الفهرس | Only 14 pages are availabe for public view |
Abstract Type 2 diabetes mellitus (DM) is a public health concern worldwide and an important cause of morbidity and mortality. Through lifelong vascular complications, DM leads to excessive rates of myocardial infarction, stroke, renal failure, blindness and amputations. The projections of its future impact are alarming. According to the WHO, DM affects more than 170 million people worldwide, and this number will increase to 370 million by 2030 (WHO, 2004). The initial stages have been called (pre-diabetes) or (intermediate hyperglycemia), terms that includes both impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Patients with impaired glucose homeostasis are generally asymptomatic. characteristics of related risk factors for cardiovascular disease may be present, even with a mild degree of hyperglycemia. They include a history of hypertension, obesity, dyslipidemia and macro vascular disease such as stroke, coronary disease or peripheral vascular disease (Aroda and Ratner, 2008). Progression of prediabetes to diabetes may take many years, but may also be rapid. The incidence is the highest in individuals with combined IFG and IGT and similar in those with isolated IFG or IGT. Family physicians have an opportunity to identify patients at high risk for developing diabetes and institute primary prevention strategies (Capes and Anand, 2001). The general objectives of the study were to assess: prevalence of impaired fasting glucose and risk factors of IFG among studied group. The study was conducted in Family Health Unit in randomly selected rural area (Horeen) in Birket Alsaba District, Menoufia Governorate. Adult persons attending to family health unite in regular visit were the target in the study. The calculated sample size was 130 case of impaired fasting blood glucose increased to 141 out of 1255 participants, who were screened for impaired fasting blood glucose. Normal subjects for fasting blood glucose were considered as control group.Each person fulfills inclusion and exclusion criteria was met separately by the researcher. The selected person was interviewed using questionnairewith the guide of the researcher. A predesigned questionnaire was usedincluding two different parts to be filled with the subject. First part:History taking: including data as age, sex, socioeconomic standard was assessed through their education, occupation, income, number of individual per room, type of housing, material possessions, etc…..). According to (El-Gilany et al., 2011) (Appendix 2), the socioeconomic status scale has 7domains with a total score of 84. Second part: Assess diabetes risk factors for study participants. The questionnaire explored various risk factors for prediabetes and diabetes as related to personal, familial and socio-demographic factors: (eating habit,exercise, smoking, history of hypertension, hyperlipidemia, heart disease,viral hepatitis, family history of diabetes and history of medication intake such as antihypertensive drugs, corticosteroids or oral contraceptive medication). Then doing complete physical examination to the participants. Diagnosis of IFG was done by measuring of fasting blood glucose level. The present study showed that, the prevalence of impaired fasting glucose was 11.2% and the prevalence of new discovered case withdiabetes was 3.1%.In a simple logistic regression models, the age, patient education, eating fruits every day, eating vegetables every day, smoking,hypertension, presence of heart diseases, viral hepatitis, receiving antihypertensive drugs, hypertensive and obese participants who showed these characteristics were positive for impaired fasting blood glucose (P < .05). Presence of hypertensive (OR=1.911) and obese participant (OR=1.474) all these factors were associated with an increased likelihood of exhibiting impaired fasting blood glucose. Based on the obtained results from the present study, one could recommend that the family physician should be focused on the primary prevention of diabetes (by modification of modifiable risk factors as diet and weight), secondary prevention (through screening of high risk group) for early detection and proper management of patient with (IFG,blood pressure control and management of obesity) to prevent and delay occurrence of diabetes and its complications and frequent monitoring of blood glucose level. |