Type 2 DIABETES: But what are its new complications?

Type 2 DIABETES: But what are its new complications?

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An earlier Australian study of 456,000 type 2 diabetes patients followed for 7 years had already revealed that only 4 traditional complications of diabetes are now among the top 10 causes of excessive hospitalizations.

The new study examined hospitalization patterns at the general (Australian) population level to identify emerging diabetes complications and improve understanding and management of the disease.

The study involved analysis of data from approximately 50% of Australians diagnosed with type 2 diabetes and whose data was in the Australian Diabetes Registry. That is, 456,265 diabetic patients, whose data were compared with those of more than 19 million controls without diabetes. The researchers were able to identify the leading causes of hospitalization and compare their incidence with the same relative risk of hospitalization in the general population. Finally, diabetes complications were divided into 3 categories:

  1. traditional complications including vascular disease, renal failure, retinopathy and cataracts, neuropathy, obesity, infections traditionally linked to diabetes (eg, urinary tract infections), and procedural complications linked to well-known complications of diabetes (eg, urinary tract infections). g., amputation);
  2. emerging complications including liver disease, mental health disorders, various types of cancer (gastrointestinal, female sexual organs);
  3. infections less commonly associated with diabetes (eg, respiratory infections, sepsis).

All other diagnoses were classified as “complications not commonly recognized”.

The analysis reveals that:

  • People with diabetes are at higher risk of being hospitalized for most of these medical conditions than the general population, with a few exceptions: prostate cancer, aortic aneurysms, and wrist fractures;
  • the main cause of excess hospitalizations in men with diabetes is cellulite, followed by anxiety disorders, iron deficiency anemia and diabetes, at least twice the risk of admission for these conditions vs. in the general population;
  • the main cause of excessive hospitalizations in women with diabetes is iron deficiency anemia, followed by the traditional complications of urinary tract infections and cellulitis;
  • even among women with diabetes, high rates of excessive hospitalization are observed for lesser-known complications, such as depression, gastrointestinal disorders, and asthma; asthma hospitalizations are more than twice as likely in women with diabetes than in the general population.

Therefore, non-traditional complications, such as anemia, stress disorders, depression, and pneumonia, are among the main reasons why people with type 2 diabetes are hospitalized more often than the general population.

Complications of type 2 diabetes are changing

  • Only 4 traditional complications of diabetes (cellulitis, heart failure, urinary tract infections and skin abscesses) are today among the 10 main causes of hospitalization in diabetic patients;
  • The incidence of traditional diabetes complications, including heart attacks, strokes, and amputations, has fallen dramatically over the past 20 years due to reduced and better controlled risk factors (including blood pressure, cholesterol, smoking, and blood sugar control) and better preventive care. and Management,
  • a wide range of lesser-known complications arise, including infections (pneumonia, sepsis), mental health disorders, and gastrointestinal conditions;
  • leading causes of death and diseases such as cancer, liver disease, and mental disorders are now showing up in people with diabetes;

“These less common complications of diabetes and mental health are becoming the leading causes of hospital admissions. They cause significant burdens that sometimes exceed the most well-known complications says lead author Dr Dee Tomic of the Baker Heart and Diabetes Institute in Melbourne.

These new complications are linked to better management of the disease

Indeed, the appearance of these new complications reflects improvements in diabetes control. Diabetic patients live longer, making them vulnerable to a wider range of complications. However, the emergence of mental health disorders and infections such as sepsis and pneumonia will place an additional burden on health systems and should be factored into treatment protocols.

mental health disorders they are an emerging complication of type 2 diabetes, confirms lead author Dr. Dianna Magliano, director of diabetes and public health at Monash University, Australia. The finding of the high burden of anemia in men and women with diabetes also suggests the possibility of a biological link between diabetes and iron deficiency.

However, these conclusions, reporting observational associations rather than cause-and-effect relationships, require confirmation by a better controlled longitudinal study (excluding people with diabetes from the control group).

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