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Prevalent vascular complications in people with diabetes: a multicentre observational cohort study

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Background

Type 2 diabetes is a chronic metabolic disease characterized by vascular complications, the prevalence of which varies widely.

Aim

Determine the prevalence of microvascular and macrovascular complications in type-2 diabetes in North India and their correlation with various risk factors.

Design

Prospective observational study

Setting

Tertiary referral centres

Methods

A total of 6400 patients attending diabetes clinic were screened, out of which 6105 patients were enrolled during April 2018 to February 2021. Data were collected using a standardized electronic case record form. Prevalence estimates of microvascular and macrovascular complications were performed, and multivariate regression was applied for the analysis of correlation with known modifiable and non-modifiable risk factors. ROC analysis was done to find the best cut-offs for predictors of diabetic vascular complications.

Results

The mean age of the participants was 58.3 ± 9.1 years (57% males). The mean duration of diabetes was 11.3 ± 7 years and HbA1c was 8.4 ± 4%. Prevalent diabetic neuropathy was observed in 30.1%, nephropathy in 18.8% and retinopathy in 13.7%. Coronary artery disease (CAD) was prevalent in 15.7%, cerebrovascular accident (CVA) in 3.6% and foot complications in 2.9%. In the multivariate regression model, all microvascular complications significantly correlated with the longer duration of diabetes but the same was not observed for macrovascular complications. Obesity [BMI cut-off>26.4 kg/m2 (AUC 0.51, p=0.04) and waist circumference>94 cm (male) and >98 cm (female)] significantly predicted prevalent diabetic neuropathy and nephropathy. A BMI of >25.7 kg/m2 had a sensitivity of 55.2% (AUC 0.57), p<0.001 for predicting foot complications.

Conclusion

There is a strong association of obesity and longer diabetes duration with the prevalent microvascular and foot complications irrespective of the glycemic control but not for macrovascular complications.

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Acknowledgments

We thank Ms Persis and Ms Reshma for data acquisition and entry.

Funding

This study has been funded by ICMR research grant number 5/4/5-7/Diab.16-NCD-II.

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Authors and Affiliations

  1. Department of Endocrinology, PGIMER, Room no-16, Nehru Extension Block, Chandigarh , 160012, India

    Bhanu Malhotra, Priya Hiteshi, Anil Bhansali & Ashu Rastogi

  2. Department of Endocrinology, PGIMS, Rohtak, Haryana, 124001, India

    Rajesh Rajput

Authors
  1. Bhanu Malhotra
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  2. Priya Hiteshi
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  3. Rajesh Rajput
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  4. Anil Bhansali
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  5. Ashu Rastogi
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Corresponding author

Correspondence to Ashu Rastogi.

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Conflict of interest

The authors declare no competing interests.

Ethical approval

The study was approved by Institute Ethics Committee vide letter No: PGI/IEC/2014/2341 and a written informed consent was obtained from all the participants. The patients were enrolled during their routine physical appointment in the clinic.

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Malhotra, B., Hiteshi, P., Rajput, R. et al. Prevalent vascular complications in people with diabetes: a multicentre observational cohort study. Int J Diabetes Dev Ctries 42, 495–504 (2022). https://doi.org/10.1007/s13410-021-01010-x

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