Epidemiological profile of type 2 diabetic patients followed at a secondary care referral center: Data from a Moroccan cohort study

Abstract

Type 2 diabetes is a major public health problem responsible for several macro and microvascular complications, including diabetic nephropathy. The main objective of this study was to describe the epidemiological profile of type 2 diabetic patients at admission to a reference center for chronic diseases and to explore associated factors with a glomerular filtration rate decline (GFR). This retrospective cohort study aims to examine the epidemiological characteristics of patients with type 2 diabetes who had at least one consultation between November 2005 and December 2020. The study included 19,953 patients, of whom 67.8% were women, with an average age of 58.2 ±12.2 years. The majority (64.7%) had a diabetes duration of less than 5 years. On admission, 37.6% of patients had high blood pressure, 41.8% were overweight, while 31.5% were obese. Nearly 9% of patients had at least one complication on admission: 2.6% had heart disease, 2% had nephropathy, 1.8% had retinopathy, 0.7% had neuropathy and 0.5% had a diabetic foot. The study found that 76.8% of patients had poorly controlled diabetes, and 30.1% had a GFR < 60 ml/min/1.73 m². Women, patients over 65 years, those with a diabetes duration > 30 months, hypertensive patients, those with at least one complication on admission, patients with overweight or obesity, and those with positive albuminuria had significantly lower GFR (p<0.001). Our study showed that most patients were initially diagnosed with Type 2 diabetes in primary healthcare and had a very high risk of complications. Primary care health centers may not have sufficient human and material resources to effectively screen for and monitor these complications. Therefore, it is crucial to strengthen secondary care referral centers to ensure comprehensive and optimal management of diabetes patients, including diabetic control and early detection and management of its complications.