Clinical diabetes mellitus in Pakistan.
The profile of clinical diabetes in Pakistani patients was studied by doing a retrospective analysis of 1000 patients registered in a diabetic clinic between 1972 and 1976. There was a female preponderance, and 50% of the patients were overweight. The distribution of patients in the two major types of diabetes was: juvenile, 22(2.2%), and maturity onset type, 948(94.8%); 37 patients amongst the latter group had the onset of diabetes at a younger age and 129 were underweight. In the remaining 30 patients (3%), diabetes mellitus was insulin dependent showing relative insulin resistance without any tendency to ketosis. The major complications of diabetes and associated conditions included ischaemic heart disease (8.5%), retinopathy (11%), nephropathy (8.6%), neuropathy (17.9%), hypertension (26.4%) and cataracts (16.4%). In contrast to the experience in western countries, peripheral vascular disease was rare being present in only one patient (0.1%). There were only three patients with cerebrovascular disease of which two had associated hypertension. It may be of interest to monitor the changes in the profile of diabetes in those migrating from this subcontinent to more temperate areas.