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269: Obesity and diabetes mellitus type 2: Prevalence and association with other risk factors for cardiovascular complications
Journal of Clinical Lipidology, Vol 2, No 5S, October 2008
patients was observed against a background of enhancement of activity of GR in erythrocytes twice as many and activity of GT in erythrocytes is 1.8 as many relative to analogous values of the controls. Activity of GPO in erythrocytes in DM2 patients did not differ from the data of the controls (p>0.05). Stability of studied glutathione dependent enzymes on serum in DM2 patients relatively to the values of the controls attracts our attention. Conclusions: Thus we revealed activation of glutathione antioxidant system in DM2 patients. Reduction of active form of glutathione and imbalance of glutathione enzymes probably effect on the character of disease course and formation of dysadaptation mechanism at oxidative stress in DM2 patients. Funding: none
267 OBESITY AND DIABETES L. Sokolova Djokic1, S. Martinovic2, B. Prosenica2. 1Institute of Public Health, Sombor, Serbia, 2Health Center, Sombor, Serbia, 3 State Public Heath Fund, Sombor, Serbia Diabetes is a chronically life long disease and it is of a great importance as a consequence of the obesity. In a Preventive Service Center, Health Center Sombor, there has been done a research over 101 patients about their obesity and diabetes. There was 24 patients younger then 50 and 77 patients older then 50. 41% from both group had a dibetes history in their families. 29% of younger and 38% older had an irregular diet and more than 50% from both groups was physically inactive. 46% of younger and 69% of older had an increased level of blood cholesterol; 54% of younger and 88% of older had an increased level of blood tryglycerids. 41% of younger and 81% of older had a Body Mass Index over 25. As a consequence, 37% of younger and a 76% of older had an increased level of blood sugar. Obesity and increased blood fats are conected with a high level of blood sugar, and the frequency of a diabetes is higher as we are getting older. Funding: none
268 ESTIMATION OF CARDIOVASCULAR RISK IN A LOCAL POPULATION OF DIABETIC PATIENTS E. Pellegrini, M.S. Simonini, M. Maurantonio, I.M. Giannico, R. D'Amico, D. Ganazzi, L. Carulli, P. Loria, M. Bertolotti, N. Carulli. University of Modena and Reggio Emilia, Modena, Italy Diabetes mellitus is a major risk factor for cardiovascular (CV) events. Many algorithms have been devised to assess CV risk, some of which specific for diabetics. Most of them, however, can hardly be extrapolated to Mediterranean countries. Aim: of this study was to analyze CV risk and the incidence of CV events in a local cohort of patients with type 2 diabetes. Methods: Clinical charts of the Diabetes Clinics of Modena in the period 1991-1995 were analyzed. Patients aged 35-65 with type 2 diabetes and no previous CV disease were eligible. Global CV risk was computed according to Framingham, RISCARD, Progetto Cuore and UKPDS algorithms and compared with the actual rate of CV events over the following 10 years. Results: 1532 patients were eligible. An absolute 10-yr risk rate for CV events of 14.6% was observed. Comparing patients with events with event-free subjects we found a significant difference in systolic blood pressure, age at visit, smoke, duration of diabetic disease, HbA1c and comorbidity with heart failure and COPD. Comparing the estimated risk rate according to the different functions, Italian algorithms were more consistent with observed data. However, most subjects with a CV event had a low-to-moderate risk estimate, particularly with Progetto Cuore algorithm. Conclusions: Estimation of CV risk is dependent on the algorithm adopted and on the baseline risk of the reference cohort. Functions designed for a specific population, including risk parameters peculiar for diabetes should be adopted to increase the performance of such functions which is presently clearly unsatisfactory. Funding: none
