Factors Influencing Microvascular Complications among Persons with Type 2 Diabetes

Main Article Content

Saifone Moungkum
Pornpan Srisopa
Wanlapa Kunsongkeit
Panicha Ponpinij
Chutima Chantamit-O-Pas
Chaicharn Deerochanawong

Abstract

The purpose of this cross-sectional descriptive study was to examine the prevalence of
microvascular complications and determining factors influencing microvascular complications among
persons with type 2 diabetes. Data were collected from 350 patients with type 2 diabetes, who
received the cares at the diabetes clinics from eleven public hospitals, Eastern region of Thailand. The
data were analyzed by means of descriptive statistics, and binary logistic regression analysis.
The results revealed that the prevalence rate of microvascular complications were 67.43
(95 %CI: 62.49 - 72.36). Among diabetic patients with microvascular complications, 62% had diabetic
kidney disease, 16.86 and 2.85 % were diabetic retinopathy and peripheral neuropathy, respectively.
There were associations between the following variables: age, duration of diabetes, HbA
1C
,
prehypertension, triglycerides level, and the complications as such with statistical signifcance
(p <. 05). Participants over age sixty had about 13.12 times the risk of microvascular complications
(OR = 13.12, 95% CI: 2.11 - 81.49) compared to participants younger than 39 years old. Those with
type 2 diabetes for over 20 years showed a 7.47 times greater chance of microvascular complications
than those with diabetes of shorter duration (OR = 7.74, 95% CI: 1.77 - 31.58). Those with HbA
1C
level
above 8% had a lower chance of microvascular complications compared to those with HbA
1C
level
less than 7% (OR = 0.44, 95% CI: 0.22 - 0.87). Participants with high level of triglyceride showed a 2.15
times of microvascular complications (OR = 2.15, 95% CI: 1.20 - 3.85) than those with normal level.
Moreover, those with prehypertension showed a lower chance of microvascular complications than
those with normal blood pressure (OR = 0.26, 95% CI: 0.08 - 0.86).
The fndings provide signifcant information for health care providers in developing precise
interventions, targeting patients with early-diagnosed diabetes mellitus, to prevent microvascular
complications including diabetic kidney disease, diabetic retinopathy, and diabetic neuropathy, and
to delay occurrences of complications by early screening in high-risk patients

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References

Aekplakorn, W., Porapukham, Y., Taneepanichsku,
S., Pukjaroon, H., W., & Thaikla, K. (2016).
Thai National Health Examination Survey,
NHES V. Nonthaburi: The Graphico Systems.
[In Thai]

Bansal, D. et al. (2014). Microvascular
Complications and Their Associated Risk
Factors in Newly Diagnosed Type 2
Diabetes Mellitus Patients. International
journal of chronic diseases, 2014, 201423.
https://doi.org/10.1155/2014/201423.

Cheema, S., Maisonneuve, P., Zirie, M., Jayyousi,
A., Alrouh, H., Abraham, A., Al-Samraye, S.,
Mahfoud, Z., Al-Janahi, M., Ibrahim, B.,
Lowenfels, A. B., Mamtani, R. (2018). Risk
Factors for Microvascular Complications of
Diabetes in a High-Risk Middle East
Population. Journal of Diabetes Research,
8964027. https://doi:10.1155/2018/8964027

Chuengsamarn, S., Sangpanich, A., & Laoopugsin,
N. (2010). Prevalence and risk factors of
peripheral arterial disease in type 2
diabetic patients at HRH Princess Maha
Chakri Sirindhorn Medical Center. Journal
of the Medical Association of Thailand,
93(Suppl 2), S32-S38. [In Thai]

Cooney, N. (2014). Literature Review: The current
situation and care model of noncommunicable diseases. Nonthaburi:
Art Qualifer. [In Thai]

Dechma, J., Durongritchai, W., & Kijtorntham, W.
(2013). The study of predictive factors’
complications of diabetes mellitus client
in community under King’s nursing theory.
Journal of Public Health Nursing, 27(2),
63-80. [In Thai]

deWit, S.C. & Kumagai, C.K., (2013). Care of patients
with hypertension and peripheral vascular
disease. In S.C. deWit & C.K. Kumagai (Eds),
Medical-Surgical Nursing concepts &
practice (2nd ed.). Missouri: Elsevier.

