Multisystem Complications of Type 2 Diabetes Mellitus: A Cross-Sectional Public Health Assessment of Preventive Care, Antidiabetic Therapy, Glycemic Control with Renal, Ocular and Neurological Outcomes

Abstract

Abstract: Type 2 diabetes mellitus (T2DM) is a major public health problem associated with progressive metabolic and vascular abnormalities that can affect multiple organ systems. Renal disease, diabetic retinopathy, and diabetic neuropathy are among the most important microvascular complications and may remain clinically silent during their early stages. Early diagnosis, appropriate antidiabetic pharmacotherapy, sustained glycemic control, and systematic screening are therefore central components of diabetes care. Objective: To assess the prevalence of renal, ocular, and neurological complications among adults with T2DM and to evaluate their relationship with preventive care practices, antidiabetic therapy, duration of diabetes, and glycemic control. Methodology: A hospital-based cross-sectional analytical study was designed among adults with established T2DM at JPMC. Demographic and clinical information included age, sex, duration of diabetes, body mass index, blood pressure, antidiabetic treatment, treatment adherence, HbA1c, and preventive screening practices. Renal outcomes were assessed using serum creatinine, estimated glomerular filtration rate (eGFR), and urinary albumin-to-creatinine ratio (UACR). Ocular assessment included documented retinal examination and diabetic retinopathy status. Neurological assessment included symptoms of peripheral neuropathy, sensory examination, and 10-g monofilament testing where available. Associations between glycemic control and complications were evaluated using descriptive and inferential statistics. Results: The results showed that 58.0% had suboptimal glycemic control (HbA1c ≥7%). Renal abnormalities were identified in 27.0%, ocular complications in 24.0% and clinical neurological manifestations consistent with peripheral neuropathy in 32.0%. Participants with HbA1c ≥7% demonstrated higher frequencies of renal, ocular and neurological complications than those with HbA1c <7%. Annual renal screening was documented in 61.0%, retinal screening in 57.5%, and annual neuropathy/foot assessment in 46.5%. Poor preventive-care adherence was more common among participants with longer diabetes duration. Conclusion: The findings supported a multisystem approach to T2DM management in which glycemic control is combined with routine renal, retinal, and neurological surveillance. The observed relationship between suboptimal glycemic control and microvascular complications emphasizes the importance of early screening, treatment adherence, patient education, and integrated primary-care follow-up.