269 OBESITY AND DIABETES MELLITUS TYPE 2: PREVALENCE AND ASSOCIATION WITH OTHER RISK FACTORS FOR CARDIOVASCULAR COMPLICATIONS
S125
Multiple Risk Factors in Cardiovascular Disease—Abstracts
J. Kovacevska1, B. Aleksov2, E. Jakimovska3. 1 EASD, Dusseldorf, Germany, 2Macedonian endocrynology organization, Skopje, Makedonija, 3 Primary Care Diabetes Group, Paris, France Aim: To determine the prevalence of obesity in patients with type 2 diabetes mellitus (DM type 2) and its association with hypertension (HTA) and dyslipidemia. Material and Methods: 222 patients (102m,120f) with DM type 2 have been analyzed, treated in the cabinet of Diabetes, J. Sandanski. Age: 51.68±6.27, DM duration: 2.98±2.69. The following parameters have been analyzed: Body Mass Index (BMI), blood pressure, total cholesterol, tryglicerides. Results: Obesity ( BMI > 30 kg/m2 ) has been determined in 81 patients with mean BMI value 34.73±4.46.Morbid obesity ( BMI > 35 ) has been determined in 28 patients. Overweight (BMI>25– 29,9) has been determined in 109 patients with mean BMI value 27.29±1.32 .BMI normal (<25) has been determined in 32 patients. Hypertension has been determined in 54% of the total number of analyzed diabetics. Hypertensive patients had higher BMI (30.92±5.54) compared with normotensive patients (BMI 27.37±4.2).Total cholesterol values were as follows: in obese patients: 5.68±1.13; in overweight patients: 5.78±1.06; in normal-weight patients: 4.88±1.68. Tryglicerides values: in obese patients 2.44±1.65; in overweight patients 2.34±1,39; in normalweight patients: 2.03±1.38. Conclusions: The obtained results show high prevalence of obesity (36%) and overweight (49%) in the analyzed patients with DM type 2. Higher BMI is associated with higher hypertension, higher tryglicerides and higher cholesterol values, as well as with great risk for development of cardiovascular complications. Funding: none
270 MANAGEMENT OF DIABETES MELLITUS IN PRIMARY CARE: SITUATION IN LITHUANIA A. Domeikiene, L. Valius, L. Gedminas. Department of Family Medecine, Kaunas University of Medicine, Kaunas, Lithuania
S126
Objective: Diabetes mellitus is one of the most common chronic disorders in industrialized countries. Insufficient glycemic control is closely related with diabetes complications. Diabetes increases the risk of coronary heart disease and stroke. Cardiovascular diseases are the primary cause of death of patients with diabetes mellitus. Methods: Cross – sectional, epidemiological study has organized in Lithuania. Family doctors filled in given questionnaires about their patients with diabetes type 1 and 2. They looked through their treatment, checked glycosylated hemoglobin (HbAlc), experienced complications (retinopathy, cardiovascular disease, nephropathy, neuropathy), diabetes duration. Results: We analyzed collected data and received the following preliminary Results: the average duration of disease for patients with diabetes type 1 was 11, 90 ± 2,50, with type 2 - 6, 78± 0,57. 57 percent of patients had HbAlc lower 7 percent, 33 percent - between 7 and 9 and 10 percent of patients - upper 9. We analyzed also the treatment of diabetes, prevalence of complications. We compared results between women and men and searched for the health differences according to residence (country – urban) criterion. Conclusions: The half of patients has glycosylated hemoglobin lower 7 percent. The bigger part of patients with diabetes type 2 has been treated with peroral antidiabetic drugs. About 88 percent patients were diagnosed hypertension, 73 percent - retinopathy, 9 percent - stroke and 15 percent - myocardial infarction. Funding: Kaunas University Hospital, Family Medicine Department
271 ETHNIC ASPECTS OF DIABETES MELLITUS OF TYPE 1 IN PATIENTS OF BURYAT POPULATION T. Bardymova1, I. Dedov2, L. Kolesnikova3. 1 Irkutsk State Institute Post-Graduate Study, Irkutsk, Russia, 2Endocrinological Research Center, Moscow, Russia, 3Scientific Centre of Medical Ecology ESSC SD RAMS, Irkutsk, Russia Objective: To study prevalence, genetic and metabolic features of diabetes mellitus of type 1 (DM1) in population of Pribaikalje (Siberia). Materials and Methods: patients with DM1 of
