Prevalence of microvascular complications in Diabetes Mellitus patients attending a Nephrology outpatient department at a tertiary care hospital in Bangladesh

Prevalence of microvascular complications in Diabetes Mellitus patients attending a Nephrology outpatient department at a tertiary care hospital in Bangladesh | medRxiv /* */ /* */ <!-- <!-- /*! * yepnope1.5.4 * (c) WTFPL, GPLv2 */ (function(a,b,c){function d(a){return"[object Function]"==o.call(a)}function e(a){return"string"==typeof a}function f(){}function g(a){return!a||"loaded"==a||"complete"==a||"uninitialized"==a}function h(){var a=p.shift();q=1,a?a.t?m(function(){("c"==a.t?B.injectCss:B.injectJs)(a.s,0,a.a,a.x,a.e,1)},0):(a(),h()):q=0}function i(a,c,d,e,f,i,j){function k(b){if(!o&&g(l.readyState)&&(u.r=o=1,!q&&h(),l.onload=l.onreadystatechange=null,b)){"img"!=a&&m(function(){t.removeChild(l)},50);for(var d in y[c])y[c].hasOwnProperty(d)&&y[c][d].onload()}}var j=j||B.errorTimeout,l=b.createElement(a),o=0,r=0,u={t:d,s:c,e:f,a:i,x:j};1===y[c]&&(r=1,y[c]=[]),"object"==a?l.data=c:(l.src=c,l.type=a),l.width=l.height="0",l.onerror=l.onload=l.onreadystatechange=function(){k.call(this,r)},p.splice(e,0,u),"img"!=a&&(r||2===y[c]?(t.insertBefore(l,s?null:n),m(k,j)):y[c].push(l))}function j(a,b,c,d,f){return q=0,b=b||"j",e(a)?i("c"==b?v:u,a,b,this.i++,c,d,f):(p.splice(this.i++,0,a),1==p.length&&h()),this}function k(){var a=B;return a.loader={load:j,i:0},a}var l=b.documentElement,m=a.setTimeout,n=b.getElementsByTagName("script")[0],o={}.toString,p=[],q=0,r="MozAppearance"in l.style,s=r&&!!b.createRange().compareNode,t=s?l:n.parentNode,l=a.opera&&"[object Opera]"==o.call(a.opera),l=!!b.attachEvent&&!l,u=r?"object":l?"script":"img",v=l?"script":u,w=Array.isArray||function(a){return"[object Array]"==o.call(a)},x=[],y={},z={timeout:function(a,b){return b.length&&(a.timeout=b[0]),a}},A,B;B=function(a){function b(a){var a=a.split("!"),b=x.length,c=a.pop(),d=a.length,c={url:c,origUrl:c,prefixes:a},e,f,g;for(f=0;f<d;f++)g=a[f].split("="),(e=z[g.shift()])&&(c=e(c,g));for(f=0;f<b;f++)c=x[f](c);return c}function g(a,e,f,g,h){var i=b(a),j=i.autoCallback;i.url.split(".").pop().split("?").shift(),i.bypass||(e&&(e=d(e)?e:e[a]||e[g]||e[a.split("/").pop().split("?")[0]]),i.instead?i.instead(a,e,f,g,h):(y[i.url]?i.noexec=!0:y[i.url]=1,f.load(i.url,i.forceCSS||!i.forceJS&&"css"==i.url.split(".").pop().split("?").shift()?"c":c,i.noexec,i.attrs,i.timeout),(d(e)||d(j))&&f.load(function(){k(),e&&e(i.origUrl,h,g),j&&j(i.origUrl,h,g),y[i.url]=2})))}function h(a,b){function c(a,c){if(a){if(e(a))c||(j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}),g(a,j,b,0,h);else if(Object(a)===a)for(n in m=function(){var b=0,c;for(c in a)a.hasOwnProperty(c)&&b++;return b}(),a)a.hasOwnProperty(n)&&(!c&&!--m&&(d(j)?j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}:j[n]=function(a){return function(){var b=[].slice.call(arguments);a&&a.apply(this,b),l()}}(k[n])),g(a[n],j,b,n,h))}else!c&&l()}var h=!!a.test,i=a.load||a.both,j=a.callback||f,k=j,l=a.complete||f,m,n;c(h?a.yep:a.nope,!!i),i&&c(i)}var i,j,l=this.yepnope.loader;if(e(a))g(a,0,l,0);else if(w(a))for(i=0;i (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0];var j=d.createElement(s);var dl=l!='dataLayer'?'&l='+l:'';j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;j.type='text/javascript';j.async=true;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-P4HH5NV'); Skip to main content Home About Submit ALERTS / RSS Search for this keyword Advanced Search Prevalence of microvascular complications in Diabetes Mellitus patients attending a Nephrology outpatient department at a tertiary care hospital in Bangladesh Ferdous Jahan , View ORCID Profile Mohammed Anwer , Mohammad Rezaul Alam doi: https://doi.org/10.1101/2025.08.12.25333485 Ferdous Jahan 1 Department of Nephrology, Bangladesh Medical University Find this author on Google Scholar Find this author on PubMed Search for this author on this site Mohammed Anwer 2 Department of Physical Sciences, Independent University , Bangladesh Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Mohammed Anwer For correspondence: manwer{at}iub.edu.bd Mohammad Rezaul Alam 1 Department of Nephrology, Bangladesh Medical University Find this author on Google Scholar Find this author on PubMed Search for this author on this site Abstract Full Text Info/History Metrics Data/Code Preview PDF Abstract Background Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with a rising global prevalence and represents a significant public health challenge. Persistent hyperglycemia in T2DM is closely linked to the development of microvascular complications. Objective To assess the prevalence of microvascular complications — namely diabetic nephropathy, retinopathy, and neuropathy—among patients with type 2 diabetes mellitus attending the nephrology outpatient department of a tertiary care hospital. Method This hospital-based cross-sectional study was