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Age and Sex ( percent )

PREVELANCE OF COMPLICATIONS OF DIABETES MELLITUS IN EGYPT Prof Morsi Arab University of Alexandria. Age and Sex ( percent ). Type of Diabetes. BMI Increased BMI and Gender. Comparative prevalences of overweight among diabetic patients at urban and rural Governorates:.

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Age and Sex ( percent )

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  1. PREVELANCE OF COMPLICATIONS OF DIABETES MELLITUS IN EGYPTProf Morsi ArabUniversity of Alexandria

  2. Age and Sex ( percent )

  3. Type of Diabetes

  4. BMI Increased BMI and Gender

  5. Comparative prevalences of overweight among diabetic patients at urban and rural Governorates:

  6. Fasting Hyperglycemia - Controlled (< 120 mg/dl ) = 19.8 % -Uncontrolled = 80.2 % • ------------------------------------- Hyperglycemic 121-150 mg/dl = 15.6 % Marked hyperglycemia -200 = 31.3 % Severe hyperglycemia -220 = 12.5 % Very severe hyperglycemia > 220 = 20.8 %

  7. Hyperglycemia Fasting 120 mg/dl

  8. Post Prandial Hyperglycemia - Controlled < 160 mg/dl = 13.5 % - Accepted 161-180 mg/dl = 7.9 % Total =21.4 % - Uncontrolled (>180 mg/dl ) = 78.6 % * Moderate -220 mg/dl = 17.4 % * Severe - 260 mg/dl = 16.0 % * Very Severe > 260 mg/dl = 45.2 %

  9. Hyperglycemia 180 mg/dl

  10. Uncontrolled ”Diastolic” Hypertension ( > 80 mmHg)

  11. Diastolic Blood Pressure 80 mm Hg

  12. Uncontrolled “Systolic” Hypertension (>130 mmHg)

  13. Systolic Blood Pressure 0.50% 130 mm Hg

  14. Hypercholsterolemia (>200 mg/dl)

  15. Lipid Control Serum Cholesterol 200 mg

  16. Hypertriglyceridemia (>150 mg/dl)

  17. Lipid ControlSerum Triglycerides 150 mg

  18. Obesity as a Risk Factor for Hyperglycemia , Hypertension and Hyperlipidemia

  19. Obesity

  20. Hypoglycemia- Occurrence of Hypoglycemic episodes in = 20.5%-------------------------------------------------------------------------- - The mean age of patients who developed hypoglycemic episodes at any time = 50.8 years - The mean age of patients who did not experience hypoglyceamic episodes = 52.1 years

  21. Diabetes KetoAcidosis (DKA)- Occurrence of DKA episodes in = 12.2 %.--------------------------------------------------------------------- The mean age in patients who developed DKA =42.5 years- The mean age in patients who never developed DKA =53.1 years

  22. Cardiac ComplicationsAngina : 15.0 %Signs of Cardiac Dysfunction: 21.3 % (C. H.V. and or arrhythmia )Positive ECG Changes : 7.9 %

  23. Cardiac Complications

  24. Serum Creatinine

  25. Retinopathy ( in 1173 patients ) - Free 68.9 % - Back ground 22.6 % - Proliferative 9.5 %

  26. Retinopathy in correlation with Duration of DM

  27. Ankle Reflex loss as early indicator of neuropathy n 1833 pts., AR was : - present in 44.5 % - absent in 55.5 %

  28. l

  29. Prevalence of foot complications 1- Fungus infection = 22.0 % 2- Foot ulcers = 6.8 % 3- Evident Ischaemic changes = 9.7 % 4- Amputations = 3.0 % 5- Deformities = 1.0 %

  30. Frequency of Foot Complications

  31. Fertility and Frequency of Abortions in Diabetic Females -The average number of normally born children / pt = 3.6 - The average number of aborted children / pt = 0.9 - The frequency of abortions among all pregnancies = 21.5%

  32. Fertility Abortions : 21.5%

  33. Conclusions : 1- The great majority of diabetic patients do not have adequate levels of glycaemic control , B.P. or serum lipids, according to accepted standards . 2- Obesity is widely prevalent , sometimes at its high degree (BMI >30) in all regional sectors of the population . 3- Obesity is a risk factor which correlates well with almost all metabolic aberrations .

  34. Conclusions : (cont. ) 4- Prevalences of hypoglycaemic episodes and DKA are matching with known global standards. 5- While E.C.G. screening may reveal the presence of CAD in 7.9% only of diabetics, suggestive symptoms (angina) may be present in twice this prevalence ( 15%) and actual clinical cardiac morbidity in three times (21.3%) of cases. 6- Prevalences of Neuropathy and Retinopathy are highly correlated with the duration of diabetes.

  35. Conclusions: ( cont.) 7- Serious foot complications are probably not as much prevalent as was anticipated . 8- Diabetic women are moderately fertile, about 1/4th of pregnancies however end into abortion.

  36. Alexandrie – Palais du Montazah Thank You

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