Time to Development of Macro vascular Complications And it’s Predictors among Type 2 Diabetes Mellitus Patients in Jimma Medical Center, Jimma, Southwest Ethiopia, 2023. A Retrospective Follow up Study.

Abstract

Background: Type 2 diabetes mellitus is a serious metabolic disease that is often associated with vascular complications. One of the most feared and common complications of diabetes and primary cause of death in diabetic patients are macrovascular complications. Objective: The objective of this study was to assess the time to development of macrovascular complications and identify its predictors among type 2 diabetes mellitus patients in Jimma medical center from 2018–2022. Methods: An institutional-based retrospective follow-up study was conducted in Jimma Medical Center among newly diagnosed T2DM patient from 2018, to 2022. A systematic sampling technique was used to recruit 440 records of T2DM patient. The data were coded and entered into Epi-Data version 4.6 and transferred to STATA version 17.0. The Kaplan Meier curve and the log-rank tests were used to determine the time to macrovascular complications, and evaluate the significant difference in survival probability among predictors respectively. Bivariable and multivariable cox-proportional hazard regression had used to identify the possible association between the variable and survival time. Results: The incidence rate of macrovascular complications was 22.4 cases/1000 person months of observation. The median time to development of macrovascular complications was 24 months. Urban residence (AHR: 2.02; 95% CI: 1.33, 3.05), having hypertension at start of diabetic treatment (AHR: 1.52; 95% CI: 1.06, 2.13), baseline age ≥60 years (AHR: 4.42; 95% CI: 1.72, 11.29), having dyslipidemia at baseline (AHR: 1.82; 95% CI: 1.13, 2.93), HDL-C levels < 40 mg/dl (AHR: 2.11; 1.16, 3.81), triglycerides > 150 mg/dl (AHR: 1.48; 95% CI: 1.02, 2.13), HgbA1C level >7%( AHR: 1.49; 95% CI: 1.04, 2.14), and OHA + insulin (AHR: 2.73; 95% CI: 1.81, 4.09) were the significant predictors for the time to development of macrovascular complications. Conclusion: - Findings in this study indicated that the incidence of macrovascular complications was high among type 2 diabetes mellitus patients’ and remains a public health problem in the Jimma Medical Center. Baseline age category in years, residence, presence of hypertension at baseline, presence of dyslipidemia at baseline, HDL-cholesterol level <40mg/dl at baseline, triglyceride >150mg/dl at baseline, HgbA1C >7% at baseline, and medication regimens were identified as independent significant predictors for the time to development of macrovascular complications among T2DM patients. Targeted intervention for T2DM patients with hypertension and dyslipidemia comorbidities should be in place to promote good survival time and reduce the death of T2DM patients.