|    editor@medjpps.com

www.medjpps.com

Received date : 13-01-2022 Revised date : 12-02-2022 Accepted date : 04-03-2022 Published date : 31-03-2022

Mediterr J Pharm Pharm Sci 2 (1): 79-86, 2022

DOI: https://doi.org/10.5281/zenodo.6399891

Original Research


Presentation and character for adult patients with diabetes in Libya

Samia A. Elmiladi


Abstract :

Diabetes is a global issue, the diabetes epidemic is expected to continue, and the burden of diabetes causes catastrophic expenditure for the healthcare system. The current study aimed to determine the presentation, the clinical feature and cardiovascular risk factors in patients with diabetes. A retrospective observational study was conducted in the out-patients department at Almustaqpal Almosherq Centre from September 2013 to September 2020, the total number of attended out-patient department were 1 024, 820 patients who were selected for this study. A special performance was completed for every patient, which included details about the patient’s demographics, points in clinical history, relevant investigations and clinical examinations recorded. The study reported that out of 820 patients, 66.0% (n=538) was female and their age range was between 14-87 years with a mean age of 56.53±13.49 years, 96.0% (n=791) were clinically diagnosed as type II diabetes, 07.0% of the patients were diagnosed as pre-diabetes, the duration of diabetes ranged from newly diagnosed to more than 10 years, with 46.0% (n=379) of the studied population were more than 10 years diabetes duration, 70.0% (581) were presented with classical symptoms of diabetes. Initial treatment for diabetes was also different in the studied sample, were absent of anti-diabetic medications in 30.0% (n=248) of the patients, they refused to start glucose lowering drugs, 34.6% (n=284) of them have morbid obesity (body mass index is more than 40), 80.0% (n=662) have high HBA1c (more than 8.0 g%), 40.3% (n=240/596) were uncontrolled hypertension on anti-hypertension drugs, 95.6% (n=682/713) were controlled on treatment of lipid lowering drugs. This study showed the presentation of diabetes was common, type II diabetes, in the age group between 41-66 years about 65.0%, female sex, with high body mass index, high glycated hemglobulin and uncontrolled hypertension. There is concern that diabetic patients occur at a high frequency in younger adults, where a longer duration of illness could increase the risk of developing more complications in later life. The rate of coexisting cardiovascular risk factors (hypertension, dyslipid-aemia, and obesity) in Libyan patients with diabetes is highlighted.

