Aim To determine parameters of glycaemic control, renal function and anthropometric measurements in patients with type 2 diabetes in family medicine offices and to examine whether there is a difference in these parameters between genders. Methods This cross-sectional study included 136 patients of both genders diagnosed with type 2 diabetes, with an average age of 69.33±10.87. General and demographic data were collected, anthropometric measurements were taken, as well as data on fasting plasma glucose, HbA 1 c and creatinine level from laboratory findings. Estimated glomerular filtration rate (eGFR) was calculated. Results The average results of fasting plasma glucose test were 8.43 mmol/L, of HbA1c 7.15%, and of creatinine 79.00 µmol/L. In 19.12% of patients eGFR was <60 mL/min/1.73m 2. 80.15% were overweight and 38.97% had a body mass index (BMI) of 30 kg/ m 2 or higher. Morbid obesity was recorded in 2.94% of patients. Females had a statistically significantly higher hip circumference (p=0.002) and BMI (p=0.019), while males had a statistically significantly higher waist-to-hip ratio (p=0.006) and BMI (p=0.007). Conclusion The patients did not reach the target value of fasting plasma glucose (<7mmol/L) and HbA1c was above recommended (<7%). Given that the patients were elderly, glucoregulation can be considered as adequate. The average eGFR classified the patients into G2 group (mildly decreased glomerular filtration). The mean BMI was not within the recommended values. It is important to educate patients on a healthy diet and physical activity, to control their weight, but also to choose medications that reduce weight in addition to glycaemic control.
Topić E, Primorac D, Janković S, Štefanović M. Medicinska biokemija i laboratorijska medicina. 2 nd ed. Zagreb: Medicinska naklada. 2018;
2.
International Diabetes Federation. Diabetes Atlas -9 th. 5AD;
3.
Fronzo D, R. From the triumvirate to the omnius octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes. 2009;773–95.
4.
Qaseem A, Vijan S, Snow V, Cross T, Weiss T, Owens D. Glycemic control and type 2 diabetes mellitus: the optimal hemoglobin A1c targets. A guidance statement from the American College of Physicians. Ann Intern Med. 2007;417–22.
5.
International Diabetes Federation. IDF Diabetes Atlas. 8. 15AD;
6.
Nolan C, Damm P, Prentki M. Type 2 diabetes across generations: from pathophysiology to prevention and management. Lancet. 2011;169–81.
7.
Proença A, Sertié R, Oliveira A, Campana A, Caminhotto R, Chimin P, et al. New concepts in white adipose tissue physiology. Braz J Med Biol Res. 2014;192–205.
8.
Vinciguerra F, Baratta R, Farina M, Tita P, Padova G, Vigneri R, et al. Very severely obese patients have a high prevalence of type 2 diabetes mellitus and cardiovascular disease. Acta Diabetol. 2013;443–9.
9.
Freemantle N, Holmes J, Hockey A, Kumar S. How strong is the association between abdominal obesity and the incidence of type 2 diabetes? Int J Clin Prac. 2008;1391–6.
10.
Alberti K, Zimmet P, Shaw J. Metabolic syndrome -a new worldwide definition. A consensus statement from the International Diabetes Federation. Diabet Med. 2006;469–80.
11.
Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults -the evidence report. Obesity Res. 1998;51–209.
12.
Kanavos P, Van Den Aardweg S, Schurer W. Diabetes expenditure, Burden of Disease and Management in 5 EU Countries. LSE Health, London School of Economics. 2012;
13.
The diabetes epidemic and its impact on Europe. 30AD;
14.
Lang B, V. Klinička inercija liječnika obiteljske medicine u regulaciji glikemije oboljelih od šećerne bolesti tip 2. Zagreb: School of Medicine. 2015;
15.
Standards of medical care in diabetes-2018 abridged for primary care providers. Clin Diabetes. 2018;14–37.
16.
Clearence C. El Camino Health. 31AD;
17.
Levey A, Perrone R, Madias N. Serum creatinine and renal function. Annu Rev Med. 1988;465–90.
18.
Levin A, Stevens P, Bilous R, Coresh J, Francisco D, Alm, et al. Kidney disease: Improving global outcomes (KDIGO) CKD work group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International Supplements. 2013;1–150.
19.
Fontela P, Winkelmann E, Ott J, Uggeri D. Estimated glomerular filtration rate in patients with type 2 diabetes mellitus. Rev Assoc Med Bras. 2014;531–7.
20.
K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;(2):1–266.
21.
Medanić D, Pucarin-Cvetković J. Obesity-a public health problem and challenge. Acta Med Croatica. 2012;347–55.
22.
Church T, Cheng Y, Earnest C, Barlow C, Gibbons L, Priest E. Exercise capacity and body composition as predictors of mortality among men with diabetes. Diab Care. 2004;83–8.
23.
Matsuzawa Y. The role of fat topology in the risk of disease. Int J Obes. 2008;83–92.
24.
Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Lisheng L. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;937–52.
25.
Conway B, Xiang Y, Villegas R, Zhang X, Li H, Wu X, et al. Hip circumference and the risk of type 2 diabetes in middle-aged and elderly men and women: the Shanghai women and Shanghai men’s health studies. Ann Epidemiol. 2011;358–66.
26.
Dowling H, Fried S, Pi-Sunyer F. Insulin resistance in adipocytes of obese women: effects of body fat distribution and race. Metabolism. 1995;987–95.
27.
Wahrenberg H, Lonnqvist F, Arner P. Mechanisms underlying regional differences in lipolysis in human adipose tissue. J Clin Invest. 1989;458–67.
28.
Seidell J, Perusse L, Despres J, Bouchard C. Waist and hip circumferences have independent and opposite effects on cardiovascular disease risk factors: the Quebec family study. Am J Clin Nutr. 2001;315–21.
29.
Snijder M, Dekker J, Visser M, Yudkin J, Stehouwer C, Bouter L, et al. Larger thigh and hip circumferences are associated with better glucose tolerance: the Hoorn study. Obes Res. 2003;104–11.
30.
Chowdhury B, Lantz H, Sjostrom L. Computed tomography-determined body composition in relation to cardiovascular risk factors in Indian and matched Swedish males. Metabolism. 1996;634–44.
31.
Parker E, Pereira M, Stevens J, Folsom A. Association of hip circumference with incident diabetes and coronary heart disease: the atherosclerosis risk in communities study. Am J Epidemiol. 2009;837–47.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
,