carried out at Bangladesh Medical University, Dhaka, and included 283 confirmed cases of type 2 diabetes mellitus in patients aged 20 years and above. Participants were selected consecutively from the outpatient departments. Microvascular complications were identified using clinical assessments and diagnostic investigations. Results Of the 283 patients with type 2 diabetes mellitus, 66.4% ( n = 188) had at least one microvascular complication. Diabetic neuropathy was the most prevalent, affecting 49.8% of patients, followed by diabetic retinopathy in 38.2% — with 19.1% of these cases showing proliferative changes. Diabetic foot was identified in 24.7% of patients. A significantly higher prevalence of microvascular complications was seen among patients with a longer duration of diabetes ( p = 0.002), coexisting hypertension ( p = 0.005), and more advanced stages of chronic kidney disease ( p = 0.003). Biochemical analyses showed that patients with microvascular complications had higher mean serum creatinine levels (3.68 ± 2.35 mg / dL vs. 2.57 ± 1.41 mg / dL ; p < 0.001) and lower eGFR values (23.40 ± 14.11 vs. 31.22 ± 14.35 mL / min /1.73 m 2 ; p < 0.001) compared to those without complications. No statistically significant associations were found with age, gender, BMI, family history of diabetes, lipid profile, fasting blood glucose, or HbA1c levels. Conclusion Microvascular complications are common among type 2 diabetes patients in the nephrology outpatient setting, with neuropathy being most frequent. Their strong links to longer disease duration, hypertension, and worsening kidney function highlight the need for early screening and integrated management to slow progression and improve outcomes. Introduction Diabetes mellitus (DM) is one of the most prevalent non-communicable diseases globally, with an estimated 537 million adults affected in 2021 — a number projected to rise to 783 million by 2045 ( 1 , 2 ). Type 2 diabetes mellitus (T2DM), a chronic metabolic condition marked by insulin resistance and sustained hyperglycemia, progressively damages multiple organ systems, particularly small blood vessels ( 3 ). T2DM represents a growing global health challenge, largely due to its strong association with microvascular complications such as diabetic nephropathy, retinopathy, and neuropathy ( 3 ). These complications are primarily driven by prolonged metabolic and hemodynamic disturbances that induce oxidative stress, inflammation, and endothelial dysfunction ( 4 ). Diabetes-related complications are generally classified as microvascular or macrovascular ( 5 ). Among these, microvascular complications — retinopathy, nephropathy, and neuropathy — are especially common and debilitating outcomes of chronic hyperglycemia, leading to capillary and small vessel damage ( 4 ). In the United States, a comprehensive study conducted from 1988 to 2014 identified diabetic nephropathy as the leading cause of end-stage renal disease (ESRD), significantly burdening nephrology services ( 6 , 7 ). Diabetic retinopathy continues to be a major cause of preventable blindness worldwide ( 8 , 9 ). Diabetic neuropathy affects up to 50% of individuals with longstanding diabetes and may present as peripheral, autonomic, or focal nerve dysfunction, severely impacting quality of life ( 10 ). It is also a major factor in the development of diabetic foot ulcers ( 11 , 12 ) and lower limb amputations ( 13 , 14 ). The burden of T2DM complications places substantial strain on global healthcare systems. However, the prevalence and presentation of these complications vary across regions, influenced by disparities in healthcare access, socioeconomic conditions, and control of risk factors. A multinational study involving approximately 16,000 patients from 38 countries across six regions examined the patterns of vascular complications associated with T2DM ( 15 ). A summary of the findings is presented in Table 1 . View this table: View inline View popup Download powerpoint Table 1. Summary of some results from ( 33 ) It is quite evident that there is a wide variation in the regional dependency of microvascular complications T2DM. In further detailed studies, in China, national surveys identified retinopathy in 27% and nephropathy in 23%, with disparities observed between urban and rural populations ( 16 – 18 ). In the Middle East, data from Saudi Arabia indicated neuropathy in 39.5%, nephropathy in 25.3%, and retinopathy in 26.6% of patients with T2DM, with poor glycemic control and obesity being prominent contributing factors ( 19 – 21 ). The vulnerability of Africa to T2DM can be understood by the number of investigations done in this region ( 19 – 27 ) In sub-Saharan Africa, an Ethiopian hospital-based study reported that 37.3% of T2DM patients had at least one microvascular complication, with retinopathy being the most prevalent ( 28 ). In Europe, the UK Prospective Diabetes Study (UKPDS) found that nearly 39% of patients had retinopathy at the time of T2DM diagnosis, and intensive glycemic control significantly reduced the risk of developing microvascular complications ( 29 , 30 ). In Germany, data from the German Diabetes Study revealed that 28% of patients already had at least one microvascular complication at diagnosis, underlining the importance of early detection ( 31 – 33 ). North American data, particularly from the United States, indicate a declining trend in microvascular complications over the past two decades, though nephropathy still affects 25– 35% of patients, with notable ethnic disparities ( 34 – 36 ). 