Clinical Profile, Risk Factors, and Comorbidities among Patients with Type 2 Diabetes Mellitus: A cross-sectional study at a Tertiary Level Hospital in Nepal

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) is a major global public health concern associated with increasing prevalence, a substantial socioeconomic burden, and long-term complications. Patients with T2DM are at increased risk of developing multiple comorbidities and diabetes-related complications that adversely affect quality of life and clinical outcomes. This study aimed to assess the clinical profile, risk factors, comorbidities and glycemic control among patients with T2DM attending a tertiary level hospital in Nepal.

Methods: A hospital-based analytical cross-sectional study was conducted among 400 patients with T2DM attending the outpatient department of Shree Birendra Hospital, Kathmandu, Nepal, from June 2024 to December 2024. Participants diagnosed with T2DM for more than six months were recruited using non-probability purposive sampling technique. Data on socio-demographic characteristics, biochemical parameters, risk factors, comorbidities, and diabetic complications were collected using a semi-structured questionnaire and medical record review. Descriptive statistics were used for data analysis using SPSS version 25. Bivariate analyses using the chi-square test were performed to examine association between selected risk factors (e.g., BMI category, family history of diabetes, and obesity) and glycemic control.

Results: The mean age of participants was 68.3 ± 6.8 years, and 59.8% were male. Nearly half (46.8%) belonged to the age group of 61–70 years. The mean body mass index was 27.53 ± 3.53 kg/m², and the mean HbA1c level was 6.03 ± 0.59%, indicating good glycemic control. Family history of diabetes was present in 28.5% of participants. According to WHO BMI classification for Asian population, 53.2% of participants were classified as obese class II (BMI ≥27.5 kg/m²). Hypertension was the most prevalent comorbidity (29.2%), followed by cardiovascular disease (3.2%) and hyperlipidemia (2.5%). Diabetic neuropathy (3.2%) and diabetic nephropathy (2.8%) were the most commonly documented complications. Metformin was the most commonly prescribed anti-diabetic drug. Bivariate analysis showed a significant association between obesity and glycemic control.

Conclusion: The study found that older adults were predominantly affected by T2DM and family history as a major risk factor. Hypertension was the most common comorbidity, whereas diabetic neuropathy and diabetic nephropathy were the most frequently observed complications. Comprehensive diabetes care emphasizing lifestyle modification, regular glycemic monitoring, and early screening for comorbidities and complications is essential to improve clinical outcomes and reduce the burden of T2DM.

Novelty: This study provides hospital-based evidence on the clinical characteristics, risk factors, comorbidities, and complications among patients with T2DM in Nepal, contributing to the limited literature available in this setting.