Micro and macrovascular complications of diabetes mellitus in Cameroon: risk factors and effect of diabetic check-up - a monocentric observational study

Abstract

Introduction: The objective of this study was to evaluate the prevalence of vascular complications among diabetes patients (DP), to find out the relationship with risk factors and to assess the effect of diabetic check-up (DC) in the onset of these complications.

Methods: Clinical and laboratory data of DP followed between 2000 and 2009 were retrospectively analyzed. Those with at least one DC were selected (140 out of 538). Risk factors were checked and listed. Prospectively, an electrocardiogram (ECG) was recorded for 121 of them.

Results: The sample was constituted of 78 (56%) men and 62 (44%) females; mean age was 55 ± 12 years. Type 2 Diabetes accounted for 94.3%. Microangiopathy distribution was: retinopathy = 23.6%, nephropathy = 25% and neuropathy = 40%. Within macroangiopathy prevalence was: 5% for stroke, 17.1% for limbs ischemic disease and 23.6% for coronary heart disease. Occurrence of complications was associated with hypertension, duration of diabetes, dyslipidemia, microalbuminuria, 24-hour proteinuria, body mass index and HbA1c. Diabetic neuropathy was neither associated to HbA1c nor microalbuminuria. HbA1c was conversely but not significantly associated with the number of DC realized.

Conclusion: Vascular complications are considerably present in diabetes patients in the studied center, especially among those practicing less glycemic controls. Normalizing the level of HbA1c, controlling risk factors, and realizing DC may prevent the onset of vascular complications in DP.

Key words: Diabetes mellitus, Microangiopathy, Macroangiopathy, HbA1c, Diabetic check-up, Cameroon