Prevalence And Factors Associated With Chronic Diabetic Complications Among Patients Attending Primary Health Care, A Multi-Centric Study In Kuwait

Abstract

Background: A substantial proportion of patients with diabetes develop long-term macrovascular and microvascular complications. Many risk factors have identified for development and progression of these complications. Objectives: The aim of the present study was to determine the prevalence of these complications among adult diabetic patients attending primary health care centers in Kuwait and to identify factors that could be associated with especially those factors that can be considered avoidable. Methods: This study was carried out in five primary health care centers representing the five health regions in Kuwait. The sample included 704 adult diabetic patients who had been diabetic for at least 2 years. The first phase of study was a cross sectional study to determine the prevalence of chronic diabetic complications. The second one was a case-control study, whereas all patients with chronic diabetic complications (case group, n = 434) were compared to diabetic patients free from chronic complications (control group, n = 270) to determine the associated factors with cases. Analysis was initially carried out based on a series of univariate comparisons followed by multiple logistic regression analysis. Results: Out of 704 diabetic patients 61.6% n= had one or more chronic diabetic complications. Cardiovascular complications were diagnosed in 30.3%, nephropathy in 12.4%, neuropathy in 32.1%, lower limb complications in 21.9%, and retinopathy in 30.7% of patients. Logistic regression analysis revealed that age, nationality, type and duration of diabetes, glycemic control, hypertension, obesity, physical exercises, and compliance with diet recommendations were proved as significant predictors of these complications. Conclusion: The high economic burden raised by diabetes and its complications challenges the Kuwaiti health care system to prevent the development and progression of diabetic complications. The study identified a group of predictor factors as hypertension and hyperglycemia, enhancement of patient’ compliance with regular follow-up visit, the role of health care providers in supplying patients with health information groups of patients who needed priorities of screening programs for development of complication.

Keywords: chronic diabetic complications - prevalence - associated factors