Progression of major diabetic microvascular complications over a period >1 year since their diagnosis in patients from northern Peru

Perez-Cunavi M.M.; Pisco Sánchez J.A.; Asenjo-Alarcón J.A. · Revista Facultad de Medicina (2026) · DOI: 10.15446/revfacmed.v74.121536

Resumen

Introduction: Microvascular complications are the main consequence of the diabetes mellitus (DM) progression. These complications significantly affect quality of life and increase the mortality rate of these patients. Diabetic neuropathy, retinopathy, and nephropathy are the most frequent microvascular complications. Objective: To describe the progression of the major diabetic microvascular complications over a period >1 year since their diagnosis in patients treated at a regional hospital in northern Peru. Materials and methods: This retrospective, longitudinal, descriptive study was conducted using data from 185 patients diagnosed with at least one of the major diabetic microvascular complications (i.e., diabetic nephropathy, neuropathy, and retinopathy) treated during 2023 at the Regional Hospital of Cajamarca, Peru. Information regarding the clinical stage or phase of each complication was collected at 5 different time points: at diagnosis, at 3, 6, and 12 months, and at the last evaluation since diagnosis. To assess the progression of diabetic nephropathy, neuropathy, and retinopathy, the measures of these microvascular complications (i.e., frequency or proportion of patients in the different stages or phases of the condition) were compared across the multiple time points using Friedman and Cochran’s Q tests. Results: Most patients were women (61.62%), with a median age of 60 years (IQR: 50.50–69) (older adults: 50.81%). The mean age at diagnosis was 52.24 ± 12.61 years, and the median time elapsed since DM diagnosis was 6 years [IQR: 2–9]. Diabetic neuropathy was the most common complication (58.92%), followed by diabetic retinopathy (40.00%). The progression of diabetic nephropathy between the time of its diagnosis (stage 1: 81.36; stage 2: 8.47%; stage 3: 8.47%) and the last evaluation (23.81%, 49.21%, 22.22%) was statistically significant (p<0.001). This was also the case for diabetic nephropathy (79.82% in the subclinical phase and 20.18% in the clinical phase at the time of diagnosis vs. 38.46% and 51.28% at the last assessment [>1 year since diagnosis], p<0.001). Conclusion: A statistically significant worsening of diabetic neuropathy and diabetic nephropathy was observed between the time of complication diagnosis and the last evaluation (>1 year since diagnosis). The prevalence of each of the three microvascular complications was high, particularly diabetic neuropathy.

Instituciones: Universidad Nacional Autónoma de Chota