Prevalence of diabetic complications in fibrocalculous pancreatic diabetic patients and type 2 diabetic patients: a cross-sectional comparative study.

OBJECTIVE: To determine the prevalence of diabetes-related complications in subjects with fibrocalculous pancreatic diabetes (FCPD) and compare them with subjects with type 2 diabetes mellitus matched for age, sex, and duration of diabetes. METHODS: The study group comprised of 277 FCPD patients and 277 age, sex, and duration of diabetes-matched type 2 diabetic patients. All the study subjects underwent a detailed clinical examination, and fasting blood samples were obtained for biochemical studies. Peripheral Doppler was used for diagnosis of peripheral vascular disease (PVD). Vibratory perception threshold (VPT) was determined using biothesiometry for diagnosis of neuropathy. Diagnosis of coronary artery disease (CAD) was based on medical history and 12-lead resting ECG. Retinal photographs were used for diagnosis of retinopathy using a modified version of Early Treatment Diabetic Retinopathy Study (ETDRS) grading system. RESULTS: FCPD patients had lower body mass index (BMI) (P<.001), systolic blood pressure (P<.0001), diastolic blood pressure (P<.001), serum cholesterol (P<.001), serum triglyceride (P<.001), and serum creatinine (P<.01) but higher glycosylated hemoglobin (P<.001) levels compared to patients with type 2 diabetes. Prevalence of CAD was significantly higher among type 2 diabetic patients (11.9%) compared to FCPD patients (5.1%), P<.003. There was no significant difference in the prevalence of other diabetic complications between the two study groups (type 2 diabetes vs. FCPD: retinopathy-37.2% vs. 30.1%, PVD-4.3% vs. 4.7%, Neuropathy-25.3% vs. 20.9%, Nephropathy-15.0% vs. 10.1%). Multiple logistic regression analysis revealed the following risk factors for diabetes complications among type 2 diabetic subjects-retinopathy: BMI (P=.028), duration of diabetes (P<.001), and glycosylated hemoglobin (P=.026); nephropathy: diastolic blood pressure (P=.016) and glycosylated hemoglobin (P=.040); neuropathy: age (P<.001), duration of diabetes (P=.003), and glycosylated hemoglobin (P=.001). Among subjects with FCPD, systolic blood pressure (P=.013), glycosylated hemoglobin (P=.021), and duration of diabetes (P<.001) were associated with retinopathy; BMI (P=.057), glycosylated hemoglobin (P=.010), and duration of diabetes (P=.024) with nephropathy and age (P=.011) and BMI (P=.010) with neuropathy. CONCLUSION: The prevalence of retinopathy, nephropathy, neuropathy, and PVD was similar among FCPD patients and type 2 diabetic patients, but the prevalence of CAD was lower among FCPD patients.

Socioeconomic status and dyslipidaemia in a South Indian population: the Chennai Urban Population Study (CUPS 11).

BACKGROUND: Socioeconomic differences have been shown to be linked with the prevalence of coronary artery disease (CAD) and its risk factors such as dyslipidaemia based on urban-rural comparisons. However, very little data are available on the prevalence of dyslipidaemia within an urban environment. The aim of this study was to assess the pattern of dyslipidaemia in two different socioeconomic groups within an urban South Indian population. METHODS: The Chennai Urban Population Study is an epidemiological study involving two residential areas in Chennai, South India representing different socioeconomic strata. Of the 1399 eligible subjects (age > or = 20 years), 1262 (90.2%) participated in the study (Tirumangalam: middle income group, 479 subjects, response rate 91.4%; and T. Nagar: low income group, 783 subjects, response rate 89.4%). A detailed questionnaire on the socioeconomic and clinical background of the subjects was collected. Biochemical investigations included lipid profile and oral glucose tolerance tests. The classification of lipid abnormalities was done according to the National Cholesterol Education Programme-Adult Treatment Panel III [NCEP (ATP III)] guidelines. RESULTS: The Tirumangalam group (mean monthly income of Rs 8075) represents the middle income group, while the T. Nagar group (mean monthly income of Rs 1399) represents the low income group. The prevalence rates of lipid abnormalities were higher among the middle income group compared to the low income group. The prevalence of high risk cholesterol levels in men was 10.6% (middle income group) v. 2.7% (low income group; p<0.001) and among women 19.1 v. 4.7% (p<0.001). Similarly, the prevalence of high risk triglyceride levels in men was 15.7% v. 9.3% (p=0.02) and among women 10.3% v. 7.5% (p<0.05); high risk low density lipoprotein (LDL) levels among men was 7.8% v. 3.0% (p=0.01), and among women 11.2% v. 4.5% (p<0.001). High density lipoprotein (HDL) cholesterol levels were lower in the low income group but the total cholesterol/HDL cholesterol ratio was higher among men in the middle income group (p<0.001) but not among women. Logistic regression analysis revealed that socioeconomic status had a strong association with hypercholesterolaemia and high LDL levels, even after adjusting for age and body mass index. CONCLUSION: Socioeconomic factors influence the pattern of dyslipidaemia in this urban South Indian population, with dyslipidaemia being more common and severe in the middle income group.