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

Abstract

OBJECTIVEdTo compare clinical profile of long-term survivors and nonsurvivors with type 2 diabetes (T2DM). RESEARCH DESIGN AND METHODSdAfter conducting a retrospective survey of .200,000 case records, we identified T2DM survivors (.40 years of duration) and age at diagnosis and sex-matched T2DMnonsurvivors. 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. RESULTSdThe mean duration of diabetes of survivors (n = 238) was 43.763.9 years and that of the nonsurvivors (n = 307), at time of death, was 22.4611.0 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%. CONCLUSIONSdLong-term survivors with T2DM had better glycemic and blood pressure control and more favorable lipid profiles.