Prevalence, pattern, and potential predictors of microvascular complications in aging Nigerians with type 2 diabetes

Submitted: 24 January 2024
Accepted: 6 June 2024
Published: 13 June 2024
Abstract Views: 119
PDF: 56
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


In low-resource settings like Nigeria, the rising prevalence of diabetes is accompanied by an excessive burden of microvascular complications from diabetes. This study aimed to determine the prevalence and predictors of microvascular complications among older patients with diabetes mellitus. Therefore, a 2-year retrospective cross-sectional study was carried out among elderly diabetes patients at the Chief Tony Anenih Geriatric Center outpatient diabetes clinic. A total of 148 diabetic patients were included in the study; the mean (± standard deviation) age was 70.89 (±6.99) years, with 71.6% of the studied population being female. Logistic regression analysis was employed to determine the prevalence and predictors of microvascular complications. Results show that the prevalence of microvascular complications in older diabetes patients was 73.9% [95% confidence interval (CI)=66.7-81.6] with peripheral neuropathy (77.1% prevalence, 95% CI=67.9-84.8) being the most common and retinopathy being the least prevalent (95% CI=4.7-16.8). The significant predictors of developing microvascular complications were intake of oral agents only [p=0.013, odds ratio (OR)=2.35, 95% CI=1.15-16.81], number of comorbidities (p=0.041, adjusted OR=5.28, 95% CI=1.09-27.93) and systolic blood pressure (p=0.042, OR=1.02, 95% CI=1.00-1.04). Considering the high prevalence of microvascular complications among aging patients with diabetes mellitus, older patients should comply with oral medications and undergo regular check-ups, and more advocacy should be undertaken to strengthen geriatric healthcare systems to mitigate comorbidities and reduce complications.



PlumX Metrics


Download data is not yet available.


