Diabetesregulatie en late complicaties bij poliklinisch behandelde patiënten met diabetes mellitus type II

– In order to obtain more information on the quality of metabolic control and presence of secondary complications in type 2 diabetic patients treated in a hospital outpatient-clinic, we studied 124 of our diabetic patients (56 males, 68 females, age 65 (SD 11) years, duration of diabetes 9, range 1-32 years). HbA_1c levels were 7.9 in patients on oral hypoglycaemic agents (n = 56), and 8.2 in insulin-treated patients (n = 59). Cholesterol and triglyceride levels tended to be lower in the insulin-treated patients.

The prevalence of vascular abnormalities was high: in comparison with a population of general practice patients more patients had hypertension (56 vs 38), coronary artery disease (48 vs 40), and cerebrovascular disease (15 vs 6). In addition, 35 of our diabetics had signs of peripheral artery disease. Retinopathy was present in 35 patients, micro-albuminuria was found in 31 patients, proteinuria in 18 patients. The presence of microalbuminuria and proteinuria was a strong indicator for cardiovascular disease, polyneuropathy and retinopathy. The use of cardiovascular medication was high: 57 patients used antihypertensive therapy, 37 used diuretics, and 26 long-acting nitrates. Only 25 patients took no medication apart from to their diabetes therapy.