Prevalence of Certain Chronic Complications of Diabetes among Type 2 Diabetic Patients in Rural Population of Kancheepuram District, Tamil Nadu- A Cross Sectional Study

Abstract

Background: Nearly 50% of diabetics in India are undiagnosed and that the newly diagnosed diabetes patients are often found to have signs of complications. Objectives: To estimate the prevalence of diabetic complications, other than retinopathy and peripheral vascular disease, among known diabetic patients treated at healthcare centers in Kancheepuram district of Tamil Nadu; and to analyze the associations between chronic complications and patient’s demographics, T2DM characteristics. Methodology: A cross sectional study was carried out in sixteen out of fifty six health care centers in Kancheepuram district in Tamil Nadu by cluster sampling method using the semi-structured questionnaire, with medical record, physical examination and biochemical investigation to identify chronic kidney disease and co-morbid conditions of type 2 diabetes. A Disability Neuropathy Score (DNS) of more than zero and negative monofilament/vibration tests were used to classify patients as having signs of peripheral neuropathy. Results: Prevalence of Ischemic heart disease and stroke were 7.8% and 0.5% respectively. Prevalence of stage I kidney disease based on the KDOQI guidelines using the estimated GFR and urine PCR values was 30.7% , while chronic kidney disease (i.e., stage II or III or PCR>0.2) was seen in 10.4% patients. Based on the DNS scoring chart 59% of them had peripheral neuropathy while 19% of them had signs of peripheral neuropathy. Participants with at least one chronic complication of diabetes (excluding retinopathy) were 32.8 percent. Prevalence of hypertension was 61.4%. and Hyperlipidemia was 85.9% ,while high LDL, TGL was seen with 60.9% and 64.6% respectively, low HDL among 83.9 % of patient. Conclusion: The high prevalence of undiagnosed microvascular complications in known diabetics treated at primary care emphasis a strong need for routine screening for complications of diabetes and to create awareness on its early detection and prevention of progression.