2018). It has been observed, across these regions, neuropathy tends to be the most prevalent microvascular complication, followed by nephropathy and retinopathy. Common risk factors include prolonged duration of diabetes, hypertension, dyslipidemia, obesity, and inadequate glycemic control. These findings emphasize the global need for integrated diabetes care, including regular screening, patient education, and multidisciplinary management to reduce the burden of microvascular complications and improve patient outcomes. Several factors are associated with the development of microvascular complications. These include poor glycemic control, long duration of diabetes, older age, presence of hypertension, and hyperlipidemia ( 24 , 37 ). Even at the time of initial diagnosis, many patients already present with one or more complications, highlighting the silent and progressive nature of T2DM ( 37 ). Studies emphasize that early diagnosis, regular monitoring, and strict metabolic control are key strategies to prevent or delay the onset of complications ( 21 , 24 ). South Asia, including Bangladesh, is experiencing a disproportionately high increase in diabetes prevalence due to rapid urbanization, sedentary lifestyles, and dietary changes ( 38 , 39 ). In Bangladesh alone, the prevalence of T2DM among adults is estimated at 9–10%, with significant public health implications ( 40 – 43 ). These results indicate that during a period of 2018 to 2022, the prevalence of diabetes has increased from 14% to 16.1% Despite growing awareness, there is limited data on the specific burden of microvascular complications among diabetic patients attending nephrology outpatient departments. These patients are often at increased risk of renal involvement and may also present with other vascular complications. Understanding the prevalence and pattern of microvascular complications in this subgroup is essential for targeted screening and intervention. In Bangladesh, the burden of diabetic nephropathy is increasingly recognized in tertiary care settings. However, there is a paucity of local data on the concurrent prevalence of other microvascular complications among diabetic patients who present to nephrology outpatient departments (OPDs). Understanding the pattern of these complications in this high-risk group is vital, as coexisting retinopathy and neuropathy often accelerate morbidity and further compromise renal outcomes ( 44 – 47 ). Early detection and integrated management of microvascular complications are key to reducing the burden of diabetes-related morbidity and mortality ( 48 ). However, in Bangladesh, underdiagnosis and inadequate screening practices persist, particularly in patients who present with advanced renal disease. Identifying the magnitude and predictors of microvascular complications among patients attending nephrology OPDs can guide the development of comprehensive screening protocols and multidisciplinary management strategies. Understanding the burden and mechanisms of these complications is essential for developing early detection strategies and integrated care models to prevent irreversible damage and improve long-term outcomes in T2DM patients. Therefore, this study aims to determine the prevalence and patterns of microvascular complications among patients with type 2 diabetes mellitus attending the Nephrology OPD in a tertiary care hospital in Bangladesh. The findings will contribute to local evidence needed to strengthen clinical practice and inform targeted interventions to improve patient outcomes. Material and Methods This is a post-facto (retrospective, a-posteriori ) study conducted at the Department of Nephrology of Bangladesh Medical University, Dhaka, between 2021 and 2023. Participants were selected from amongst the patients who came for treatment at the outpatient department. The sample size n was calculated using where z α / 2 = 1 96 is the two-tailed 95% confidence level p ≈ 0.16, the microvascular prevalence from previous studies ( 38 , 39 ) d = 0.05 is the error level With these values, the sample size n is evaluated to be 283. Therefore, the study included 283 adults (181 men and 102 women) aged 20 years and above with a confirmed diagnosis of type 2 diabetes mellitus. Patients with acute kidney