Late Complications of Diabetes mellitus in the Republic of Uzbekistan

Background: Diabetes mellitus (DM) is a major cause of blindness, and cardiovascular risk is the highest in diabetics. More than 40% of all trauma-unrelated lower extremity amputations are performed because of diabetic foot syndrome and lower extremity gangrene; 35–40% of all deaths due to uremia occur in diabetics. Objective: To study the prevalence of late complications of DM in the Republic of Uzbekistan and risk factors contributing to their progression. Methods: 1,000 and 1,141 patients with type 2 DM, resident in urban and rural areas of Uzbekistan, respectively, underwent general clinical examination in which arterial pressure, carbohydrate and lipid metabolism parameters were measured. A special questionnaire was filled out for each patient. Results: The study established a higher prevalence of late complications of DM in urban diabetics as compared with those in rural regions (p < 0.001). The incidence of macroangiopathies of lower extremity vessels, diabetic foot syndrome and myocardial infarction was found to be higher in males than that in females, while the prevalence of ischemic heart disease was registered as higher in females regardless of region. An increase in the incidence of late complications of DM with disease duration was found in residents of both regions (p < 0.001). The prevalence of macroangiopathies, diabetic polyneuropathy and diabetic foot syndrome in the decompensated stage of disease was high among both urban and rural residents. The smokers had a higher prevalence of diabetic retinopathy, macroangiopathies of lower extremity vessels, myocardial infarction and ischemic heart disease regardless of region. Age also contributes to the progression of late complications of DM. Conclusions: The incidence of late complications of DM was higher in urban diabetics than in their rural counterparts in the present study. Sex, age, disease duration, compensation stage and bad habits were found to be risk factors for the progression of late complications of DM.