References

1. Whiting DR, Guariguata L, Weil C, Shaw J (2011) IDF Diabetes Atlas: Global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Research and Clinical Practice. 94 (3): 311-321. doi: 10.1016/j.diabres. 2011.10.029
2. Al Rashed AM (2011) Pattern of presentation in type 1 diabetic patients at the diabetes center of a university hospital. Annals of Saudi Medicine. 31 (3): 243-249. doi: 0.4103/0256-4947.81529
3. Cahill GF, Mc Devill HO (1981) Insulin-dependent diabetes mellitus: The initial lesion. The New England Journal of Medicine. 304: 1454-1464. doi: 10.1056/NEJM198106113042403
4. Bloom A, Hayes TM, Gamble DR (1975) Register of newly diagnosed diabetic children. British Medical Journal. 3 (5983): 580-583. doi: 10.1136/bmj.3.5983.580
5. Colosia AD, Palencia R, Khan S (2013) Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: A systematic literature review. Diabetes, Metabolic Syndrome and Obesity. 6 (1): 327-338. doi: 10.2147/DMSO.S51325
6. Cassano PA, Segal MR, PS Vokonas, PS, Weiss ST (1990) Body fat distribution, blood pressure, and hypertension. A prospective cohort study of men in the normative aging study. Annals of Epidemiology. 1 (1): 33-48. doi: 10.1016/1047-2797(90)90017-m
7. Kotchen TA (2010) Obesity-related hypertension: epidemiology, pathophysiology, and clinical management. American Journal of Hypertension. 23 (11): 1170-1178. doi: 10.1038/ajh.2010.172
8. Savini I, Catani MV, Evangelista D, Gasperi V, Avigliano L (2013) Obesity-associated oxidative stress: strategies finalized to improve redox state. International Journal of Molecular Sciences. 14 (5): 10497-10538. doi: 10.3390/ijms140510497
9. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, Peters A, Tsapas A, Wender R, Mathews DR (2015) Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the study of diabetes. Diabetes Care. 38 (1): 140-149. doi: 10.2337/dc14-2441
10. Wong ND, Patao C, Wong K, Malik S, Franklin SS, Iloeje U (2013) Trends in control of cardiovascular risk factors among US adults with type 2 diabetes from 1999 to 2010: comparison by prevalent cardiovascular disease status. Diabetes and Vascular Disease Research. 10 (6): 505-513. doi: 10.1177/1479164113496828
11. Cahill GF, McDevill HO (1981) Insulin-dependent diabetes mellitus: The initial lesion. The New England Journal of Medicine. 304: 1454-1464. doi: 10.1056/NEJM198106113042403
12. Bloom A, Hayes TM, Gamble DR (1975) Register of newly diagnosed diabetic children. British Medical Journal. 3 (5983): 580-583. doi: 10.1136/bmj.3.5983.580
13. Rajesh V, Jeethu MM, Linu T, Mathew J (2018) Impact of demographic variables on blood pressure and glycemic control. Asian Journal of Pharmaceutical and Clinical Research. 11 (10): 179-181. doi: 10.22159/ ajpcr.2018.v11i10.25599
14. De P, Banu S, Muthukumar D (2018) Predictors of poor glycemic control in type 2 diabetic patients in South Indian population. International Journal of Research in Medical Sciences. 6 (2): 545-550. doi: 10.18203/2320-6012.ijrms20180295
15. Fiagbe J, B S, Opong J, Takramah W, Axame W, Owusu R, Parbey PA, Adjuik M, Tarkang E, Kweku M (2017) Prevalence of controlled and uncontrolled diabetes mellitus and associated factors of controlled diabetes among diabetic adults in the hohoe municipality of Ghana. Diabetes Management. 7 (5): 343-354. doi: Nil.
16. Handelsman Y, Bloomgarden ZT, Grunberger G (2015) American association of clinical endocrinologists and American college of endocrinology-clinical practice guidelines for developing a diabetes mellitus compre-hensive care plan-2015. Endocrine Practice. 21 (1S): 1-87. doi: 10.4158/EP15672
17. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, Peters AL, Tsapas A, Wender R, Mathews DR (2015) Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the study of diabetes. Diabetes Care. 38 (1): 140-149. doi: 10.2337/dc14-2441
18. Lozovey NR, Lamback EB, Mota RB, Caarls MB, Neto LV (2017) Glycemic control rate in type 2 diabetes mellitus patients at a public referral hospital in Rio de Janeiro, Brazil: demographic and clinical factors. Journal of Endocrinology and Metabolism. 7 (2): 61-67. doi: 10.14740/jem390w
19. Rajesh VM, Linu T, Mathew J (2018) Impact of demographic variables on blood pressure and glycemic control. Asian Journal of Pharmaceutical and Clinical Research. 11 (10): 179-181. doi: 10.22159/ajpcr.2018.v11i10. 25599
20. Adeniyi OV, Yogeswaran P, Mbenza B, Goon D, Ajayi IA (2016) Cross-sectional study of patients with type 2 diabetes in OR Tambo district, South Africa. British Medical Journal Open. 6 (7): e010875. doi: 10.1136/ bmjopen-2015-010875
