Prevalence of Microvascular Complications and Associated Risk Factors among Diabetes Mellitus Patients attending Nyeri County Referral Hospital, Kenya: a cross-sectional Study

Abstract

Microvascular complications are one of the major causes of morbidity and mortality worldwide among patients with diabetes mellitus (DM). In Kenya, Nyeri County has the highest prevalence of diabetes mellitus compared to other counties. More than 50% of Nyeri County Referral Hospital (NCRH) admissions result from non-communicable diseases (NCDs) and over 55% of hospital deaths are attributable to NCDs. This study therefore sought to assess the prevalence of microvascular complications and the associated risk factors among patients attending Nyeri County Referral Hospital in Kenya. A hospital-based cross-sectional study was conducted on 314 DM patients on follow-up at NCRH from August 2022 to October 2022. The socio-demographic, anthropometric, biochemical, and clinical data were recorded using a structured survey. All the recruited patients underwent an extensive examination for the presence of Microvascular complications like neuropathy, retinopathy, and nephropathy. Data were analyzed using STATA version 17. Univariate and multivariate logistic regression analyses are used to determine the risk factors associated with Microvascular complications of DM. Among the 314 patients with DM, 58% were women. The overall prevalence of Microvascular complications (MVCs) is 36.62%. Diabetic peripheral neuropathy was the most frequent complication (27.4%), followed by retinopathy (10.8%) and nephropathy (8%). Inadequate physical exercise was a risk factor for all MVCs. Age, marital status, and level of education were risk factors for neuropathy while smoking and alcohol intake were risk factors for nephropathy. Additionally marital status was a risk factor for retinopathy. Further, the analysis revealed the risk of non-smokers getting neuropathy reduced by 98% compared to smokers (P-0.0001; CI 0.003058-0.191502). lack of regular physical exercise was significantly associated with retinopathy (P 0.012; CI 0.046816-0.690638). One in ten patients with DM had a microvascular complication. The benefits of microvascular complications prevention should thus be factored into the management of patients with diabetes mellitus.