Objective
This study was aimed to evaluate prevalence of complications and factors associated with it among patients with type 2 diabetes (T2D) in the rural areas of North Iran.
Materials and methods
This was a cross-sectional, descriptive study conducted at rural areas of Golestan province, Iran. In these areas, diabetes care is provided free of cost through rural government health centers. Three hundred forty patients with T2D were included in this study by stratified random sampling method. The data was collected using a checklist from the medical records of the patients. The data were analyzed using SPSS 16 software.
Results
Of 340 participants with T2D, 100 had some form of diabetes complications (32.5%). The majority of them were female (71%) and 9% were smokers. More than 80% of patients did not exercise at least three times a week (for 150 minutes). The most common complications of diabetes were related to decreased foot sensation (13.9%), visual impairments (7.7%), heart complications (6.2%) and kidney complications (5.1%) (Fig. 1).
Advanced age, longer duration of T2D and history of smoking were associated with higher rate of diabetes complications and complications of diabetes in patients who smoke were 2.64 times higher than other patients (Tab. 1).
|
Variable |
Mean ± SD / Number |
P-value |
|
|
Patients with complications |
Patients without complications |
||
|
Age [years] |
59.8 ± 9 |
55.6 ± 10 |
0.001 |
|
Family size |
4.1 ± 1.6 |
4.5 ± 1.8 |
0.072 |
|
Duration of the disease [years] |
8.5 ± 6 |
7 ±5 |
0.048 |
|
Glycated hemoglobin [%] |
7.9 ± 1.6 |
8.1 ± 1.8 |
0.340 |
|
Body mass index [kg/m²] |
29.2 ± 7 |
29.2 ± 5 |
0.944 |
|
Low-density lipoprotein [mg/dL] |
106 ± 37 |
99.4 ± 35 |
0.140 |
|
Sex |
0.233 |
||
|
Male |
33 |
55 |
|
|
Female |
67 |
153 |
|
|
Smoking (cigarettes, drugs) |
0.002 |
||
|
Yes |
16 |
13 |
|
|
No |
84 |
195 |
|
Discussion
Similar to studies from around the world, our study found higher prevalence of diabetes complications in rural Iran [1, 2]. Age, diabetes duration and smoking were associated with increasing rate of diabetes complications.
Our study calls have important clinical implications. Patient education, improving the quality of care, adherence of government diabetes program and optimal glycemic control may help to lower complications among people with T2D in rural Iran.
Our study has many limitations. Cross-sectional design, small sample size and collection of data from records are major limiting factors. Generalization of our findings are also limited.
Funding
This study received no financial support.
Acknowledgements
The research team of this study would like to thank Golestan University of Medical Sciences and all the study participants for their sincere cooperation.
Conflict of interest
None declared.