Chin-Hsiao Tseng
Department of Internal Medicine,
National Taiwan University Hospital, Taipei,
Taiwan
Chin-Hsiao Tseng
Department of Internal Medicine,
National Taiwan University Hospital, Taipei,
Taiwan
| Diabetes mellitus is one of the major risk factors for atherosclerosis. A series of atherosclerosis-related studies carried out in diabetic patients in Taiwan are reviewed. In a 4-year follow-up stduy of 479 patients with non-insulin-dependent diabetes mellitus (NIDDM) aged 40 years or over in northern Taiwan, the annual cumulative incidence rates for ischemic heart disease, stroke, and leg vascular disease were 5.5%, 1.0%, and 0.4%, respectively. The most significant risk factor associated with the development of any of these vascular diseases was cholesterol level. The prevalence of hypertension in NIDDM was about 30% to 36%, which was about two times higher than the general population. Hypertension in NIDDM was associated with diabetic duration, body mass index, insulin treatment, insulin level, and uric acid. The presence of retinopathy, proteinuria, peripheral vascular disease (PVD) and ischemic heart disease was associated with hypertension in NIDDM. Cigarette smoking and hypertension were major risk factors for peripheral vascular disease in NIDDM. In a study following the survival status of diabetic amputees, the presence of ischemic heart disease and hypertension at the time of amputation was associated with poor prognosis. Cerebral infarction and infection were found to be the major causes of mortality after lower-extremity amputations in diabetic patients. In order to prevent macrovascular complications in the diabetic patients, it is important to control risk factors such as hypertension, hypercholesterolemia, and cigarette smoking. (J Intern Med Taiwan 1999;10:93-98) |