Predictive parameters for macroangiopathy complications in insulin-dependent type diabetes mellitus (Spanish text)

Objective. To evaluate whether endocrine-metabolic parameters in Type 2 Diabetes Mellitus (DM) are useful to predict macroangiopathy.; Methods. Prospective observational case-control study. The following endocrine-metabolic parameters were measured: clinical (age, sex and Body Mass Index (BMI)) and biochemical parameters (basal glycemia, glycosylated hemoglobin, C-peptide, insulin, total cholesterol, HDL, LDL and triglycerides). Patients studied were 176 with type 2 DM needing insulin therapy and 194 healthy subjects.; Results. Our interest was focused on insulin-dependent subjects with type 2 diabetes mellitus, a special and the most severe category of diabetes. In our study, we found high levels of basal glycemia and glycosylated hemoglobin, and those patients with elevated concentrations of glycosylated hemoglobin had more cardiovascular events. The prevalence of macroangiopathy in normal subjects from the study area is high, and even higher in the patients. In both men and women, the prevalence of type 2 DM is increased by obesity. However, the prevalence starts from a BMI > 27 in men and a BMI > 25 in women. Obesity in type 2 diabetes mellitus was not related to an increment of prevalence of ischemic heart disease. Ischemic heart disease and stroke are more likely to occur in patients. Insulin and C-peptide are 2 and 5 times higher in overweight women (BMI > 30) than in ideal weight women. Hyperinsulinemia occurs in obese subjects.; Conclusions. The prevalence of macroangiopathy is higher in diabetic patients. Concerning diabetes prevalence, obesity has a different effect on men and women. Ischemic heart disease and cerebrovascular events are the most frequent manifestations of macroangiopathy in insulin-dependent type 2 DM. Obesity is excluded as a cause of macroangiopathy.