The comorbidity burden of type 2 diabetes mellitus (T2DM): sex differences and associated factors among 830 cases in North-Eastern Morocco.

Background and aim: Type 2 diabetes is prone to numerous comorbidities resulting from complex mechanisms involving hyperglycemia, insulin resistance, low-grade inflammation and accelerated atherogenesis. The purpose of the present study was to investigate these disorders and their associated risk factors according to patient sex in a population of type 2 diabetics in North-Eastern Morocco.

Methods: This study was conducted in a medical analysis laboratory over a 1-year period from 01/10/2018 to 01/10/2019. This epidemiological study was carried out on 830 subjects aged 18 and over. Quantitative variables were expressed as means ± standard deviation, and qualitative variables as frequencies and percentages. Hypothesis tests used to compare means and proportions were Student's t-test and Chi-square test of independence, respectively. Logistic regression was used to predict risk factors for each diabetes.

Results: 830 patients were surveyed. 95.66% had diabetes-related comorbidities. Hypertension (23.7%), nephropathy (18.19%), dyslipidemia (14.82%), thyroid dysfunction (10.72%), cataract (10.12%), diabetic foot (7.23%), ketoacidosis (6.27%), retinopathy (3.49%), and skin disorders (2.77%) were observed. Sex was associated with dyslipidemia (p = 0.025), hypertension (p = 0.032) and retinopathy (p = 0.029). Uncontrolled blood sugar, unbalanced lipid profile, age, physical activity, obesity, smoking, and alcohol consumption were risk factors with differential involvement in the occurrence of the mentioned pathologies.

Conclusions: The results of our study showed that a significant proportion of the population suffers from diabetic comorbidities. To meet this challenge, further research is needed to identify the mechanisms of action of these factors, to control them and combat diabetogenic environments by setting up adapted educational programs.