64-PUB: Risk of Complications in Type 2 Diabetes Mellitus with Increase in Disease Duration—A Report of Real-World Data of Indian Population

Introduction: T2DM is a progressive disease characterized by worsening of not only β cell function but also an increased risk of complications with time.

Methods: In this real world single center study we did a cross sectional analysis of patients to evaluate common markers of diabetes complications based on the duration of diabetes (DoD). Total 3330 patients were identified who had sufficient information to qualify for the study. Patients were categorized as duration of <1; 1 - <5; 5 - 10 and >10 years of diabetes (self-reported). BMI, waist circumference (WC), HbA1C, eGFR, UACR, FIB4 score and NT proBNP were collected.

Results: In 3330 T2DM patients, male and female were 1762 (53%) and 1568 (47%). Mean DoD was 7.6 years, age 45 years, HbA1c 8.3%, BMI 27.6 Kg/m², WC 97.6 cms, NT proBNP 153 pg/mL and FIB4 1.34, eGFR 91 mL/min/1.73m². A progressive increase in mean HbA1c 7.8% to 8.7%, NT proBNP 117 to 220 pg/mL, FIB4 score 1.15 to 1.48 and WC 97.9 to 97.2 cms for duration < 1 to >10 years was noted. eGFR declined from 94 to 86 mL/min/1.73m² over same duration. Oral medication differed significantly from 70% to 41%, while injectable increased from 30% to 59%. Similarly, NT ProBNP (n=275), risk of heart failure increased from 37% to 45%; FIB4 score (n=802), at indeterminant and high risk of NAFLD significantly increased (p<0.01) from 29% to 38% and 2% to 9%, respectively. eGFR level (n=1134) at mild to moderate and severe risk significantly increased from 44% to 53% and 2% to 20%, respectively.

Conclusion: Our study documents the duration associated decline in various markers of diabetes complications from a single center in India. Of note, this is one of the first studies to document the effect of duration on FIB4, NT proBNP and eGFR from this part of the world. An arbitrary 10-year mark seems to segregate significant deterioration of functional markers when compared to those with early disease. The effects of medication on delaying the progression of complications need to be considered in further analysis.