = 15.6 % Marked hyperglycemia -200 = 31.3 % Severe hyperglycemia -220 = 12.5 % Very severe hyperglycemia > 220 = 20.8 %

  7. Hyperglycemia Fasting 120 mg/dl

  8. Post Prandial Hyperglycemia - Controlled < 160 mg/dl = 13.5 % - Accepted 161-180 mg/dl = 7.9 % Total =21.4 % - Uncontrolled (>180 mg/dl ) = 78.6 % * Moderate -220 mg/dl = 17.4 % * Severe - 260 mg/dl = 16.0 % * Very Severe > 260 mg/dl = 45.2 %

  9. Hyperglycemia 180 mg/dl

  10. Uncontrolled ”Diastolic” Hypertension ( > 80 mmHg)

  11. Diastolic Blood Pressure 80 mm Hg

  12. Uncontrolled “Systolic” Hypertension (>130 mmHg)

  13. Systolic Blood Pressure 0.50% 130 mm Hg

  14. Hypercholsterolemia (>200 mg/dl)

  15. Lipid Control Serum Cholesterol 200 mg

  16. Hypertriglyceridemia (>150 mg/dl)

  17. Lipid ControlSerum Triglycerides 150 mg

  18. Obesity as a Risk Factor for Hyperglycemia , Hypertension and Hyperlipidemia

  19. Obesity

  20. Hypoglycemia- Occurrence of Hypoglycemic episodes in = 20.5%-------------------------------------------------------------------------- - The mean age of patients who developed hypoglycemic episodes at any time = 50.8 years - The mean age of patients who did not experience hypoglyceamic episodes = 52.1 years

  21. Diabetes KetoAcidosis (DKA)- Occurrence of DKA episodes in = 12.2 %.--------------------------------------------------------------------- The mean age in patients who developed DKA =42.5 years- The mean age in patients who never developed DKA =53.1 years

  22. Cardiac ComplicationsAngina : 15.0 %Signs of Cardiac Dysfunction: 21.3 % (C. H.V. and or arrhythmia )Positive ECG Changes : 7.9 %

  23. Cardiac Complications

  24. Serum Creatinine

  25. Retinopathy ( in 1173 patients ) - Free 68.9 % - Back ground 22.6 % - Proliferative 9.5 %

  26. Retinopathy in correlation with Duration of DM

  27. Ankle Reflex loss as early indicator of neuropathy n 1833 pts., AR was : - present in 44.5 % - absent in 55.5 %

  28. l

  29. Prevalence of foot complications 1- Fungus infection = 22.0 % 2- Foot ulcers = 6.8 % 3- Evident Ischaemic changes = 9.7 % 4- Amputations = 3.0 % 5- Deformities = 1.0 %

  30. Frequency of Foot Complications

  31. Fertility and Frequency of Abortions in Diabetic Females -The average number of normally born children / pt = 3.6 - The average number of aborted children / pt = 0.9 - The frequency of abortions among all pregnancies = 21.5%

  32. Fertility Abortions : 21.5%

  33. Conclusions : 1- The great majority of diabetic patients do not have adequate levels of glycaemic control , B.P. or serum lipids, according to accepted standards . 2- Obesity is widely prevalent , sometimes at its high degree (BMI >30) in all regional sectors of the population . 3- Obesity is a risk factor which correlates well with almost all metabolic aberrations .

  34. Conclusions : (cont. ) 4- Prevalences of hypoglycaemic episodes and DKA are matching with known global standards. 5- While E.C.G. screening may reveal the presence of CAD in 7.9% only of diabetics, suggestive symptoms (angina) may be present in twice this prevalence ( 15%) and actual clinical cardiac morbidity in three times (21.3%) of cases. 6- Prevalences of Neuropathy and Retinopathy are highly correlated with the duration of diabetes.

  35. Conclusions: ( cont.) 7- Serious foot complications are probably not as much prevalent as was anticipated . 8- Diabetic women are moderately fertile, about 1/4th of pregnancies however end into abortion.

  36. Alexandrie – Palais du Montazah Thank You

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