Glycemic Control and the Risk of Microvascular and Macrovascular Complications in Patients with Type 2 Diabetes Mellitus: A Hospital-Based Cross-Sectional Study

Abstract

Background: Chronic hyperglycemia is the principal modifiable driver of both microvascular and macrovascular complications in type 2 diabetes mellitus (T2DM). Glycated hemoglobin (HbA1c) integrates glycemic exposure over ~3 months and is the accepted surrogate for long-term control. This study examined the relationship between the degree of glycemic control and the prevalence of chronic diabetic complications.

Methods: A hospital-based cross-sectional study was conducted on 300 adults with established T2DM attending a tertiary care diabetes clinic. Participants were stratified by HbA1c into good (<7.0%), moderate (7.0–8.9%), and poor (≥9.0%) control. Microvascular (retinopathy, nephropathy, neuropathy) and macrovascular (coronary artery disease, peripheral vascular disease, stroke) complications were ascertained clinically and by record review. Associations were tested using the chi-square test and multivariable logistic regression, adjusting for age, diabetes duration, body mass index (BMI), and systolic blood pressure.

Results: The prevalence of every complication rose progressively across worsening glycemic strata (all p<0.05). Any microvascular complication affected 26.7%, 45.8%, and 73.3% of the good, moderate, and poor control groups, respectively. After adjustment, poor control independently predicted any diabetic complication (adjusted odds ratio [aOR] 5.84, 95% CI 3.01–11.34), as did longer diabetes duration and higher systolic blood pressure.

Conclusion: Poorer glycemic control was strongly and independently associated with a higher burden of diabetic complications. The findings reinforce individualized but sustained glycemic targets as a cornerstone of complication prevention in T2DM