Association of hsCRP Levels with Microvascular Complications in Prediabetics, Newly Diagnosed and on Treatment Type 2 Diabetes Mellitus Patients: A Cross-sectional Study

Introduction: Low-grade chronic inflammation is recognised as the predominant cause of the pathogenesis and progression of Type 2 Diabetes Mellitus (T2DM) and its microvascular complications. High-sensitivity C-Reactive Protein (hsCRP) is a biomarker for inflammation that may indicate the underlying mechanisms of diabetes, such as insulin resistance and vascular damage. Aim: To compare hsCRP levels across three glycaemic categories- prediabetes, newly diagnosed T2DM, and ontreatment T2DM- and to determine its correlation with glycaemic control measures Glycated Haemoglobin (HbA1c), Fasting Blood Sugar (FBS), Post Prandial Blood Sugar (PPBS) and microvascular complications such as diabetic retinopathy, nephropathy, and neuropathy. Materials and Methods: The present hospital-based, crosssectional, analytical study was conducted over 18 months (October 2023 to March 2025) at Dr DY Patil Medical College, Hospital, and Research Centre, Pimpri, Pune, Maharashtra, India. One hundred fifty participants aged ≥18 years were randomly assigned to three groups: prediabetics, newly diagnosed T2DM (≤18 months), and T2DM under treatment. Measurements included FBS, PPBS, HbA1c, and hsCRP using an immunoturbidimetric assay. Diabetic retinopathy was diagnosed via fundoscopy, nephropathy was assessed through the urine albumin-creatinine ratio, and peripheral neuropathy was screened using a 10g monofilament and sensory examination. Data were analysed using IBM Statistical Package for Social Sciences (SPSS) v20. Comparisons between groups were conducted with One-way Analysis of Variance (ANOVA) and the Chi-square test. A p-value of <0.05 was considered statistically significant. Results: Mean hsCRP values were significantly higher in newly diagnosed (7.87±1.26 mg/L) and on-treatment diabetics (7.26±2.30 mg/L) compared with pre-diabetics (2.72±2.80 mg/L; p<0.001). hsCRP exhibited a strongly positive correlation with HbA1c (r=0.616), FBS (r=0.223), and PPBS (r=0.461). Patients with diabetic retinopathy, nephropathy, and neuropathy had significantly elevated hsCRP levels compared to those without complications (p<0.001). Conclusion: hsCRP is a valuable marker of inflammation associated with poor glucose control and the development of diabetic microvascular complications. Regular monitoring can aid in the early detection of risk, facilitating targeted antiinflammatory therapy and strict glycaemic control.