21. Bayisa B, Bekele M (2017) Glycemic Control and associated factors among type II diabetic patients on chronic follow up at Southwest Ethiopia. Research and Reviews: Journal of Medical and Health Sciences. 6 (3): 13-20. doi: Nil.
22. Kahya NE, Harman E, Dolek D, Tutuncuoglu AP, Emren SV, levent F, Korkmaz G, Tuluce SY, Nazli C (2014) Rate of blood pressure control and antihypertensive treatment approaches in diabetic patients with hypertension. Turk Kardiyoloji Dernrgi Arsivi (Turkish Cardiology Association Archive). 42 (8): 733-740. doi: 10.5543/tkda. 2014.53384
23. Paul B, Sapra B, Maheshwari S, Goyal R (2000) Role of losartan therapy in the management of diabetic hypertension. The Journal of the Association Physicians in India. 48 (5): 514-518. PMID: 11273147.
24. Kotchen TA (2007) Hypertension control: trends, approaches, and goals. Hypertension. 49 (1): 19-20. doi: 10.1161/01.HYP.0000250394.05703.06
25. Abdissa D , Kene K (2020) Prevalence and determinants of hypertension among diabetic patients in Jimma University Medical Center, Southwest Ethiopia, 2019, Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 13: 2317-2325. doi: 10.2147/DMSO.S255695
26. Nouh F, Omar M, Younis M (2017) Prevalence of hypertension among diabetic patients in Benghazi: A study of associated factors. Asian Journal of Medicine and Health. 6 (4): 1-11. doi: 10.9734/AJMAH/2017/35830
27. Berraho M, Achhab YE (2012) Hypertension and type 2 diabetes: a cross-sectional study in Morocco (EPIDIAM Study) Mohamed. The Pan African Medical Journal. 11, 52. PMID: 22593788. PMCID: PMC3343680.
28. Alqudah BM, Mahmoud H, Alhusamia S, Sh A, Al L, Alawneh ZE (2017) Prevalence of hypertension among diabetic type 2 patients attending medical clinic at Prince Hashem bin Abdullah Hospital in Aqaba. Indian Journal of Medical Research and Pharmaceutical Science. 4: 47-54. doi: 10.5281/zenodo.815699
29. Mansour AA (2012) Prevalence and control of hypertension in Iraqi diabetic patients: a prospective cohort study. The Open Cardiovascular Medicine Journal. 6: 68-71. doi: 10.2174/1874192401206010068
30. Arshad AR (2014) Control of blood pressure in hypertensive patients with diabetes mellitus type 2. Pakistan Heart Journal. 47 (02): 78-83. doi: 10.13140/2.1.2283.5845
31. Tseng CH (2006) Higher risk of hypertension in indigenous type 2 diabetic patients in Taiwan. Journal of Hypertension. 24 (9): 1817-1821. doi: 10.1097/01.hjh.0000242406.76085.c4
32. Chuhwak EK, Puepet FH, Okeahialam BN, Ohwovoriole AE (2002) Hypertension and diabetes in Jos, Nigeria. Diabetes International. 12: 25-26. doi: Nil.
33. Giday A, Wolde M, Yihdego D (2010) Hypertension, obesity and central obesity in diabetics and non-diabetics in Southern Ethiopia. Ethiopian Journal of Health Development. 24 (2): 145-147. doi: 10.4314/ejhd.v24i2. 62964
34. Satman I, Yilmaz T (2002) Population-based study of diabetes and risk characteristics in Turkey. Diabetes Care. 25 (9): 1551-1556. doi: 10.2337/diacare.25.9.1551
35. Venugopal K, Mohammed MZ (2014) Prevalence of hypertension in type-2 diabetes mellitus. Journal of Health Research. 1 (4): 223-227. doi: 10.4103/2348-3334.142981
36. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, Karsidag K, Genc S, Telci A, Canbaz B, Turker F, Yilmaz T, Cakir B, Toumilehto J (2013) Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. European Journal of Epidemiology. 28 (2): 169-180. doi: 10.1007/s10654-013-9771-5
37. Chehade JM, Gladysz M, Mooradian AD (2013) Dyslipidemia in type 2 diabetes: prevalence, pathophysiology, and management. Drugs. 73 (4): 327-339. doi: 10.1007/s40265-013-0023-5
38. Kannel WB (1985) Lipids, diabetes, and coronary heart disease: insights from the Framingham study. American Heart Journal. 110 (5): 1100-1107. doi: 10.1016/0002-8703(85)90224-8
39. Pratipanawatr T, Rawdaree P, Chetthakul T, Bunnag P, Ngarmukos C, Benjasuratwong Y, Leelawatana R, Kosachunhanun N, Plengvidhya N, Deerochanawong C, Suwanwalaikorn S, Krittiyawong S, Mongkol-somlit, Komoltri C (2006) Thailand diabetes registry project: current status of dyslipidemia in Thai dabetic patients. Journal of Medical Association of Thailand. 89: S60-S65. PMID: 17715835.

Citation :

Elmiladi SA (2022) Presentation and character for adult patients with diabetes in Libya. Mediterr J Pharm Pharm Sci. 2 (1): 79-86. [Article number: 56]. https://doi.org/10.5281/zenodo.6399891

Share :