injury, non-diabetic kidney diseases, or incomplete records were excluded. Data were collected through face-to-face interviews using a pre-structured questionnaire, along with a review of medical records and recent laboratory tests. Variables gathered included demographic information, age at diabetes onset, duration of the disease, comorbidities such as hypertension, and key biochemical markers (HbA1c, lipid profile, serum creatinine, and 24-hour urinary protein). Chronic kidney disease (CKD) stages were determined using estimated glomerular filtration rate (eGFR) derived from serum creatinine levels. Microvascular complications — including retinopathy, neuropathy, and diabetic foot were identified through clinical examination and specialist confirmation, with ophthalmologic and neurologic assessments conducted when needed. Data entry and analysis were performed using SPSS version 27. Categorical variables were analyzed with chi-square tests, while continuous variables were compared using independent t-tests. A p -value of less than 0.05 was considered statistically significant. Results and Discussion This study provides valuable insights into the baseline characteristics, biochemical profile, and burden of microvascular complications among patients with type 2 diabetes mellitus (T2DM) attending the outpatient nephrology department in a tertiary care hospital in Bangladesh. The baseline characteristics of the patients in the sample are shown in Table 2 . View this table: View inline View popup Download powerpoint Table-2. Baseline characteristics of patients ( n = 283) As shown in Table 2 , the mean age of the patients was 55.7 ± 10.03 years, with the majority (63.3%) in the 41–60 years age group, and a male predominance (64%, male-to-female ratio 1.8:1). This demographic pattern is consistent with other studies conducted in Bangladesh and South Asia, which indicate that T2DM commonly affects middle-aged adults with a slight male predominance ( 38 – 41 ). Notably, over half of the patients (57.6%) had a duration of diabetes of less than 10 years ( Table 2 ), yet the prevalence of hypertension was found to be as high at 60%, indicating an early clustering of cardiovascular risk factors. This finding is comparable with other local and regional studies showing high rates of hypertension among diabetic populations (49). In this cohort, the mean BMI was 23.49 ± 3.06 kg / m 2 ( Table 2 ), with 65.7% of patients having normal BMI, further supporting the well-established evidence that South Asians are more prone to T2DM and its complications at lower BMI thresholds due to increased visceral adiposity and insulin resistance ( 50 ). The biochemical profile ( Table 3 ) revealed a mean HbA1c of 7.25 ± 1.72%, indicating suboptimal glycemic control, slightly exceeding the target HbA1c of < 7% recommended by the American Diabetes Association ( http://diabetes.org ). Additionally, the mean serum creatinine was elevated at 3.31 ± 2.14 mg/dL, with a mean eGFR of ± 14.64 mL / min /1.73 m 2 , reflecting a substantial burden of renal impairment among these patients, which is expected in a nephrology clinic population. View this table: View inline View popup Download powerpoint Table-3. Biochemical and clinical profile of the patients Table 4 highlights that 66.4% of the patients had at least one microvascular complication. Diabetic neuropathy was the most prevalent (49.8%), followed by diabetic retinopathy (38.2%), including 19.1% with the proliferative form, while diabetic foot was present in 24.7% of patients. These findings are comparable to previous studies in Bangladesh and other low- and middle-income countries where neuropathy remains the most common microvascular complication in long-standing diabetes ( 51 ). View this table: View inline View popup Download powerpoint Table-4. Prevalence of microvascular complications among patients As shown in Table 5 , microvascular complications were significantly associated with longer duration of diabetes ( p = 0.002), presence of hypertension ( p = 0.005), advanced CKD stages ( p = 0.003), higher serum creatinine ( p < 0.001), and lower eGFR ( p < 0.001). These findings highlight the cumulative impact of poor glycemic and blood pressure control on the development of diabetic nephropathy and other microvascular complications (Adler et al., 2003). View this table: View inline View popup Download powerpoint Table-5. Association of microvascular complications with clinical and demographic factors among patients Interestingly, BMI and most lipid parameters (TC, LDL, TG) were not significantly associated with microvascular complications ( Table 4 ). This could be due to overall suboptimal metabolic control among most patients, masking individual contributions of isolated lipid abnormalities. These findings emphasize that addressing all modifiable risk factors – including hyperglycemia, hypertension, and dyslipidemia – is critical to prevent