Clinical Profile of Long-Term Survivors and Nonsurvivors With Type 2 Diabetes

  1. Ranjit Unnikrishnan, MD, DIPDIAB (UK)
  1. Madras Diabetes Research Foundation, Madras, India
  2. Dr. Mohan’s Diabetes Specialities Centre, Gopalapuram, Chennai, India
  3. World Health Organization Collaborating Centre for Noncommunicable Diseases Prevention and Control, IDF Centre for Education, Chennai, India
  1. Corresponding author: Viswanathan Mohan, drmohans{at}diabetes.ind.in

Abstract

OBJECTIVE To compare clinical profile of long-term survivors and nonsurvivors with type 2 diabetes (T2DM).

RESEARCH DESIGN AND METHODS After conducting a retrospective survey of >200,000 case records, we identified T2DM survivors (>40 years of duration) and age at diagnosis and sex-matched T2DM nonsurvivors. Prevalence of complications and causes of death were analyzed. Retinopathy was diagnosed by retinal photography. Microalbuminuria and macroalbuminuria, peripheral vascular disease based on ankle-brachial index <0.9, coronary artery disease, based on history of myocardial infarction or coronary revascularization, and neuropathy, based on vibration perception threshold >20 V, were compared in both groups.

RESULTS The mean duration of diabetes of survivors (n = 238) was 43.7 ± 3.9 years and that of the nonsurvivors (n = 307), at time of death, was 22.4 ± 11.0 years (P < 0.001). Nonsurvivors had significantly higher systolic and diastolic blood pressures, plasma glucose, HbA1c, serum cholesterol, LDL cholesterol, triglycerides, and lower HDL cholesterol compared with long-term survivors (P < 0.001 for all parameters except systolic blood pressure, which was P = 0.027). Myocardial infarction (46.4%) and renal failure (16.6%) were the most common causes of death. Prevalence of most complications were higher among survivors because of longer duration and older age, as follows, for survivors versus nonsurvivors: retinopathy, 76 vs. 62%; microalbuminuria, 39.1 vs. 27.3%; macroalbuminuria, 8.4 vs. 23.7%; neuropathy, 86.5 vs. 63.5%; peripheral vascular disease, 23.1 vs. 11.4%; and coronary artery disease, 44.5 vs. 40.7%.

CONCLUSIONS Long-term survivors with T2DM had better glycemic and blood pressure control and more favorable lipid profiles.

  • Received June 21, 2012.
  • Accepted January 15, 2013.

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This Article

  1. Diabetes Care
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