Geospatial Analysis and Determinant Factors of Comorbidity Presence in Patients with Diabetes

Introduction The prevalence of diabetes mellitus (DM) has shown a significant increase in recent decades, leading to a rise in associated complications.

To explore the determinant factors and geographical distribution of comorbidities and their number in patients with diabetes in Peru.

Cross-sectional study based on a database providing detailed demographic and clinical information on DM patients affiliated with the Comprehensive Health Insurance (SIS: acronym in spanish) in Peru. The dependent variables in this study are twofold: the type of comorbidities present in DM patients and the number of comorbidities they have. Comorbidities were categorized into three groups: DM with obesity/dyslipidemia, DM with hypertension, and DM with mental health disorders. The number of comorbidities was classified as none, one, two, or three comorbidities.

A total of 1,355,354 patients were included. Male patients, older individuals, and those with a longer time since diagnosis have different probabilities of presenting the comorbidities and a higher number of them. Additionally, the geospatial analysis showed apparent regional variations in the prevalence and number of comorbidities, highlighting the influence of environmental and socioeconomic factors and access to healthcare services.

This study identified significant demographic and clinical factors associated with comorbidities in patients with DM in Peru. These findings showed the need for personalized, region-specific diabetes management. Therefore, public health policies should adapt to meet the needs of different regions and groups. Improving healthcare access is crucial, especially where comorbidity prevalence is high. Further education programs must address diet and exercise comorbidities, focusing on vulnerable people. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study https://www.datosabiertos.gob.pe/dataset/afiliados-activos-en-el-seguro-integral-de-salud-con-diagn%C3%B3stico-de-diabetes-mellitus-sis is self-financed. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data availability The data supporting the findings of this study can be accessed by the original research paper at the follow link: https://www.datosabiertos.gob.pe/dataset/afiliados-activos-en-el-seguro-integral-de-salud-con-diagn%C3%B3stico-de-diabetes-mellitus-sis