or delay microvascular damage ( http://diabetes.org ). The high prevalence of complications shown in Tables 4 and 5 underscores the need for systematic early screening, especially for neuropathy and retinopathy, and integrated multidisciplinary care targeting tight glycemic and blood pressure control, lipid management, and renal function preservation ( https://kidgo.org ). Conclusion In summary, this study demonstrates a high prevalence of microvascular complications among T2DM patients attending a nephrology OPD in a tertiary care hospital in Bangladesh. Duration of diabetes, hypertension, and worsening renal function were significantly associated with microvascular complications. These findings underscore the need for multidisciplinary interventions focusing on early detection and comprehensive management to prevent progression and improve patient outcomes. Limitations of this study include its single-center design and cross-sectional nature, which restrict causal inference. However, the findings provide baseline data to guide larger, multicenter longitudinal studies exploring the burden and determinants of microvascular complications in the Bangladeshi diabetic population. Data availability statement The data is proprietary of the hospital where the study was conducted. However, the data can be made available upon request. Ethics statement All patients consented to participate in the study with anonymity. The IRB of Bangabandhu Sheikh Mujib Medical University (BSMMU, predecessor of Bangladesh Medical University, BMU) waived the ethical requirement citing ‘no patients were selected for the purpose of research, but rather their past medical record were used after they received regular treatment.’ Author contributions FJ: Conceptualization, Data collection, Data curation, Formal analysis, Investigation, Methodology, Resources, Writing – original draft, Writing – review & editing. MRA: Conceptualization, Data collection, Data curation, Formal analysis. MA: Methodology, Software Supervision, Validation, Writing – review & editing. Funding The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article. Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Footnotes ( ferdousjahan1999{at}bsmmu.edu.bd ) ( nipponreza{at}gmail.com ) References 1. ↵ WHO . Diabetes ( 2022 ). Available online at: https://www.who.int/health-topics/diabetes . 2. ↵ International Diabetes Federation . IDF Diabetes Atlas . 10th ed. Brussels, Belgium : International Diabetes Federation ( 2021 ). Available at: https://www.diabetesatlas.org . 3. ↵ Brownlee , M. The pathobiology of diabetic complications: a unifying mechanism . Diabetes , ( 2005 ) 54 ( 6 ), 1615 – 1625 . doi: 10.2337/diabetes.54.6.1615 . OpenUrl FREE Full Text 4. ↵ Forbes JM , Cooper ME . Mechanisms of diabetic complications . Physiological Reviews , ( 2013 ) 93 ( 1 ), 137 – 188 . doi: 10.1152/physrev.00045.2011 . OpenUrl CrossRef PubMed 5. ↵ Mansour A , Mousa M , Abdelmannan D , Tay G , Hassoun A , Alsafar H Microvascular and macrovascular complications of type 2 diabetes mellitus: Exome wide association analyses . Frontiers in Endocrinology , ( 2023 ) 14 , p. 1143067 . doi: 10.3389/fendo.2023.1143067 . OpenUrl CrossRef PubMed 6. ↵ Maryam A , Zelnick LR , Hall YN , Heagerty PJ , Tuttle K , Weiss NS , de Boer IH . Clinical manifestations of kidney disease among US adults with diabetes, 1988-2014 . JAMA ( 2016 ) 316 ( 6 ): 602 – 610 . doi: 10.1001/jama.2016.10924 . OpenUrl CrossRef PubMed 7. ↵ Tuttle KR , Bakris GL , Bilous RW , Chiang JL , de Boer IH , Goldstein-Fuchs J , Hirsch IB , Kalantar-Zadeh K , Narva AS , Navaneethan SD , Neumiller JJ , Patel UD , Ratner RE , Whaley-Connell AT , Molitch M. Diabetic kidney disease: a report from an ADA Consensus Conference . Diabetes Care , ( 2014 ) 37 ( 10 ), 2864 – 2883 . doi: 10.2337/dc14-1296 OpenUrl Abstract / FREE Full Text 8. ↵ Stefánsson E , Einarsdottir A. Public health and prevention of blindness in diabetes. (editorial) Int J Diab Mell ( 2015 ) 3 , 1 – 3 . doi: 10.1016/j.ijdm.2011.01.011 . OpenUrl CrossRef 9. ↵ Cheung , N. , Mitchell , P. , & Wong , T. Y. . Diabetic retinopathy . The Lancet , ( 2010 ) 376 ( 9735 ), 124 – 136 . doi: 10.1016/S0140-6736(09)62124-3 . OpenUrl CrossRef PubMed Web of Science 10. ↵ Feldman EL , Callaghan BC , Pop-Busui R , Zochodne DW , Wright DE , Bennett DL. , Bril V , Russell JW. , Viswanathan V. Diabetic neuropathy . Nature Reviews Disease Primers , ( 2019 ) 5 ( 1 ), 1 – 18 . doi: 10.1038/s41572-019-0092-1 . OpenUrl CrossRef PubMed 11. ↵ Volmer-Thole M , Lobmann R. Neuropathy and Diabetic Foot Syndrome . Int. J. Mol. Sci . ( 2016 ), 17 ( 917 ). doi: 10.3390/ijms17060917 . OpenUrl CrossRef PubMed 12. ↵ Tesfaye S , Boulton AJM , Dyck PJ , Freeman R , Horowitz M , Kempler P , Lauria G , Malik RA , Spallone V , Vinik A ; Bernardi L ; Valensi P. Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments . Diabetes Care ( 2010 ); 33 ( 10 2285 – 2293 . doi: 10.2337/dc10-1303 . OpenUrl Abstract / FREE Full Text 13. ↵ Dweib , M. and El Sharif , N. , Diabetes-related microvascular complications in primary health care settings in the West Bank, Palestine . Journal of Clinical Medicine , ( 2023 ) 12 ( 21 ), p. 6719 . doi: 10.3390/jcm12216719 . OpenUrl CrossRef PubMed 14. ↵ Manickum P , Ramklass SS , Madiba TE . Diabetes and lower extremity amputation – rehabilitation pathways and outcomes at a regional hospital . S Afr J Surg .( 2021 ) 59 ( 3 ): 128a – 128g . doi: 10.17159/2078-5151/2021/v59n3a3264 . OpenUrl CrossRef PubMed 15. ↵ Bramlage P , Lanzinger S , van Mark G , Hess E , Fahrner S , Heyer CHJ , Friebe M , Seufert J , Danne T , Holl RW . Patient and disease characteristics of type-2 diabetes patients with or without chronic kidney disease: an analysis of the German DPV and DIVE databases Cardiovascular Diabetology ( 2019 ) 18 ( 33 ). doi: 10.1186/s12933-019-0837-x . OpenUrl CrossRef 16. ↵ Mao W , Winnie CY , Chen W. Complications of diabetes in China: health system and economic implications BMC Public Health ( 2019 ) Mar 6; 19 : 269 . doi: 10.1186/s12889-019-6569-8 . OpenUrl CrossRef PubMed 17. Xu Y , Lu J , Li M , Wang T , Wang K , Cao Q , Ding Y , Xiang Y , Wang S , Yang Q , Zhao X , Zhang X , Xu M , Wang W , Bi Y , Ning G. Diabetes in China part 1: epidemiology and risk factors The Lancet Public Health ( 2024 ) Volume 9 , Issue 12 , Pages e1089 – e1097 . doi: 10.1016/S2468-2667(24)00250-0 . OpenUrl CrossRef 18. ↵ Xu Y , Lu J , Li M , Wang T , Wang K , Cao Q , Ding Y , Xiang Y , Wang S , Yang Q , Zhao X , Zhang X , Xu M , Wang W , Bi Y , Ning G. Diabetes in China part 2: prevention, challenges, and progress The Lancet Public Health ( 2024 ) Volume 9 , Issue 12 , e1098 – 104 . doi: 10.1016/S2468-2667(24)00251-2 . OpenUrl CrossRef PubMed 19. ↵ Robert AA , Al Dawish MA . Microvascular complications among patients with diabetes: An emerging health problem in Saudi Arabia . Diab Vasc Dis Res ( 2019 ) 16 ( 3 ) 227 – 235 14 doi: 10.1177/147916411882071 . OpenUrl CrossRef PubMed 20. El-Alameey IR , Al-Abdudullatif GA , Alqubali RA , Al-Harbi SR , Al-Mutairi AA , Alamri RD , Saed RS . Microvascular Complications and Associated Risk Factors in Patients with Type 2 Diabetes Mellitus in Al-Madinah Al-Munawara, Saudi Arabia . Biomedi.al & Pharmacology Journal ( 2023 ) 16 ( 4 ): 2031 – 2039 . doi: 10.13005/bpj/2779 . OpenUrl CrossRef 21. ↵ Alnaim , M.M. , Alrasheed , A. , Alkhateeb , A.A. , Aljaafari , M.M. and Alismail , A. , 2023 . Prevalence of microvascular complications among patients with type 2 diabetes mellitus who visited diabetes clinics in Saudi Arabia . Saudi Medical Journal , 44 ( 2 ), p. 211 . doi: 10.15537/smj.2023.44.2.20220719 . OpenUrl Abstract / FREE Full Text 22. N-Mbanya JC , Sobngwi E. Diabetes microvascular and macrovascular disease in Africa European journal of cardiovascular prevention and rehabilitation ( 2003 ) 10 ( 2 ): 97 – 102 . doi: 10.1177/174182670301000204 . OpenUrl CrossRef PubMed 23. Msanga D , Reis K , Kayange N , Bakalemwa R , Kidenya B , Hau D , Mwanansao C , Mahamba D , Ottaru S , Kwiyolecha E , Peck R. Diabetic Microvascular Complications Among Children and Adolescents in Northwestern Tanzania: A Cross-Sectional Study . Annals of Glob Hea . ( 2020 ) Volume: 86 Issue: 1 , doi: 10.5334/aogh.2669 . OpenUrl CrossRef 24. ↵ Merid , F. , Getahun , F. , Esubalew , H. and Gezahegn , T. , 2024 . Diabetic microvascular complications and associated factors in patients with type 2 diabetes in Southern Ethiopia . Frontiers in Endocrinology , 15 , p. 1342680 . doi: 10.3389/fendo.2024.1342680 . OpenUrl CrossRef PubMed 25. Hussein , M. and Menasri , S. , 2019 . Prevalence of microvascular complications in type 2 diabetics attending a primary healthcare center in Sudan . International Journal of Diabetes and Metabolism , 25 ( 3-4 ), pp. 127 – 133 . doi: 10.1159/000500914 . OpenUrl CrossRef 26. Negussie YM , Sento M , Fati NM . Diabetic microvascular complications among adults with type 2 diabetes in Adama, central Ethiopia . Sci Rep ( 2024 ) 14 , 24910 . doi: 10.1038/s41598-024-77183-2 . OpenUrl CrossRef PubMed 27. ↵ Kumie G , Nigatie M , Alamrew A , Gedifie S , Kassahun Woldeteklehaymanot , Jemal A , Mulugeta C , Ayana S , Ayele M , Shitie E , Gtsadik B , Abebe W , Ashagre A , Misganaw T , Dejazmach Z , Sisay A , Asmare Z , Gashaw M , Getachew E , Gashaw Y , Tadesse S , Abate BB , Kidie AA , Reta MA . Prevalence of microvascular complications and associated factors among diabetes mellitus patients in Ethiopia: Systematic review and meta-analysis . Microvasc Res ( 2025 ) Mar : 158 : 104779 . doi: 10.1016/j.mvr.2024.104779 . OpenUrl CrossRef PubMed 28. ↵ Seid MA , Akalu Y , Gela YY , Belsti Y , Diress M , Fekadu SA , Dagnew B , Getnet M. Microvascular complications and its predictors among type 2 diabetes mellitus patients at Dessie town hospitals , Ethiopia Diabetology & Metabolic