Prevalence Of, And Factors Associated With, Type 2 Diabetes And Its Microvascular Complications Among The Elderly In Kathmandu, Nepal

Abstract

Diabetes mellitus (DM) has caused global pandemic which principally involves type 2 DM. DM can cause several complications including microvascular complications, that impose a tremendous burden on the individual and on the health care system. The main purpose of this study was to determine the prevalence of type 2 DM and its microvascular complications, and to identify factors associated with these, among the elderly population of Kathmandu, Nepal. A cross-sectional study was conducted among 306 participants aged 60 years and above at Kathmandu district. Firstly, home visits were conducted, where a structured questionnaire was administered by the interviewer. Anthropometric measurements, blood pressure and fasting blood glucose test were done using standard medical tools. Those who were identified as diabetic during home visits were invited to a health camp later, where a detailed physical examination was done to detect microvascular complications. Associations of independent variables with presence of type 2 DM, and of microvascular complications, were assessed in bivariate analysis with binary logistic regression. The study reveals that prevalence of type 2 DM in this study was 23.5% and among all cases of type 2 DM 26.3% were the new cases diagnosed during survey and 43.1% had one or more microvascular complications. Inadequate physical activity, unhealthy diet, frequent visit to fast food centers, family history of type 2 DM, presence of hypertension and history of gestational diabetes mellitus were statistically significantly positively associated with presence of type 2 DM. Above normal waist circumference and DM duration were significantly positively associated with microvascular complications of type 2 DM, as compared to DM without such complications. In conclusion, the prevalence of type 2 DM and its microvascular complication was high in Kathmandu. The burden of undetected cases was also high. This warrants mass screening for diagnosing diabetes. The burden of microvascular complications should also alert olicy makers to devise some strategy to increase access to health care facilities. Health education and cost effective preventive interventions should be promoted on a mass scale in order to prevent the rising trend of type 2 DM.