Glycemic Control and Its Complications Among Type 2 Diabetes Mellitus Patients in Tertiary Hospitals

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by persistent hyperglycemia which if inadequately controlled leads to serious microvascular and macrovascular complications. Methods: A hospital-based cross-sectional observational study was conducted at the Department of Medicine, Al Haramain Hospital, Sylhet and Ideal Clinic, Sylhet from March 2022 to February 2023. A total of 296 T2DM patients aged 30 years and above diagnosed for at least one year were considered as candidate for the study. Data on demographic variables, clinical history, laboratory parameters including HbA1c and diabetes-related complications were collected using structured questionnaires and patient records. Glycemic control was categorized as good (HbA1c <7%) or poor (HbA1c ≥7%). Statistical analyses were performed using SPSS to identify associations between glycemic control, demographic factors, and complications.  Results: Among the 296 participants, 98 (33.1%) had good glycemic control, while 198 (66.9%) had poor control. Microvascular complications were highly prevalent, affecting 62.8% of patients, with diabetic neuropathy (35.1%) being the most frequent, followed by retinopathy (29.4%) and nephropathy (24.3%). Macrovascular complications were also common, with ischemic heart disease observed in 27.8%, stroke in 10.1%, and peripheral arterial disease in 8.8%. Older age (≥60 years) and longer duration of diabetes (>10 years) were significantly associated with poor glycemic control and higher complication rates (p<0.05). No significant gender differences were found in glycemic control or complication prevalence. Conclusion: The study highlights a substantial burden of poor glycemic control and related complications among T2DM patients in this tertiary care setting.