Gender Dependency of Microvascular Complications in Patients of Diabetes Mellitus at a Tertiary Level Hospital in Bangladesh

Author(s): Jahan F, Alam MR, Hossain M, Islam SF, Hossain MK, Ahmed AHH, Islam MN, Khan MMR, Rahman AKMS.

Background: Diabetes and chronic kidney disease (CKD) are major public health burden in a developing country like Bangladesh. Chronic hyperglycemia in diabetes mellitus (DM) leads to serious microvascular complications. Aim: To assess gender-based differences in the prevalence and severity of microvascular complications and chronic kidney disease (CKD) among diabetic patients at a tertiary-level hospital in Bangladesh. Method: This cross-sectional study was conducted at the outpatient department of a tertiary-level hospital in Bangladesh between July 2022 to December 2022 and included 282 diabetic patients (182 males and 100 females). Data were collected using structured questionnaires from medical records, and laboratory test results. Demographic details, clinical characteristics, biochemical parameters, and microvascular complications were assessed. CKD stages were determined using estimated glomerular filtration rate (eGFR). Results: Out of 282 diabetic patients (182 males, 100 females) with most aged between 40–60 years, the highest age group among males was 50–60 years (38%) and among females that was 40–50 years (36%). Females were more likely to be from urban areas (68% versus 52%, p= 0.024) and showed non-significant trends toward higher rates of hypertension (34.3% versus 26.5%) and family history of diabetes (52% versus 40.9%). Biochemical parameters- including renal status, lipid levels, and glycemic markers were compared between sexes. However, females had significantly lower mean eGFR (22.88 ml/minute/1.73m² versus 27.8 ml/minute/1.73m², p= 0.006), with 46.1% in CKD Stage IV compared to 35.4% of males. Among males, advanced CKD stages were significantly associated with proliferative diabetic retinopathy (p<0.001) and neuropathy (p= 0.008). Conclusion: These results are clear indication that there is considerable difference in prevalence of different microvascular diabetic complications related to chronic kidney disease between male and female. There are social, economic, and perhaps metabolic reasons for these differences.