Microvascular Complications and Their Associated Risk Factors Among Rural Type 2 Diabetic Population: A Cross-Sectional Study

To determine the factors associated with progression of microvascular complications in T2DM patients and also to investigate the relationship between glycated hemoglobin (HbA1c, %) levels and risk factors associated with microvascular complications. A cross-sectional study was conducted in the rural area of Guntur, Andhra Pradesh, India. A total of 64 subjects with the history of T2DM more than 5-year duration were included in the study. Micro-albuminuria, fundoscopy examination, and other biochemical parameters were assessed to rule out nephropathy and retinopathy. Out of the total 64 subjects, 48 (75%) were males and 16 (25%) were females. The mean age among the subjects was 57.9 ± 8.3 years. A strong association between poor glycemic control and progression of non-proliferative diabetic retinopathy (NPDR) and severely increased urinary albumin-creatinine ratio (UACR, mg/g) and diabetic nephropathy (DN) (p = 0.018, OR 3.95, and 95% CI 1.22, 12.78 and p = 0.0005, OR 6.5, and 95% CI 2.7.19.48) was observed. The level of education, annual income, and body mass index (BMI, kg/m2
) are strongly associated with the development of NPDR (p < 0.05), and annual income, hypertension, and duration of T2DM are the influencing progression of micro-albuminuria (p < 0.05). The risk of developing NPDR, DN, and poor glycemic control among hypertensives (OR 1.5, 0.6, and 0.7) are more compared to normotensives. Some risk factors were not significant. The level of education, annual income, duration of diabetes, and BMI are the major risk factors for the progression of NPDR and also poor glycemic control that provokes to microvascular complications. Interventions are needed to regulate glycemic control to prevent or reverse the further progression of these complications.