TOPLINE:

Patients with type 2 diabetes (T2D) in Nepal carried a substantial burden of both microvascular and macrovascular comorbidities, with nephropathy being the most common, followed by hypertension, cardiac problems, retinopathy, and neuropathy. Poor dietary adherence, lower education levels, longer diabetes duration, and inadequate glycemic control emerged as key determinants of these comorbidities.

METHODOLOGY:

• T2D is frequently accompanied by comorbidities that worsen outcomes, and understanding their epidemiology is essential for developing integrated approaches for diabetes care in low- and middle-income countries such as Nepal.
• Researchers conducted a cross-sectional study to determine the prevalence of and factors associated with common comorbidities among 492 patients with T2D in Nepal.
• Participants were diagnosed on the basis of a fasting plasma glucose level ≥ 126 mg/dL or a 2-hour plasma glucose level ≥ 200 mg/dL following a 75-g oral glucose load and were required to be permanent residents of rural and urban municipalities.
• Data were collected via in-person interviews from June 2023 to March 2024 using structured questionnaires that captured sociodemographic characteristics, diabetes history, self-reported symptoms, and comorbid conditions.
• Outcomes of interest were diabetes-related comorbidities (hypertension, nephropathy, neuropathy, retinopathy, and cardiac problems) documented based on patients’ self-reports and subsequently verified using physician prescriptions and clinical records.

TAKEAWAY:

• Overall, 92.1% of patients had at least one comorbidity. Nephropathy was the most common (40.1%), followed by hypertension (25.4%), cardiac problems (21.1%), retinopathy (18.5%), and neuropathy (9.8%); 68.3% had one comorbidity, and 23.8% had two comorbidities.
• The odds of hypertension were higher in men than in women (adjusted odds ratio [aOR], 1.73) and in those with poor adherence to dietitian-recommended plans (aOR, 2.04); cardiac comorbidities were more common in participants with lower vs higher education levels and in retirees vs business professionals.
• Diabetic nephropathy was strongly linked to poor glycemic control (aOR, 2.22) and younger age, particularly 35-50 years (aOR, 14.29); by contrast, younger age (35-50 years) was associated with lower odds of retinopathy (aOR, 0.31).
• Neuropathy was more common in patients with normal BMI than in those with obesity (aOR, 4.44) and in those with T2D duration of longer than 6 years.

IN PRACTICE:

“Addressing modifiable factors such as dietary adherence and glycemic control could substantially reduce comorbidity rates and improve patient outcomes. Meanwhile, targeted interventions focusing on education, early screening, and personalized care for high-risk groups are crucial to effectively managing and preventing diabetes-related comorbidities,” the authors of the study wrote.

SOURCE:

The study was led by Nitendra Kumar Chaurasia, Health Research Group, University of Rajshahi, Rajshahi, Bangladesh. It was published online in BMC Endocrine Disorders.

LIMITATIONS:

The cross-sectional design of the study prevented establishing causal relationships between the identified risk factors and comorbidity outcomes. Additionally, the use of snowball sampling may have introduced selection bias, and recall and reporting biases could have arisen from the use of self-reported data.

DISCLOSURES:

The authors reported receiving no financial support or grants for this research and disclosed having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.