Investigating metabolic control and complications in type 2 diabetic patients with low income in northwest of Iran, 2023.

Abstract

Background and aim: Socioeconomic factors are very important in non-communicable diseases (NCD) and their complications as a risk factor or as a barrier to receive effective health care. This study aimed to determine the prevalence of diabetes complications and factors related to glycemic control in type 2 diabetic patients with low income in Kurdistan Province, Iran.

Method: This cross-sectional study was conducted on 608 diabetic patients supported by the Imam Khomeini Relief Foundation in 2023 in the province of Kurdistan, northwest of Iran. In addition to collecting demographic data, major complications of diabetes were specified by clinical examination by specialist physicians and paraclinical data. Data analysis was performed in Stata version 16 using descriptive statistics and logistic regression modeling.

Results: A total of 608, 76.6% female, with mean and standard deviation age 62.7 ± 9.7 years were investigated. Prevalence of retinopathy, nephropathy, neuropathy, and diabetic foot ulcers were 42.9%, 6.9%, 3.3% and 4.3%, respectively. HbA1C levels were favorable (≤ 7.5) in only 231 (38.0%) patients. Longer duration of diabetes was associated with worse glycemic control0.95 (OR = 0.95; 95%CI:0.90-0.96), whereas comorbidity of DM and hypertension (OR = 2.05; 1.36-3.10) was significantly associated with good glycemic control.

Conclusion: Based on the results obtained, the health care and glycemic control status of low-income diabetic patients is not favorable. Considering the vulnerability of this group due to their low-risk perception and low income, it is recommended to teach self-care behaviors and plan routine care to prevent disease complications and, if necessary, fully cover the cost of care for these patients by the national health system.