Association of gender with symptoms and complications in type II diabetes mellitus.
Females with Type II diabetes appear more likely than males to experience symptoms and vascular complications related to their disease.
Biomedical subjects
Publications and source records attributed to J H Summerson.
Females with Type II diabetes appear more likely than males to experience symptoms and vascular complications related to their disease.
OBJECTIVE: To compare the frequency of common symptoms and complications between African- and white American adults with type 2 diabetes mellitus in a primary care setting, and to examine associations of these conditions with glycemic control. DESIGN: Three hundred and four adults with type 2 diabetes participated in this cross-sectional analysis; 142 of whom were African-Americans. Patients were recruited from a family practice ambulatory care unit and a community health center. RESULTS: Both male and female African-Americans had higher mean diastolic blood pressure and poorer metabolic control than their white counterparts. After adjustment for diabetes duration, glycosylated hemoglobin and diastolic blood pressure, African-American females were significantly more likely to experience constipation and hypertension but less likely to experience chest pain, claudication, peripheral neuropathy or have peripheral vascular disease. Among male subjects, African-Americans were significantly more likely to experience blurred vision and hypertension but less likely to have peripheral atherosclerotic disease. Poor glycemic control was more strongly associated with the occurrence of common diabetic symptoms in African-American subjects. CONCLUSIONS: Both African- and white Americans with type 2 diabetes are likely to experience a wide variety of symptoms and vascular complications. African-American subjects appear more likely than whites to experience symptoms related to glycemic control but less likely to have, or experience symptoms and complications of, cardiovascular disease. That nearly half of these subjects seen in a primary care setting had microalbuminuria suggests that vascular complications are likely to be present in the majority of adults with type 2 diabetes, even in these currently asymptomatic. These findings may have implications for screening and preventive strategies for the treatment of this disease.
Two hundred and seventy patients were studied to investigate the cross sectional association between exercise and other preventive health behaviors in a diabetic population. Patients included both insulin and noninsulin dependent diabetics and were recruited from the Family Practice and Pediatrics Clinics at Bowman Gray School of Medicine. During screening, patients underwent a physical examination as well as completing a survey to assess exercise and health behavior habits. Three exercise groups were compared: (a) patients who expended more than 600 kilocalories per week during exercise, (b) patients who expended 600 kilocalories or less, and (c) patients who did not exercise. The mean body weights of both exercise groups were found to be less than the nonexercise group, and the heavy exercise group also had a lower mean body mass index. Heavy exercisers reported greater caloric intakes than both moderate and nonexercisers. There were no differences found concerning the composition of their diets among groups. The heavy exercise group reported wearing their seatbelts a greater percentage of the time and visited the dentist more often compared with the sedentary group. There were no significant differences found among exercise groups concerning blood sugar monitoring, alcohol consumption, smoking, or in obtaining periodic health examinations. It was concluded that exercise was associated with several, but not a majority, of other healthful behaviors in a population of diabetics.
BACKGROUND: The excretion of small amounts of urinary protein, known as microalbuminuria, among patients with essential hypertension is associated with increased mortality from cardiovascular disease and, possibly, future renal decline. Correlates of microalbuminuria among primary care patients with essential hypertension, however, have not been well described. METHODS: One hundred forty patients enrolled in a large family practice ambulatory care center who had essential hypertension but not diabetes participated in a screening project to document cardiovascular and renal diseases in this population. Patients underwent a brief physical examination and submitted blood and urine samples for analysis. RESULTS: Twenty-five percent of patients had elevated urinary albumin excretion (UAE) rates, defined as greater than 30 micrograms/min. Patients with elevated UAE rates did not differ from patients without elevated UAE rates by age, race, sex, duration of hypertension, or type of antihypertensive medications used (if any). Although no patients had abnormally elevated glycosylated hemoglobin, after controlling for age and duration of hypertension, elevated UAE rates were significantly related to higher mean glycosylated hemoglobin levels (odds ratio [OR] = 3.06, 95 percent confidence interval [CI] = 1.11 to 8.41) and to current smoking (OR = 3.14, 95 percent CI = 1.09 to 9.04). CONCLUSIONS: These data are the first in a primary care population to show a threefold increase in risk for elevated UAE rates among patients with essential hypertension who currently smoke or who have above-average glycosylated hemoglobin levels. Although cross-sectional in nature, these data can also point toward subgroups of hypertensive patients who have a worse cardiovascular prognosis.