Prevalence of microvascular complications in Diabetes Mellitus patients attending a Nephrology outpatient department at a tertiary care hospital in Bangladesh

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Abstract

Background

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with a rising global prevalence and represents a significant public health challenge. Persistent hyperglycemia in T2DM is closely linked to the development of microvascular complications.

Objective

To assess the prevalence of microvascular complications — namely diabetic nephropathy, retinopathy, and neuropathy—among patients with type 2 diabetes mellitus attending the nephrology outpatient department of a tertiary care hospital.

Method

This hospital-based cross-sectional study was carried out at Bangladesh Medical University, Dhaka, and included 283 confirmed cases of type 2 diabetes mellitus in patients aged 20 years and above. Participants were selected consecutively from the outpatient departments. Microvascular complications were identified using clinical assessments and diagnostic investigations.

Results

Of the 283 patients with type 2 diabetes mellitus, 66.4% ( n = 188) had at least one microvascular complication. Diabetic neuropathy was the most prevalent, affecting 49.8% of patients, followed by diabetic retinopathy in 38.2% — with 19.1% of these cases showing proliferative changes. Diabetic foot was identified in 24.7% of patients. A significantly higher prevalence of microvascular complications was seen among patients with a longer duration of diabetes ( p = 0.002), coexisting hypertension ( p = 0.005), and more advanced stages of chronic kidney disease ( p = 0.003). Biochemical analyses showed that patients with microvascular complications had higher mean serum creatinine levels (3.68 ± 2.35 mg / dL vs. 2.57 ± 1.41 mg / dL ; p < 0.001) and lower eGFR values (23.40 ± 14.11 vs. 31.22 ± 14.35 mL / min /1.73 m 2 ; p < 0.001) compared to those without complications. No statistically significant associations were found with age, gender, BMI, family history of diabetes, lipid profile, fasting blood glucose, or HbA1c levels.

Conclusion

Microvascular complications are common among type 2 diabetes patients in the nephrology outpatient setting, with neuropathy being most frequent. Their strong links to longer disease duration, hypertension, and worsening kidney function highlight the need for early screening and integrated management to slow progression and improve outcomes.

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