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Subject:  Disciplined diabetics live longer, better

 

Disciplined diabetics live longer, better

http://timesofindia.indiatimes.com/city/chennai/Disciplined-diabetics-live-longer-better/articleshow/20905318.cms

-- Doctors always tell diabetics that it is important to maintain sugar , blood and cholesterol levels for better quality of life. Now, a study pinpoints how keeping these parameters under control ensures a long and quality life for people with type- 2 diabetes . 

A study by Madras Diabetes Research Foundation, published in medical journal Diabetes Carerecently shows that diabetics with better glycemic , blood pressure control and more favorable lipid profiles lived longer when compared to others . "Most non-survivors died due to heart attacks (46.4%) and renal failure (16.6%). Some of the long-term survivors also developed complications like problems of the eye , kidneys , heart , nerves and blood vessels ," said senior diabetologist Dr V Mohan . 

Although there have been many studies across the globe on long-term survivors with type-1 , there has been very limited studies on people with type-2 . "That is possibly because in mostcountries people get the disorder very late in life. But in India , many people are pre-disposed to the disorder because we have certain genes that put us at a higher risk of diabetes . Central obesity , decreased physical activity and food habits have increased the incidence of diabetes in India ," said diabetologist Dr Anjana Mohan Ranjit . 

From the database of the Dr Mohan's Diabetes Centre , the research team identified 238 patients with type-2 diabetes who had survived with 40 years of documented duration of diabetes . They also obtained data on 307 people who had died of various causes before 40 years of duration . Medical records of both the groups were reviewed and the biochemical and clinical data were recorded along with age , duration of diabetes , age and duration of diabetes and time of death . They also collected information about the family and smoking history , besides details of medications. 

The results did not come as a surprise . "But it confirmed what we already knew . Diabetes with obesity and hypertension kills," said epidemiologist Shanthi Rani . The results showed that obesity was present in 37 % of the non-survivors compared with 33.6% of long-term survivors . The meanBMI was also lesser among survivors . Most non-surviours died due to myocardial infarction and renal disease . Infections and cancer contributed the rest . "It appears reasonable to conclude that if T2DM patients do not die of Coronary Artery Disease (CAD) or nephropathy within the first 20-30 years of T2DM, then they tend to live longer and die of other causes , including cancer ," she said . The long-term survivors were using more statin and insulin . However , data on the prevalence of complications among survivors were high , possibly due to longer duration of diabetes . Doctors say this made them slightly sick. For instance retinopathy was present in 76% of the survivors in this study . Microabluminuria was present in 8.4% and only one patient among the survivors required dialysis . "So the progression to end-stage renal disease appears to be uncommon . But the incidence of prevalence of renal disease was higher among the nonsurvivors ," said Dr Mohan. 

The most common complication among survivors was neuropathy (problems of the nerves ), which was reported in 86 .5% of the patients apart from peripheral vascular (blood vessels ) disease in 23 .1% of the survivors . Cardiac disease was diagnosed in 45% of patients . "The study is a reassurance that better control will lead to better quality of lifestyle ," he said.

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