Macrovascular Complications and their associated Factors among persons with Type 2 Diabetes in Karachi, Pakistan - A multi-center Study

Objective: To assess the prevalence of macrovascular complications and factors associated with these complications among persons with Type 2 diabetes. Methods: A multi-center, cross-sectional survey was conducted in three diabetes clinics of Karachi from November 2000 to April 2001. Six hundred and seventy-two persons were interviewed to determine the prevalence of ischemic heart disease (IHD), cerebrovascular disease (CVA) and diabetic foot (DF). Demographic data and co-variables obtained include age, sex, duration of diabetes, body mass index (BMI), smoking status, exercise habits and history of hypertension (HTN). Results: Overall, 26.4%, 6.8% and 3.9% of individuals had IHD, CVA and DF respectively. Multiple logistic regression analysis showed that subjects having IHD were more likely to have HTN (AOR=1.88, 95% CI 1.31-2.69), not performing regular exercise (AOR=2.09, 95% CI 1.39-3.17) and be current smokers (AOR=1.85, 95% CI 1.10-3.10). Subjects having CVA were more likely to have diabetes for more than 5 years (AOR=1.94, 95% CI 0.97-3.87). Males were more prone than females to have DF (AOR=3.48, 95% CI 1.46-8.31). Those who had DF were more likely to have diabetes for more than 5 years (AOR=3.29, 95% CI 1.09-9.89) and of reporting current smoking (AOR=4.01, 95% CI 1.49-10.71). Conclusion: Large proportions of persons with Type 2 diabetes were suffering from preventable macrovascular complications in Karachi, Pakistan. There is a need to develop risk factor modification interventions to reduce the impact of long-term complications.