Hadi, H. A., & Suwadi, J. A. (2007). Endothelial
dysfunction in diabetes mellitus. Vascular
Health and Risk Management, 3(6), 853-876.

Hurst, C., Thinkhamrop, B., & Tran, H.T. (2015).
The Association between Hypertension
Comorbidity and Microvascular
Complications in Type 2 Diabetes Patients:
A Nationwide Cross-Sectional Study in
Thailand. Diabetes & Metabolism Journal,
39(5), 395-404

International Diabetes Federation [IDF] Atlas.
(2017). IDF Diabetes atlas (8th ed.). Retrieved
October 5, 2019, from: http://www.diabet
esatlas.org/resources/2015

International Diabetes Federation [IDF] Atlas.
(2019). IDF Diabetes atlas (9th ed.). Retrieved
October 5, 2019, from: http://www.diabet
esatlas.org/resources/2015

Laksawut, S. (2014). Factor affecting diabetes
nephropathy of diabetes type 2 patient,
Nongkungsri hospital, Kalasin public health
offce 2556. Research and development
health system journal, 7(1), 198-207.

Mongkolsomlit, S. & Rawdaree, P. (2010). Factors
affecting microalbuminuria in type 2
Diabetes: Meta-analysis. Srinagarind
Medical Journal, 25(3), 185-193. [in Thai]

Moungkum, S. (2011). Factors influencing foot
conditions among people with type 2
diabetes in East Thailand. Journal of
Science, Technology, and Humanities, 9(2),
65-74

Nitiyanant, W., Chetthakul, T., Sang-A-kad, P.,
Therakiatkumjorn, C., Kunsuikmengrai, K., &
Yeo, J. P. (2007). A survey study on diabetes
management and complication status in
primary care setting in Thailand. Journal of
the Medical association of Thailand, 90(1),
65-71. [In Thai]

Orasanu, G., & Plutzky, J. (2009). The continuum
of diabetic vascular disease: From macro -
to micro. Journal of the American College
of Cardiology, 53(Suppl 5), S35-S42.

Peduzzi, P., Concato, J., Kemper, E., Holford, T., &
Feinstein, A. (1996). A simulation of the
number of events per variable in logistic
regression analysis. Journal of Clinical
Epidemiology, 99, 1373-1379

Pichiwong, W. (2015). Diabetes and-Kidney
Disease. Journal of the department of
medical service, September - October,
19-24. [In Thai]

Rhee, S. Y., Guan, H. Liu, Z. M., Cheng, S.W.,
Waspadji, S., Palmes, P., ... Kim, Y. S. (2007).
Multi-country study on the prevalence
and clinical features of peripheral arterial
disease in Asian type 2 diabetes patients
at high risk of atherosclerosis. Diabetes
Research and Clinical Practice, 76(1), 82-92

Satirapod, B. (2011). Diagnosis and management
of diabetic nephropathy. Royal Thai Army
Medical Journal, 64(1), 53-63. [In Thai]

Sriwijitkamol, A., Moungngern, Y., & Vannaseang,
S. (2011). Assessment and Prevalence of
diabetic complications in 722 Thai Type 2
Diabetes Patients. Journal of the Medical
Association of Thailand, 94(Suppl. 1),
S168-S174

Wilson, A. M., Sadrzadeh-Rafe, A. H., Myers, J.,
Assimes, T., Nead, K. T., Higgins, M., ... Cooke,
J. P. (2011). Low lifetime recreational
activity is a risk factor for peripheral
arterial disease. Journal of Vascular Surgery,
54(2), 427-432

Yang, H., Young, D., Gao, J., Yuan, Y., Shen, M.,
Zhang, Y., ... Sun, X. (2019). Are blood
lipids associated with microvascular
complications among type 2 diabetes
mellitus patients? A cross-sectional study
in Shanghai, China. Lipids in health and
disease, 18(1), Doi.org/10.1186/s12944-019-
0970-2.