Research Article Open Access
Abougalambou et al. J DiabeteMeta 2011, 2:1
DOI: 10.4172/2155-6156.1000115
Volume 2 • Issue 1 • 1000115
J Diabete Metab
ISSN:2155-6156 JDM, an open access journal
Introduction
Diabetes mellitus is associated with an increased risk for a number
of serious and sometimes life-threatening macro-and microvascular
complications. Macrovascular disease, that includes coronary heart
disease (CHD), cerebrovascular disease, and peripheral vascular
disease, is the leading cause of mortality in people with diabetes.
Diabetes mellitus patients carry an increased risk two to four times
greater for heart attack, stroke and other complications related to poor
circulation [1] and depend on ADA [2] the majority of deaths are due
to CHD. In another study by Vijan et al. [3] said that up to 80% of Type
2 diabetic patients will develop or die of macrovascular disease.
Microvascular complications include efects on small vessels,
including arterioles, capillaries and venules. Te development of
these complications starts early in the pathogenesis of Type 2 DM and
accounts for morbidity in the form of retinopathy, neuropathy and
nephropathy
In Malaysia, there is a growing public concern due to the escalation
with number of people with diabetes while complication rates and
associated diseases amongst diabetics are high. In addition high
prevalence of complications such as blindness, end stage renal disease,
lower extremity amputations as well as premature cardiovascular
disease, stroke and premature mortality related to poor control of blood
glucose [4].
Te present study was to determine prevalence and focused on
presence risk factor afecting on diabetic vascular complications among
type 2 diabetic outpatients in tertiary center.
Material and Methods
A prospective study was conducted for study period of one year (1
st
Jan 2008 till 31
st
Dec 2008) in order to determine the prevalence diabetic
vascular complications and risk factors afect on these complications
among type 2 diabetes mellitus in outpatient diabetic care at teaching
hospital USM which is located in the state of Kelantan, Malaysia.
Te research‘s protocol was approved by the Human Research and
Ethics Committee of the School of Medicine in the Universiti Sains
Malaysia. Signed informed consent was obtained from all patients
All patients with type 2 diabetes mellitus, age range 18 to 88years,
were screened for diabetic vascular complications.
Te information obtained from the interview included the patient’s
identifcation data such as age, sex, and race, alcohol, smoking history,
physical activity and level of education. Tey were classifed smoking
history to (never, previous, current), the level of education was
classifed by the level of completion of their formal education either
less than secondary school, secondary and more than secondary
school and physical activity was classifed into active (if the duration of
physical activity was equal or more than150min/week), and non active
(if physical activity duration was less than 150 min/week). Glycaemic
control based on measurement (poor glycaemic control if HbA1c >7%),
and blood pressure (BP hypertension if systolic BP> 130 mm Hg or
diastolic BP> 80 mm Hg.
Diagnosis of retinopathy is based on fnding the diagnostic signs of
retinopathy on eye exams by fundoscopy.
Patients were considered to have neuropathy if symptoms of pain
anesthesia, paresthesia, muscular weakness, loss of tendon refexes, and
impaired vibration sense.
Patients were considered to have nephropathy if they have
microalbuminuria or proteinuria.
Coronary artery disease was diagnosed by documented angina
symptoms and confrmed by performed an ECG, or from results of
percutaneous transcoronary angiography (PTCA) in patients record.
Cerebrovascular disease was defned by present of transient
ischemic attack or stroke in past medical history.
Ethical approval of study
Ethical approval was obtained for this research study from research
and ethics committee, USM in January 2008.
Result
A total of 1077 Type 2 diabetic patients were involved in this study.
About 476 were males and 601 were females, the mean (± SD) duration
of Type 2 DM is 11 (± 6.81) years, ranging from less than one year to
forty years. Te majority of patients 794 (73.7%) did not achieve target
of HbA1c levels ≤ 7.0%. Positive family history of DM was 141 patients
while a total of 936 patients had no known family history of diabetes.
Type of vascular complications among type 2 dm patients
Most of the patients, 841 (78%) had microvascular complications
alone and 188 (17.5%) had combination of microvascular and
macrovascular complications (Figure 1).
Macrovascular complications
In this study most of the diabetic patients 1014 (82.6%) had
*Corresponding author: Salwa Selim Ibrahim Abougalambou, Discipline of
Clinical Pharmacy, School of Pharmaceutical Sciences,Universiti Sains , Malaysia
(USM), E-mail: salwasl2005@yahoo.com
Received January 19, 2011; Accepted January 26, 2011; Published January 27,
2011
Citation: Abougalambou SSI, Hassali MA, Sulaiman SAS, Abougalambou
AS (2011) Prevalence of Vascular Complications among Type 2 Diabetes
Mellitus Outpatients at Teaching Hospital in Malaysia. J Diabetes Metab
2:115. doi:10.4172/2155-6156.1000115
Copyright: © 2011 Abougalambou SSI, et al. This is an open-access article
distributed under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.
Prevalence of Vascular Complications among Type 2 Diabetes Mellitus
Outpatients at Teaching Hospital in Malaysia
Salwa Selim Ibrahim Abougalambou
1
*, Mohamed Azmi Hassali
2
, Syed Azhar Syed Sulaiman
3
and Ayman S. Abougalambou
4
1
Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences,Universiti Sains Malaysia (USM)
2
Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, USM
3
Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, USM
4
Cardiologist, National Heart Institute (IJN), Kuala Lumpur
J
o
u
r
n
a
l
o
f
D
i
a
b
e
t
e
s
&
M
e
t
a
b
o
l
i
s
m
ISSN: 2155-6156
Journal of Diabetes and Metabolism