Prevalence of Micro- and Macrovascular Diabetes Complications at Time of Type 2 Diabetes Mellitus Diagnosis: A Cross-sectional Study

Aim and background:The aim of this study was to determine the prevalence of micro and macrovascular complications among newly diagnosed type 2 diabetes mellitus (T2DM) patients in an Indian clinical setting.Materials and methods: We conducted a cross-sectional study among 4,126 newly diagnosed T2DM patients between January and August 2025.Prevalence was assessed at baseline through clinical evaluation and laboratory tests.Prevalence ratios (PRs) with 95% confidence intervals (CIs) were calculated using log-binomial regression, adjusting for age and sex.Results: At diagnosis, 42% (N = 1,734) of patients had complications.Of these, 17% (N = 701) had microvascular complications, 21% (N = 867) had macrovascular complications, and 4% (N = 166) had both.Microvascular complications were most frequently retinopathy (11%), followed by nephropathy (4%) and neuropathy (2%).Macrovascular complications included ischemic heart disease (IHD) (13%), cerebrovascular disease (5%), and peripheral vascular disease (PVD) (3%).Glycated hemoglobin (HbA1c) 7.5% was associated with microvascular complications (aPR: 1.38; 95% CI: 1.12-1.70)but not macrovascular disease (aPR: 0.94; 95% CI: 0.78-1.15).Macrovascular complications were significantly associated with male gender, age 50 years, obesity, dyslipidemia, smoking, and hypertension.Conclusion: More than two-fifths of Indian patients with newly diagnosed T2DM had established vascular complications at baseline, indicating delayed diagnosis.Hyperglycemia appears more strongly linked to microvascular disease, whereas macrovascular disease is associated with metabolic syndrome and cardiovascular risk factors.Early detection is urgently needed in the Indian setting for achieving an improved outcome.Clinical significance: A substantial proportion of newly diagnosed T2DM patients already have vascular complications, emphasizing the need for early screening and risk stratification.Timely management targeting glycemia may prevent progression and improve outcomes.