Asthenia in Patients with Type 2 Diabetes Mellitus in Real-Time Clinical Practice

Aim. To study the incidence and risk factors associated with asthenia in patients with type 2 diabetes mellitus (DM2) in real-time clinical practice.

Design. Cross-sectional clinical study.

Materials and methods. 2373 patients were examined for symptoms of asthenia in outpatient settings; these patients were followed up by primary care physician therapeutics for chronic non-communicable diseases (CNCD). A group of DM2 patients (n = 527) was separated from this cohort.

All patients were interviewed; their medical information was collected; their systems and organs were examined; and medical records were reviewed. A diagnosis of CNCD was confirmed on the basis of results and current clinical recommendations. Asthenia and its intensity were identified using the Multidimensional Fatigue Inventory 20 (MFI-20) and Fatigue Severity Scale (FSS).

Results. The incidence of asthenia in DM2 patients was 38.52 % (n = 203) on MFI-20 and 26.76 % (n = 141) on FSS. The most common disorders on MFI-20 were: General Asthenia (20.11 %; n = 106), Physical Asthenia (16.13 %; n = 85) and Hypoactivity (13.09 %; n = 69). Presence of symptoms of asthenia in DM2 patients was associated with elderly age (60.0 (48.0; 68.0) vs. 53.0 (45.0; 64.0) years old in patients without asthenia; р < 0.0001) and multimorbidity: a history of acute myocardial infarction was observed in 7.88 % of patients with asthenia vs. 0.62 % of patients without asthenia (p < 0.00001), acute cerebrovascular accident — 5.91 % vs. 0.31 % (p < 0.0001), malignancies — 15.76 % vs. 1.54 % (p < 0.000001). DM2 patients with symptoms of asthenia were more often smokers vs. patients without asthenia (30.05 % and 20.68 %, respectively; p < 0.05), monitored their blood pressure regularly (65.02 % and 49.07 %; p < 0.001), took antihypertensives (45.32 % and 25.00 %; p < 0.00001) and statins regularly (34.48 % and 15.74 %; p < 0.00001).

Conclusion. Asthenia is common in DM2 patients seeking outpatient medical assistance. Age-associated multimorbidity requiring longterm sophisticated treatment strategies and constant control of a number of parameters is probably one of the causes of asthenia in this patient category.

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