patients was observed against a background of enhancement of activity of GR in erythrocytes twice as many and activity of GT in erythrocytes is 1.8 as many relative to analogous values of the controls. Activity of GPO in erythrocytes in DM2 patients did not differ from the data of the controls (p>0.05). Stability of studied glutathione dependent enzymes on serum in DM2 patients relatively to the values of the controls attracts our attention. Conclusions: Thus we revealed activation of glutathione antioxidant system in DM2 patients. Reduction of active form of glutathione and imbalance of glutathione enzymes probably effect on the character of disease course and formation of dysadaptation mechanism at oxidative stress in DM2 patients. Funding: none
267 OBESITY AND DIABETES L. Sokolova Djokic1, S. Martinovic2, B. Prosenica2. 1Institute of Public Health, Sombor, Serbia, 2Health Center, Sombor, Serbia, 3 State Public Heath Fund, Sombor, Serbia Diabetes is a chronically life long disease and it is of a great importance as a consequence of the obesity. In a Preventive Service Center, Health Center Sombor, there has been done a research over 101 patients about their obesity and diabetes. There was 24 patients younger then 50 and 77 patients older then 50. 41% from both group had a dibetes history in their families. 29% of younger and 38% older had an irregular diet and more than 50% from both groups was physically inactive. 46% of younger and 69% of older had an increased level of blood cholesterol; 54% of younger and 88% of older had an increased level of blood tryglycerids. 41% of younger and 81% of older had a Body Mass Index over 25. As a consequence, 37% of younger and a 76% of older had an increased level of blood sugar. Obesity and increased blood fats are conected with a high level of blood sugar, and the frequency of a diabetes is higher as we are getting older. Funding: none
268 ESTIMATION OF CARDIOVASCULAR RISK IN A LOCAL POPULATION OF DIABETIC PATIENTS E. Pellegrini, M.S. Simonini, M. Maurantonio, I.M. Giannico, R. D'Amico, D. Ganazzi, L. Carulli, P. Loria, M. Bertolotti, N. Carulli. University of Modena and Reggio Emilia, Modena, Italy Diabetes mellitus is a major risk factor for cardiovascular (CV) events. Many algorithms have been devised to assess CV risk, some of which specific for diabetics. Most of them, however, can hardly be extrapolated to Mediterranean countries. Aim: of this study was to analyze CV risk and the incidence of CV events in a local cohort of patients with type 2 diabetes. Methods: Clinical charts of the Diabetes Clinics of Modena in the period 1991-1995 were analyzed. Patients aged 35-65 with type 2 diabetes and no previous CV disease were eligible. Global CV risk was computed according to Framingham, RISCARD, Progetto Cuore and UKPDS algorithms and compared with the actual rate of CV events over the following 10 years. Results: 1532 patients were eligible. An absolute 10-yr risk rate for CV events of 14.6% was observed. Comparing patients with events with event-free subjects we found a significant difference in systolic blood pressure, age at visit, smoke, duration of diabetic disease, HbA1c and comorbidity with heart failure and COPD. Comparing the estimated risk rate according to the different functions, Italian algorithms were more consistent with observed data. However, most subjects with a CV event had a low-to-moderate risk estimate, particularly with Progetto Cuore algorithm. Conclusions: Estimation of CV risk is dependent on the algorithm adopted and on the baseline risk of the reference cohort. Functions designed for a specific population, including risk parameters peculiar for diabetes should be adopted to increase the performance of such functions which is presently clearly unsatisfactory. Funding: none
269 OBESITY AND DIABETES MELLITUS TYPE 2: PREVALENCE AND ASSOCIATION WITH OTHER RISK FACTORS FOR CARDIOVASCULAR COMPLICATIONS
S125
