Correlation of Incidence of Microvascular and Macrovascular Complications in Indian Diabetic Versus Nondiabetic Females
Authors: Garg Sudanshu , Garre Indrani , Anne Beatrice , Raju Y. Sathyanarayana 
Published: December 2019

Background There are 425 million people afflicted with diabetes in the World (IDF 2018). The most common cause of death among people with type 2 Diabetes Mellitus (DM) is cardiovascular nature. The relative risks for ischemic heart disease (IHD) and cerebrovascular disease (CVD) are 2- to 4-fold and 2- to 3-fold higher, respectively, than the risk in nondiabetic subjects. Since there is less data correlating the incidence of microvascular and macrovascular complications in Indian females with type 2 DM, this study has been conducted.

Aim To evaluate the occurrence of symptomatic cardiac disease among female patients with and without type 2 DM.

Material & Methods The study was conducted from the outpatient department (OPD) of a tertiary care hospital in Hyderabad. Female patients with and without type 2 DM patients were selected for the study after taking informed consent. The study was approved by the Institutional Ethics Committee (IEC) and was conducted in the endocrinology department and general medicine department to eliminate the bias of cardiovascular symptoms. Patients were subjected to a clinical questionnaire and relevant clinical investigations were conducted. The results of the study were systematically selected and statistically analyzed.

The study included female patients with and without type 2 DM of age more than 18 years and excluded male patients, n, and female patients with diabetes of less than 18 years.

Results This was a case-control observational study and a total of 200 study subjects were enrolled from the patients who visited the OPD from 1st January 2018 to 31st June 2018. The total population was divided into two groups, that is, case (DM) group and control (non-DM) group with 100 subjects, respectively, in each group. The cases were selected from the patients attending the endocrinology OPD and the controls belonged to the general medicine department in our institute. The average age in the case group (DM) was 55.65 ± 10.07 years, and the control (non-DM) group was 50.21 ± 13.7 years. The average duration of diabetes was 9.1 years; hypertension (HTN) was 6.83 years in the case group (DM) versus 3.5 years among the control (non-DM) group. Among all cases, 64% were found to be symptomatic for cardiovascular diseases.

Nephropathy was seen in 18 diabetic cases versus 2 in nondiabetic cases and it was statistically significant (p = 0.000). Neuropathy was seen in 47% cases versus 18% in control group with statistical significance (p = 0.000). Retinopathy was seen in 6 diabetic cases versus 1 in nondiabetic cases with statistical significance (p = 0.052).

For cardiac symptoms (i.e., chest pain, dyspnea, and diaphoresis), statistical significance was not achieved between the cases and controls.

Conclusion The incidence of symptomatic cardiac disease was much more frequent than other microvascular complications of diabetes.

Hence, screening for the cardiac disease should be conducted at the time of detection of diabetes rather than on follow-up.