Lifestyle-related Risk Factors and Complications in Patients with Type 2 Diabetes Mellitus

Abstract

Objective: To evaluate the association between lifestyle, glycemic control, and complications related to Type 2 Diabetes Mellitus (T2DM). Methods: Cross-sectional study, using non-probability consecutive sampling, during the months of January to December 2023 in the Family Medicine Unit number 77 of the Mexican Social Security Institute (IMSS) of Ciudad Madero, Tamaulipas. Mexico. Lifestyle was assessed using the Instrument for Measuring Lifestyle in Diabetics (IMEVID). Glycemic control was defined as HbA1c ≤7%. Results: The mean age was 52.9 ± 6.5 years; 65.2% were women; the mean HbA1c was 7.86% (range 5.1–14.0). 39.6% achieved HbA1c ≤7%. IMEVID scores were: favorable 34.4%, somewhat favorable 45.6%, and unfavorable 20.0%. 18.1% presented with ≥1 complication (neuropathy 5.2%, nephropathy 4.4%, retinopathy 3.7%). In the multivariable model, hypertension (aOR 1.32; 95% CI 1.01–1.75; p=0.034), dyslipidemia (1.62; 1.05–2.48; p=0.021), metabolic syndrome (1.87; 1.25–2.80; p=0.001), and higher HbA1c (1.58; 1.10–2.26; p=0.015) increased the likelihood of complications. Compared to combination therapies, oral therapy alone (3.46; 1.73–6.82; p=0.001) and insulin alone (2.15; 1.19–3.90; p=0.004) were associated with a higher risk. An unfavorable IMEVID score was the strongest predictor (4.29; 2.47–7.46; p<0.001), while a favorable IMEVID score was protective (0.38; 0.26–0.54). Marital status “married” showed a protective association (0.21; 0.14–0.63; p=0.015). Conclusions: In primary care, lifestyle factors as measured by the IMEVID were independently associated with type 2 diabetes complications, beyond glycemic control and comorbidities. Integrating behavioral assessment with metabolic management and favoring combination therapies could reduce the burden of late complications in patients.