Syndrome ( 2021 ) 13 : 86 . doi: 10.1186/s13098-021-00704-w OpenUrl CrossRef PubMed 29. ↵ Huang Y , Zheng Z , Chen H , Gu C. Association of socioeconomic status with diabetic microvascular complications: a UK Biobank prospective cohort study . Diabetology & Metabolic Syndrome ( 2025 ) 17 ( 1 ). doi: 10.1186/s13098-025-01584-0 OpenUrl CrossRef 30. ↵ Vithian K , Hurel S. Microvascular complications: pathophysiology and management . Clin Med (Lond) ( 2010 ) Oct ; 10 ( 5 ): 505 – 509 . doi: 10.7861/clinmedicine.10-5-505 . OpenUrl FREE Full Text 31. ↵ Kolaczynski WM , Hankins M , Ong SH , Richter H , Clemens A , Toussi M. Microvascular Outcomes in Patients with Type 2 Diabetes Treated with Vildagliptin vs. Sulfonylurea: A Retrospective Study Using German Electronic Medical Records . Diabetes Ther 7 , 483 – 496 ( 2016 ). doi: 10.1007/s13300-016-0177-8 OpenUrl CrossRef PubMed 32. Happich M , John J , Stamenitis S , Clouth J , Polnau D. The quality of life and economic burden of neuropathy in diabetic patients in Germany in 2002—Results from the diabetic microvascular complications (DIMICO) study Diabetes Research and Clinical Practice ( 2008 ) 81 ( 2 ), Pages 223 – 230 . doi: 10.1016/j.diabres.2008.03.019 OpenUrl CrossRef PubMed 33. ↵ Kosiborod M , Gomes MB , Nicolucci A , Pocock S , Rathmann W , Shestakova MV. , Watada H , Shimomura I , Chen H , Cid-Ruzafa J , Fenici P , Hammar N , Surmont F , Tang F , Khunti K. Vascular complications in patients with type 2 diabetes: prevalence and associated factors in 38 countries Cardiovasc Diabetol ( 2018 ) 17 ( 150 ). doi: 10.1186/s12933-018-0787-8 . OpenUrl CrossRef 34. ↵ Gregg EW , Wang YLJ , Burrows NR , Ali MK , Rolka D , Williams DE , Geiss L. Changes in Diabetes-Related Complications in the United States, 1990–2010 N Engl J Med ( 2014 ) 370 ( 16 ): 1514 – 1523 . doi: 10.1056/NEJMoa1310799 OpenUrl CrossRef PubMed Web of Science 35. Patel SA . Diabetes Complications in the U.S.: Following the Data to Guide Comprehensive Action Diabetes Care ( 2025 ) 48 ( 1 ): 15 – 17 . doi: 10.2337/dci24-002 . OpenUrl CrossRef PubMed 36. ↵ Saelee R , Bullard KM , Hora IA , Pavkov ME , Pasquel FJ. Holliday CS , Benoit SR . Trends and Inequalities in Diabetes-Related Complications Among U.S. Adults, 2000–2020 . Diabetes Care ( 2025 ) 48 ( 1 ): 18 – 28 doi: 10.2337/dci24-0022 . OpenUrl CrossRef PubMed 37. ↵ Mitra VV , Ram T , Neusha D , Sanghani S , Anusha Y , Tanvi N. Incidence of microvascular complications in newly diagnosed diabetes mellitus . J. Evid. Based Med. Healthc . ( 2019 ); 6 ( 42 ), 2760 – 2764 . doi: 10.18410/jebmh/2019/573.263 OpenUrl CrossRef 38. ↵ Chowdhury MAB , Islam M , Rahman J , Uddin MJ , Haque MR . Diabetes among adults in Bangladesh: changes in prevalence and risk factors between two cross-sectional surveys . BMJ Open ( 2022 ) 12 : e055044 . doi: 10.1136/bmjopen-2021-055044 . OpenUrl Abstract / FREE Full Text 39. ↵ Hossain MB , Khan M.N , Oldroyd JC , Rana J , Magliago DJ , Chowdhury EK , Karim MN , Islam RM . Prevalence of, and risk factors for, diabetes and prediabetes in Bangladesh: Evidence from the national survey using a multilevel Poisson regression model with a robust variance . PLOS Glob Public Health ( 2022 ) 2 ( 6 ): e0000461 . doi: 10.1371/journal.pgph.0000461 . OpenUrl CrossRef 40. ↵ Akter S , Rahman MM , Abe SK , Sultana P. Prevalence of diabetes and prediabetes and their risk factors among Bangladeshi adults: a nationwide survey . Bull World Health Organ . 2014 ; 92 ( 3 ): 204 – 213 . doi: 10.2471/BLT.13.128371 OpenUrl CrossRef PubMed 41. ↵ Biswas T , Islam A , Rawal LB , Islam SMS . Increasing prevalence of diabetes in Bangladesh: a scoping review . Public Health ( 2016 ) 138 : 4 – 11 doi: 10.1016/j.puhe.2016.03.025 . OpenUrl CrossRef PubMed 42. Akhtar S , Nasir JA , Sarwar A , Nasr N , Javed A , Majeed R , Salam MA , Billah B. Prevalence of diabetes and pre-diabetes In Bangladesh: a systematic review and meta-analysis . BMJ Open ( 2020 ) 10 : e036086 . doi: 10.1136/bmjopen-2019-036086 . OpenUrl Abstract / FREE Full Text 43. ↵ Khan N , Oldroyd JC , Hossain MB , Islam RM . Awareness, Treatment, and Control of Diabetes in Bangladesh: Evidence from the Bangladesh Demographic and Health Survey 2017/18 Int J Clin Prac ( 2022 ) Article ID 8349160, 9 pages. doi: 10.1155/2022/8349160 . OpenUrl CrossRef 44. ↵ Thomas DE , Elliott EJ , Naughton GA . Exercise for type 2 diabetes mellitus . Cochrane Database Syst Rev .( 2006 ) Jul 19 ( 3 ): CD002968 . doi: 10.1002/14651858.CD002968.pub2 . OpenUrl CrossRef 45. Colberg SR , Sigal RJ , Fernhall B , Regensteiner JG , Bryan Blissmer J , Rubin RR , Chasan-Taber L , Albright AL , Braun B. Exercise and Type 2 Diabetes Diabetes Care . ( 2010 ) Dec ; 33 ( 12 ): e147 – e167 . doi: 10.2337/dc10-9990 . OpenUrl Abstract / FREE Full Text 46. Batrakoulis A , Jamurtas T , Fatouros IG . Exercise and Type II Diabetes Mellitus: A Brief Guide for Exercise Professionals . Strength & Conditioning Journal ( 2022 ) 44 ( 6 ): 64 – 72 . doi: 10.1519/SSC.0000000000000731 . OpenUrl CrossRef 47. ↵ Tonga E , Worboys H , Davies MJ , Ng GA , Evans RA , Yates T , Singh SJ . Physical activity guidelines for adults with type 2 Diabetes: Systematic review . Diab Res Clin Prac . ( 2025 ) 220 : 111982 . doi: 10.1016/j.diabres.2024.111982 . OpenUrl CrossRef 48. ↵ American Diabetes Association (ADA ). Standards of Medical Care in Diabetes — 2025 . Diabetes Care . 