Background: Diabetes mellitus (DM) has become a global public health challenge. The increasing urbanisation and the significant lifestyle changes have resulted in an unprecedented rise in the rates of type 2 DM and, consequently, its microvascular complications which are the major outcome of the disease. It is the low- and middle-income countries where 80% of the diabetic patients live that face the greatest burden of the disease. Study Objectives: Our primary objective was to estimate the frequency of microvascular complications among patients diagnosed with type 2 DM. Our secondary objective was to investigate the relationship between the microvascular outcomes and the different characteristics and potential variables among patients with type 2 DM. Methodology: An observational descriptive clinic-based cross-sectional survey was conducted to calculate the prevalence of microvascular complications of type 2 DM and the associated risk factors in a lower middle-income country, Sudan. The study was carried out at Shambat Primary Healthcare Clinic during the period between May and June 2018. All patients aged 20 years and above visiting the clinic were included. Patients excluded from selection were those on steroid therapy and those having bilateral eye cataract. A total of 209 patients constituted the sample and were selected through systemic random sampling. Statistical analysis was carried out using SPSS software version 21. For the continuous variables, the mean was used as a measure of central tendency and the standard deviation as a measure of dispersion. The associations between the microvascular complications and the other variables were analysed using the χ2 test. The p value was used as a test for statistical significance. Results: The response rate to the survey was 72.6%. The age of the enrolled subjects ranged from 24 to 88 years. Males constituted 61.7% of the study sample and females 38.3%. The mean body mass index (BMI) was 26.92 ± 2.06. Out of 209 patients known to have type 2 DM, 96 (45.9%) developed any of the microvascular complications. Nephropathy was the most frequent with a prevalence of 38.8%, followed by retinopathy and neuropathy with a frequency of 23.9 and 22.5%, respectively. The presence of other co-morbidities, namely hypertension, ischaemic heart disease, chronic kidney disease and dyslipidaemia, was a predictor for the occurrence of the small-vessel conditions. Conclusions: This study is probably the first of its kind to shed light on the magnitude of the microvascular complications of DM in Sudan. The yielded results reveal a significant burden caused by microvascular complications in the country. The concurrent presence of other chronic medical disorders, namely hypertension, ischaemic heart disease, chronic kidney disease and dyslipidaemia, amplifies the risk for the development of microvascular sequelae. The mean BMI of the sample reflects an overweight trend. Facing the high tide of the metabolic syndrome and its sequelae requires a holistic perspective and a multidisciplinary approach. The health authorities and other stakeholders need to prioritise healthcare expenditure and invest more in DM research. A national diabetes registry will serve as a key player in guiding the efforts.

中文翻译：

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在苏丹初级保健中心就诊的 2 型糖尿病患者微血管并发症的患病率

背景：糖尿病（DM）已成为全球公共卫生挑战。城市化进程的加快和生活方式的显着改变导致 2 型 DM 的发病率空前上升，因此，其微血管并发症也是该疾病的主要结果。80% 的糖尿病患者生活在低收入和中等收入国家，面临着最大的疾病负担。研究目标：我们的主要目标是估计诊断为 2 型 DM 的患者中微血管并发症的频率。我们的次要目标是调查微血管结局与 2 型 DM 患者的不同特征和潜在变量之间的关系。方法：进行了一项基于观察性描述性诊所的横断面调查，以计算中低收入国家苏丹 2 型 DM 微血管并发症的患病率和相关危险因素。该研究于 2018 年 5 月至 6 月期间在 Shambat 初级保健诊所进行。 包括所有 20 岁及以上就诊的患者。排除在选择之外的患者是接受类固醇治疗的患者和患有双侧眼白内障的患者。共 209 名患者构成样本，并通过系统随机抽样选择。使用SPSS软件21版进行统计分析。对于连续变量，使用平均值作为集中趋势的量度，标准差作为离散度的量度。使用 χ2 检验分析微血管并发症与其他变量之间的关联。p值用作统计显着性的检验。结果：调查的回应率为 72.6%。入选受试者的年龄范围为 24 至 88 岁。男性占研究样本的 61.7%，女性占 38.3%。平均体重指数 (BMI) 为 26.92 ± 2.06。在已知患有 2 型糖尿病的 209 名患者中，96 名 (45.9%) 出现了任何微血管并发症。肾病最常见，患病率为 38.8%，其次是视网膜病和神经病，分别为 23.9% 和 22.5%。其他合并症的存在，即高血压、缺血性心脏病、慢性肾病和血脂异常，是小血管疾病发生的预测因素。结论：这项研究可能是首次阐明苏丹 DM 微血管并发症的严重程度。结果表明，该国微血管并发症造成了重大负担。同时存在其他慢性疾病，即高血压、缺血性心脏病、慢性肾病和血脂异常，增加了发生微血管后遗症的风险。样本的平均 BMI 反映了超重趋势。面对代谢综合征及其后遗症的高潮，需要一个整体的视角和多学科的方法。卫生当局和其他利益相关者需要优先考虑医疗保健支出并加大对糖尿病研究的投资。国家糖尿病登记处将作为指导工作的关键参与者。这项研究可能是首次阐明苏丹 DM 微血管并发症的严重程度。结果表明，该国微血管并发症造成了重大负担。同时存在其他慢性疾病，即高血压、缺血性心脏病、慢性肾病和血脂异常，增加了发生微血管后遗症的风险。样本的平均 BMI 反映了超重趋势。面对代谢综合征及其后遗症的高潮，需要一个整体的视角和多学科的方法。卫生当局和其他利益相关者需要优先考虑医疗保健支出，并在 DM 研究上投入更多资金。国家糖尿病登记处将作为指导工作的关键参与者。这项研究可能是首次阐明苏丹 DM 微血管并发症的严重程度。结果表明，该国微血管并发症造成了重大负担。同时存在其他慢性疾病，即高血压、缺血性心脏病、慢性肾病和血脂异常，增加了发生微血管后遗症的风险。样本的平均 BMI 反映了超重趋势。面对代谢综合征及其后遗症的高潮，需要一个整体的视角和多学科的方法。卫生当局和其他利益相关者需要优先考虑医疗保健支出，并在 DM 研究上投入更多资金。国家糖尿病登记处将作为指导工作的关键参与者。