The Influencing Factors Of Type 2 Diabetes Vascular Complications

Objective: The aim of the study was to find clinical evidences for the management of diabetes mellitus through analyzing the influence factors of type 2 diabetic Vascular complications.Method: According to diagnostic standard of WHO (1999), 399 cases of type 2 diabetes mellitus were collected in the fist affiliated hospital of Fijian medical university during 2004 to 2006. Data have been analyzed by using case-control study.Results: Among 399 cases with type 2 diabetes mellitus, there are 329 cases with different complications to a certain extent, and 219 cases (taking up 53.1%) having above 2 complications. Only 4 cases reached the diabetes mellitus controlling target (ASIAN-PACIFIC TYPE 2 DIABETES POLICY GROUP, 1999), taking up 1.0%. Average systolic blood pressure (SBP) level (136.8±20.1) mmHg, glycosylated hemoglobin [HbA1c,(8.6±2.4)%], total cholesterol [TC,(5.0±1.3) mmol/L], low density lipoprotein [LDL-C,(3.0±1.0)mmol/L] are higher than the demand. Regression analysis indicates: age to hypertension(OR=1.084 , P=0.026) , cerebrovascular diseases (OR=1.040, P=0.003) , course of diseases to hypertension (OR=1.045, P=0.013);cerebrovascular diseases (OR=1.045, P=0.025),retinal degenerative diseases (OR=1.061, P=0.024),smoking to coronary heart disease (OR=2.673, P=0.017);education level to cerebrovascular diseases (OR=1.045, P=0.013)having positive correlation. Hypertension acted as a risk fact to coronary heart disease (DBP,OR=1.040, P=0.015)and nephropathy (SBP , OR=1.031, P=0.000) ; CR was related to hypertention(OR=1.027, P=0.007) , so did UA(OR=1.004, P=0.009) ;hypertension and coronary heart disease (OR=1.004, P=0.018)exists obvious correlation;the morbidity of coronary heart disease is different in male and female (OR=0.251, P=0.043);HDL-C to cerebrovascular diseases is protected factors;retinopathy (OR=7.420, P=0.001),urine minim protein excretion rate (OR=1.067, P=0.000) reflect the progress of nephropathy. The morbidity of coronary heart disease(χ~2=10.501, P=0.001)and nephropathy(χ~2=5.304,P=0.021) are higher in the metabolic syndrome group, but there is no statistical significance in cerebrovascular diseases (χ~2=2.463,P=0.134)and retinopathy(χ~2=0.455,P=0.500).Conclusion:1. Metabolic disorder is the basis of vascular complications of diabetes mellitus.2. The key of getting to the ideal diabetes mellitus controlling targets is to prevent and treat vascular complications of diabetes mellitus.3. Different vascular complications of diabetes mellitus affect each other, then lead to the deterioration of state of diseases.4. The metabolic syndrome is a risk fact of microvascular and macrovascular complications in Diabetes. 5. Risk factors having some interactive effects,which promote the development of diseases. 6. Combined therapy is the best way to treat diabetes mellitus.