Abstract
Background
Patients with type 2 diabetes mellitus (T2D) have an increased risk of vascular complications. Despite the rise in the prevalence of T2D and its complications throughout the globe, there is a paucity of data regarding the prevalence and determinants of vascular complications of T2D in Ethiopia. Hence, this study aimed to assess the prevalence, patterns, and determinants of the microvascular and macrovascular complications of T2D among patients attending a teaching hospital in Addis Ababa, Ethiopia.
Methods
A hospital-based cross-sectional study was done by reviewing the electronic medical records of adult patients with T2D attending the general medical and endocrine referral clinics of Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia. SPSS version 25 was used to analyze the data. Descriptive analysis was used to summarize the data on the sociodemographic characteristics, clinical profiles, laboratory investigations, and patterns of vascular complications. Bivariate and multivariate logistic regression models were fitted, and the crude odds ratio (COR) and adjusted odds ratio (AOR), together with the 95% confidence interval (CI), were computed to identify the determinants of vascular complications of T2D.
Results
A total of 272 patients with T2D were included in this study; 50.5% were females, and the mean age was 56.34 ± 12.8 years. The mean glycated hemoglobin (HbA1c) was 7.75 ± 1.91%, and only 48.5% had good glycemic control with a target HbA1c value of < 7%. The majority of patients (62.5%) had diabetes for ≥ 5 years. The overall prevalence of vascular complications was 39%. Microvascular and macrovascular complications were observed in 23.5% and 21% of the patients, respectively. The determinants of microvascular complications were age ≥ 60 years (AOR = 2.25, 95% CI: 1.17, 4.33), diabetes duration of ≥ 5 years (5–10 years [AOR = 3.13, 95% CI: 1.37, 7.18], and > 10 years [AOR = 3.88, 95% CI: 1.66, 9.06], and HbA1c ≥ 7% (AOR = 2.21, 95% CI: 1.14, 4.28). The odds of developing macrovascular complications were higher with diabetes duration of ≥ 5 to 10 years (AOR = 2.89, 95% CI: 1.37, 6.12) as compared with diabetes duration of < 5 years.
Conclusions
This study demonstrated a high prevalence of vascular complications in patients with T2D. Older age, prolonged duration of diabetes, and poor glycemic control were the determinants for the development of microvascular complications, while prolonged duration of diabetes was the determining factor for the development of macrovascular complications. Hence, targeted initiatives are required to enhance the prevention and early detection of vascular complications of T2D in resource-limited countries such as Ethiopia.