2024 ; Vol. 48 , S1 – S5 . doi: 10.2337/dc25-SINT OpenUrl CrossRef 50. ↵ Misra A , Shrivastava U. Obesity and dyslipidemia in South Asians . Nutrients . 2013 ; 5 ( 7 ): 2708 – 2733 . doi: 10.3390/nu5072708 . OpenUrl CrossRef PubMed 51. ↵ Afroz A , Zhang W , Loh AJW , Lee DXJ , Billah B. Macro- and micro-vascular complications and their determinants among people with type 2 diabetes in Bangladesh Diab Metab Synd : Clin Res & Rev . ( 2019 ) 13 ( 5 ): 2939 – 2946 doi: 10.1016/j.dsx.2019.07.046 OpenUrl CrossRef View the discussion thread. Back to top Previous Next Posted August 14, 2025. Download PDF Data/Code Email Thank you for your interest in spreading the word about medRxiv. NOTE: Your email address is requested solely to identify you as the sender of this article. Your Email * Your Name * Send To * Enter multiple addresses on separate lines or separate them with commas. You are going to email the following Prevalence of microvascular complications in Diabetes Mellitus patients attending a Nephrology outpatient department at a tertiary care hospital in Bangladesh Message Subject (Your Name) has forwarded a page to you from medRxiv Message Body (Your Name) thought you would like to see this page from the medRxiv website. Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Share Prevalence of microvascular complications in Diabetes Mellitus patients attending a Nephrology outpatient department at a tertiary care hospital in Bangladesh Ferdous Jahan , Mohammed Anwer , Mohammad Rezaul Alam medRxiv 2025.08.12.25333485; doi: https://doi.org/10.1101/2025.08.12.25333485 Share This Article: Copy Citation Tools Prevalence of microvascular complications in Diabetes Mellitus patients attending a Nephrology outpatient department at a tertiary care hospital in Bangladesh Ferdous Jahan , Mohammed Anwer , Mohammad Rezaul Alam medRxiv 2025.08.12.25333485; doi: https://doi.org/10.1101/2025.08.12.25333485 Citation Manager Formats BibTeX Bookends EasyBib EndNote (tagged) EndNote 8 (xml) Medlars Mendeley Papers RefWorks Tagged Ref Manager RIS Zotero Tweet Widget Facebook Like Google Plus One Subject Area Endocrinology (including Diabetes Mellitus and Metabolic Disease) Subject Areas All Articles Addiction Medicine (568) Allergy and Immunology (863) Anesthesia (299) Cardiovascular Medicine (4425) Dentistry and Oral Medicine (443) Dermatology (382) Emergency Medicine (607) Endocrinology (including Diabetes Mellitus and Metabolic Disease) (1507) Epidemiology (15221) Forensic Medicine (30) Gastroenterology (1123) Genetic and Genomic Medicine (6588) Geriatric Medicine (667) Health Economics (997) Health Informatics (4524) Health Policy (1368) Health Systems and Quality Improvement (1612) Hematology (540) HIV/AIDS (1264) Infectious Diseases (except HIV/AIDS) (15910) Intensive Care and Critical Care Medicine (1103) Medical Education (623) Medical Ethics (145) Nephrology (667) Neurology (6588) Nursing (346) Nutrition (998) Obstetrics and Gynecology (1143) Occupational and Environmental Health (956) Oncology (3331) Ophthalmology (970) Orthopedics (369) Otolaryngology (420) Pain Medicine (435) Palliative Medicine (129) Pathology (663) Pediatrics (1690) Pharmacology and Therapeutics (691) Primary Care Research (710) Psychiatry and Clinical Psychology (5440) Public and Global Health (9220) Radiology and Imaging (2195) Rehabilitation Medicine and Physical Therapy (1369) Respiratory Medicine (1196) Rheumatology (593) Sexual and Reproductive Health (710) Sports Medicine (529) Surgery (710) Toxicology (99) Transplantation (289) Urology (265) (function(){function c(){var b=a.contentDocument||a.contentWindow.document;if(b){var d=b.createElement('script');d.innerHTML="window.__CF$cv$params={r:'9ffd87527b6952ad',t:'MTc3OTQ3MDgxNQ=='};var a=document.createElement('script');a.src='/cdn-cgi/challenge-platform/scripts/jsd/main.js';document.getElementsByTagName('head')[0].appendChild(a);";b.getElementsByTagName('head')[0].appendChild(d)}}if(document.body){var a=document.createElement('iframe');a.height=1;a.width=1;a.style.position='absolute';a.style.top=0;a.style.left=0;a.style.border='none';a.style.visibility='hidden';document.body.appendChild(a);if('loading'!==document.readyState)c();else if(window.addEventListener)document.addEventListener('DOMContentLoaded',c);else{var e=document.onreadystatechange||function(){};document.onreadystatechange=function(b){e(b);'loading'!==document.readyState&&(document.onreadystatechange=e,c())}}}})();