World Health Organization. Reducing the burden of non-communicable diseases through strengthening prevention and control of diabetes; 2021. Available from:
Kirkman MS, Briscoe VJ, Clark N, et al. Diabetes in older adults. Diabetes Care 2012;35:2650-64. DOI:
Mansour A, Mousa M, Abdelmannan D, et al. Microvascular and macrovascular complications of type 2 diabetes mellitus: exome wide association analyses. Front Endocrinol 2023;14:1143067. DOI:
International Diabetes Federation. IDF Diabetes Atlas. 10th ed. Brussels, Belgium: International Diabetes Federation; 2021.
Ong KL, Stafford LK, McLaughlin SA, et al. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2023;402:203-34. DOI:
Mordarska K, Godziejewska-Zawada G. Diabetes in the elderly. Prz Menopauzalny 2017;16:38-43. DOI:
Bellary S, Kyrou I, Brown JE, Bailey CJ. Type 2 diabetes mellitus in older adults: clinical considerations and management. Nat Rev Endocrinol 2021;17:534-48. DOI:
Meneilly GS, Tessier D. Diabetes in elderly adults. J Gerontol A Biol Sci Med Sci 2001;56:M5-13. DOI:
Chang AM. Halter JB. Aging and insulin secretion. Am J Physiol Endocrinol Metab 2003;284:E7-12. DOI:
Maedler K, Schumann DM, Schulthess F, et al. Aging correlates with decreased β-cell proliferative capacity and enhanced sensitivity to apoptosis: a potential role for Fas and pancreatic duodenal homeobox-1. Diabetes 2006;55:2455-62. Retracted in: Diabetes 69:494. DOI:
Rankin MM, Kushner JA. Adaptive β-cell proliferation is severely restricted with advanced age. Diabetes 2009;58:1365-72. DOI:
Meneilly GS, Tessier D. Diabetes in the elderly. Diab Med 1995;12:949-60. DOI:
Huang ES, Laiteerapong N, Liu JY, et al. Rates of complications and mortality in older patients with diabetes mellitus. The diabetes and aging study. JAMA Intern Med 2014;174:251-8. DOI:
Sanyaolu A, Marinkovic A, Prakash S, et al. Diabetes mellitus: an overview of the types, prevalence, comorbidity, complication, genetics, economic implication, and treatment. World J Meta-Anal 2023;11:134-43. DOI:
Asghar S, Asghar S, Shahid S, et al. Metabolic syndrome in type 2 diabetes mellitus patients: prevalence, risk factors, and associated microvascular complications. Cureus 2023;15:e39076. DOI:
Oyakhire F, Adejumo BIG, Aiyegbusi OV, et al. Coagulation profile in diabetes mellitus and its association with microvascular complications in uncontrolled and controlled diabetes at Edo specialist hospital, Benin-City, south-south, Nigeria. Med Lab Tech J 2023;9. DOI:
Purnamasari D, Tetrasiwi EN, Kartiko GJ, et al. Sarcopenia and chronic complications of type 2 diabetes mellitus. Rev Diabet Stud 2022;18:157-65. DOI:
Lu B, Yang Z, Wang M, et al. High prevalence of diabetic neuropathy in population-based patients diagnosed with type 2 diabetes in the Shanghai downtown. Diabetes Res Clin Pract 2010;88:289-94. DOI:
Yang Q, Zhang Y, Zeng Q, et al. Correlation between diabetic peripheral neuropathy and sarcopenia in patients with type 2 diabetes mellitus and diabetic foot disease: a cross-sectional study. Diabetes Metab Syndr Obes 2020;13:377-86. DOI:
Owolabi MO, Ipadeola A. Total vascular risk as a strong correlate of severity of diabetic peripheral neuropathy in Nigerian Africans. Ethn Dis 2012;22:106-12.
Seid MA, Akalu Y, Gela YY, et al. Microvascular complications and its predictors among type 2 diabetes mellitus patients at Dessie town hospitals, Ethiopia. Diabetol Metab Syndr 2021;13:86. DOI:
Alami HE, Haddou I, Benaadi G, et al. Prevalence and risk factors of chronic complications among patients with type 2 diabetes mellitus in Morocco: a cross-sectional study. Pan African Med J 2022;41:182.
Shiferaw WS, Akalu TY, Work Y, Aynalem YA. Prevalence of diabetic peripheral neuropathy in Africa: a systematic review and meta-analysis. BMC Endocr Disord 2020;20:49. DOI:
Yokono K. Concept and clinical characteristics of diabetes mellitus in the elderly. Nihon Rinsho 2013;71:1893-8. [Article in Japanese].
Gnonlonfoun DD, Sowanou A, Gnigone P, et al. Prevalence and associated factors with peripheral neuropathies in the general population in the rural area of Adjohoun in Benin. J Clin Neurosci 2023;109:32-8. DOI:
Corriere M, Rooparinesingh N, Kalyani RR. Epidemiology of diabetes and diabetes complications in the elderly: an emerging public health burden. Curr Diab Rep 2013;13:805-13. DOI:
Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146-56. DOI:
Crandall J, Schade D, Ma Y, et al. The influence of age on the effects of lifestyle modification and metformin in prevention of diabetes. J Gerontol A Biol Sci Med Sci 2006;61:1075-81. DOI:
Tesfaye S, Stevens L, Stephenson J, et al. Prevalence of diabetic peripheral neuropathy and its relation to glycaemic control and potential risk factors: the EURODIAB IDDM complications study. Diabetologia 1996;39:1377-84. DOI:
Schernthaner G, Schernthaner-Reiter MH. Diabetes in the older patient: heterogeneity requires individualisation of therapeutic strategies. Diabetologia 2018;61:1503-16. DOI:
Zofia Dice-C, Ronny P. Elderly HbA1c goals and complications. Curr Res Diabetes Obes J 2022;16:555931. DOI:
Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Phys Ther 2008;88:1254-64. DOI:
Olamoyegun M, Ibraheem W, Iwuala S, et al. Burden and pattern of micro vascular complications in type 2 diabetes in a tertiary health institution in Nigeria. Afri Health Sci 2015;15:1136-41. DOI:
Kyari F, Tafida A, Sivasubramaniam S, et al. Prevalence and risk factors for diabetes and diabetic retinopathy: results from the Nigeria national blindness and visual impairment survey. BMC Public Health 2014;14:1299. DOI:
Billah M, Rahim M, Anisur Rahman M, et al. Pattern and risk factors of diabetic retinopathy among type 2 diabetic patients: experience in a tertiary care hospital. J Med 2016;17:17. DOI:
Fahmy H, Khalifa W, Sharafeldin M, et al. Diabetic retinopathy and major risk factors among type 2 diabetic patients attending Assiut university hospitals. J Med Sci Clin Res 2016;4:11782-90. DOI:
Magan T, Pouncey A, Gadhvi K, et al. Prevalence and severity of diabetic retinopathy in patients attending the endocrinology diabetes clinic at Mulago hospital in Uganda. Diabetes Res Clin Pract 2019;152:65-70. DOI:
Mathur R, Bhaskaran K, Edwards E, et al. Population trends in the 10-year incidence and prevalence of diabetic retinopathy in the UK: a cohort study in the clinical practice research Datalink 2004-2014. BMJ Open 2017;7:e014444. DOI:
Shah A. Prevalence of diabetic retinopathy in the United States, 2011-2014. Value Health 2016;19:A199. DOI:
Zhang X, Saaddine JB, Chou CF, et al. Prevalence of diabetic retinopathy in the United States, 2005–2008. JAMA 2010;304:649-56. DOI:
Tracey ML, McHugh SM, Fitzgerald AP, et al. Risk factors for macro-and microvascular complications among older adults with diagnosed type 2 diabetes: findings from the Irish longitudinal study on ageing. J Diabetes Res 2016;2016:5975903. DOI:
Ekoru K, Doumatey A, Bentley AR, et al. Type 2 diabetes complications and comorbidity in Sub-Saharan Africans. EClinicalMedicine 2019;16:30-41. DOI:
Haque M, Emerson SH, Dennison CR, et al. Barriers to initiating insulin therapy in patients with type 2 diabetes mellitus in public-sector primary health care centres in Cape Town. S Afr Med J 2005;95:798-802. DOI:
Jasper US, Opara MC, Pyiki EB, Akinrolie O. Knowledge of insulin use and its determinants among Nigerian insulin requiring diabetes patients. J Diabetes Metab Disord 2014;13:10. DOI:
Ugwu E, Ojobi J, Ndibuagu E. Misconceptions about insulin and barriers to insulin initiation in type 2 diabetes among general physicians in southeast Nigeria. J Adv Med Med Res 2020;32:30-8. DOI:
Shaw JE, Hodge AM, de Courten M, et al. Diabetic neuropathy in Mauritius: prevalence and risk factors. Diabetes Res Clin Pract 1998;42:131-9. DOI:
Aikaeli F, Njim T, Gissing S, et al. Prevalence of microvascular and macrovascular complications of diabetes in newly diagnosed type 2 diabetes in low-and-middle-income countries: a systematic review and meta-analysis. PLOS Glob Public Health 2022;2:e0000599. DOI:
Mana ST, Mahdi DS, Altemimi MT. The Prediction of Macrovascular Complications in Individuals with Type 2 diabetes mellitus with Different Risk Factors in ThiQar. UTJsci 2023;10:964. DOI:
Zarora R, Jani R, MacMillan F, et al. Challenges to introducing integrated diabetes care to an inner-regional area in south western Sydney, Australia. Int J Integr Care 2020;20:6. DOI:
Powers MA, Bardsley JK, Cypress M, et al. Diabetes self-management education and support in adults with type 2 diabetes: a consensus report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care 2020;43:1636-49. DOI:

How to Cite

Balogun, W., Emuze, M., Adebusoye, L., & Olowookere, O. (2024). Prevalence, pattern, and potential predictors of microvascular complications in aging Nigerians with type 2 diabetes. Geriatric Care, 10(1).