Prevalence, determinants and microvascular complications of type 2 diabetes mellitus among elderly population of Kathmandu, Nepal

Abstract

Background: 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. There is little known about prevalence of Type 2 DM and its complications among elderly. 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 them among elderly population of Kathmandu, Nepal. Methods: Cross sectional study was conducted among 306 participants above age 60 from urban and rural areas of Kathmandu district. Firstly home visits were conducted, where structured questionnaire was used to collect information from the participants. Anthropometric measurements, blood pressure and fasting blood glucose test was done using standard medical tools. Those who were identified as diabetic during home visits were invited to a health camp later, where detailed physical examination, was done for detecting microvascular complications. Data Analysis was done using binary logistic regression with statistical significance of each analysis against the p value of 0.05. Results: Prevalence of Type 2 DM in this study was 23.5% which is similar to the findings of previous studies in Kathmandu. Among all cases of Type 2 DM 26.3% were the new cases diagnosed during survey and 43.1% have one or more of the 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 significantly positively associated with presence of Type 2 DM. Likewise, Above Normal waist circumference and DM Duration were significantly positively associated with microvascular complications of Type 2 DM. Whereas, Healthy Diet was negatively associated with microvascular complications. Conclusions: Prevalence of Type 2 DM and its microvascular complication is high in Kathmandu, along with undetected cases of Type 2 DM. The burden of DM and its microvascular complications calls the attention of the policy makers to devise some strategy to increase access to health care facilities. Health education and cost effective preventive interventions must be promoted to prevent the rising trend of Type 2 DM.