Multiple Risk Factors in Cardiovascular Disease—Abstracts
J. Kovacevska1, B. Aleksov2, E. Jakimovska3. 1 EASD, Dusseldorf, Germany, 2Macedonian endocrynology organization, Skopje, Makedonija, 3 Primary Care Diabetes Group, Paris, France Aim: To determine the prevalence of obesity in patients with type 2 diabetes mellitus (DM type 2) and its association with hypertension (HTA) and dyslipidemia. Material and Methods: 222 patients (102m,120f) with DM type 2 have been analyzed, treated in the cabinet of Diabetes, J. Sandanski. Age: 51.68±6.27, DM duration: 2.98±2.69. The following parameters have been analyzed: Body Mass Index (BMI), blood pressure, total cholesterol, tryglicerides. Results: Obesity ( BMI > 30 kg/m2 ) has been determined in 81 patients with mean BMI value 34.73±4.46.Morbid obesity ( BMI > 35 ) has been determined in 28 patients. Overweight (BMI>25– 29,9) has been determined in 109 patients with mean BMI value 27.29±1.32 .BMI normal (<25) has been determined in 32 patients. Hypertension has been determined in 54% of the total number of analyzed diabetics. Hypertensive patients had higher BMI (30.92±5.54) compared with normotensive patients (BMI 27.37±4.2).Total cholesterol values were as follows: in obese patients: 5.68±1.13; in overweight patients: 5.78±1.06; in normal-weight patients: 4.88±1.68. Tryglicerides values: in obese patients 2.44±1.65; in overweight patients 2.34±1,39; in normalweight patients: 2.03±1.38. Conclusions: The obtained results show high prevalence of obesity (36%) and overweight (49%) in the analyzed patients with DM type 2. Higher BMI is associated with higher hypertension, higher tryglicerides and higher cholesterol values, as well as with great risk for development of cardiovascular complications. Funding: none
270 MANAGEMENT OF DIABETES MELLITUS IN PRIMARY CARE: SITUATION IN LITHUANIA A. Domeikiene, L. Valius, L. Gedminas. Department of Family Medecine, Kaunas University of Medicine, Kaunas, Lithuania
S126
Objective: Diabetes mellitus is one of the most common chronic disorders in industrialized countries. Insufficient glycemic control is closely related with diabetes complications. Diabetes increases the risk of coronary heart disease and stroke. Cardiovascular diseases are the primary cause of death of patients with diabetes mellitus. Methods: Cross – sectional, epidemiological study has organized in Lithuania. Family doctors filled in given questionnaires about their patients with diabetes type 1 and 2. They looked through their treatment, checked glycosylated hemoglobin (HbAlc), experienced complications (retinopathy, cardiovascular disease, nephropathy, neuropathy), diabetes duration. Results: We analyzed collected data and received the following preliminary Results: the average duration of disease for patients with diabetes type 1 was 11, 90 ± 2,50, with type 2 - 6, 78± 0,57. 57 percent of patients had HbAlc lower 7 percent, 33 percent - between 7 and 9 and 10 percent of patients - upper 9. We analyzed also the treatment of diabetes, prevalence of complications. We compared results between women and men and searched for the health differences according to residence (country – urban) criterion. Conclusions: The half of patients has glycosylated hemoglobin lower 7 percent. The bigger part of patients with diabetes type 2 has been treated with peroral antidiabetic drugs. About 88 percent patients were diagnosed hypertension, 73 percent - retinopathy, 9 percent - stroke and 15 percent - myocardial infarction. Funding: Kaunas University Hospital, Family Medicine Department
271 ETHNIC ASPECTS OF DIABETES MELLITUS OF TYPE 1 IN PATIENTS OF BURYAT POPULATION T. Bardymova1, I. Dedov2, L. Kolesnikova3. 1 Irkutsk State Institute Post-Graduate Study, Irkutsk, Russia, 2Endocrinological Research Center, Moscow, Russia, 3Scientific Centre of Medical Ecology ESSC SD RAMS, Irkutsk, Russia Objective: To study prevalence, genetic and metabolic features of diabetes mellitus of type 1 (DM1) in population of Pribaikalje (Siberia). Materials and Methods: patients with DM1 of