Prevalence of Microvascular Complications and Associated Risk Factors among Diabetes Mellitus Patients Attending Nyeri County Referral Hospital, Kenya

Abstract

Diabetes mellitus and its associated microvascular complications is a public health concern globally. In Kenya, Nyeri County has the highest prevalence of DM compared to other counties. More than 50% of admissions to Nyeri County Referral Hospital are the result of Non-communicable Diseases (NCDs), and over 55% of hospital deaths are attributable to NCDs.This study assessed the prevalence of diabetes microvascular complications and associated risk factors among diabetes mellitus patients attending Nyeri County Referral Hospital. A hospital-based cross-sectional study design was conducted among 314 adult patients attending NCRH from August to October 2022. All the recruited patients underwent an extensive examination for the presence of microvascular complications, i.e, neuropathy, retinopathy, and nephropathy. A semi-structured interviewer-administered questionnaire was used to collect data on factors associated with Diabetic peripheral neuropathy, retinopathy, and nephropathy. Data was analyzed using STATA version 17. Descriptive analysis was performed, and the associations between the complications and risk factors were tested using chi-square statistics. Variables with significant associations at univariate analysis were subjected to binomial logistic regression. Differences between parameter estimates were deemed statistically significant at p<0.05. More than half of the respondents, 159(50.6%), were recruited from the diabetes clinic (DM), while the rest were from the diabetes outpatient clinic (DOPC). The cumulative diabetes microvascular complications were 36.62%. The prevalence of diabetes neuropathy, retinopathy, and nephropathy was 27.4%, 10.8%, and 8%, respectively. MVCs were more commonly seen in the diabetes outpatient clinic compared to patients seen in the diabetes clinic. Inadequate physical exercise was a risk factor for all MVCs. The odds for non-smokers getting nephropathy are reduced by 98% ( OR=0.02, 95% CI 0.002549-0.145117, P-0.0001). Analysis also revealed that the risk of diabetic Retinopathy was reduced by 86% in those who exercise 2-3 times a week compared to those who exercise ( OR= 0.18; 95% CI 0.046816-0.690638, P 0.012). daily . Lastly, there is a significant correlation between eating plans and physical exercise with all forms of MVCs.This study illustrates the presence of a major burden of diabetes microvascular complications. It also indicated that the diabetes-related self-care activities were directly linked with diabetes microvascular complications.