Endocrine Abstracts

Background and Aims: The objective of our study is to evaluate the degenerative profile in diabetic patients and their glycemic control

Materials and Methods: This analytical cross-sectional study for analytical purposes was conducted during the period from January 2022 to January 2023, within the department of endocrinology and metabolic diseases of the Military Hospital of Instruction Mohamed V of Rabat.

Results: 215 patients were included, all with type 2 diabetes, whose mean age was 59.3+/-8.59 years. 54.9% (118) were male with a sex ratio (M/W) of 1.21. HbA1c was less than 7.5% in 41.4% (89) of the patients, and the median age of diabetes was 10 [6,14.5] years. Regarding the antidiabetic treatment; 33% (71) of our patients were under oral treatment containing a hypoglycemic sulfonamide, 26% (56) were under oral treatment without sulfonamide, 30.7% (66) were under basal-bolus insulin therapy, and 10.2% (22) were under bed-time. The degenerative complications of diabetes were present in 47% of cases, distributed as follows: 34% (75) of the patients had diabetic retinopathy, 18.6% (40) had diabetic nephropathy, 6.5% (14) had ischemic heart disease, 1% (2) had ischemic stroke and 2.3% (5) had diabetic neuropathy. In multivariate analysis, and adjusting for age, sex, duration of diabetes and glycemic control, the duration of diabetes (OR: 1.26 IC95% [1.09-1.45]) is a risk factor for microangiopathy while intensification of treatment with insulin therapy is a protective factor (OR:0.056 IC95%[0.2-0.8]), for macroangiopathy: male sex (OR:1.3 IC95%[1.2-0.0025]) glycemic imbalance and insulin therapy are risk factors (P<0.001 OR>1).

Discussion: The degenerative complications are the gravity of diabetes mellitus, Their frequency increases with that of diabetes; according to the IDF (International Diabetes Federation): DR is present in 35% of diabetic patients, and remains among the first causes of blindness, the same result has been reported in our study 34%. The IDF also reports a rate of 36% of diabetic patients suffering from ND, a rate that is much higher than that found in our study. Regarding macroangiopathic complications; coronary artery disease was present in 6.5% of our patients, the IDF reported a much higher figure between 12 and 31%, while only 1% of our patients reported a history of stroke.

Conclusion: In spite of the efforts made by the learned societies, diabetes remains a frequent and serious disease by its evolution towards complications difficult to avoid, and involving a major social and personal handicap.