Risk Factors for Degenerative Complications inPatients with Type 2 Diabetes: Nested Case-Control Study ‘Epidiam’ MoroccoRisk Factors for Degenerative Complications inPatients with Type 2 Diabetes: Nested Case-Control Study ‘Epidiam’ MoroccRisk Factors for Degenerative Complications inPatients with Type 2 Diabetes: Nested Case-Control Study ‘Epidiam’ MoroccoRisk factors for degenerative complications in patients with type 2 diabetes: nested case-control study ‘epidiam’ Morocco

Aims: Our study aims to determine associated risk factors with complications of diabetes in patients with type 2 diabetes followed in primary care centers in Morocco. Methods:We conducted a nested case - control study. Cases were type 2 diabetic’s patients who suffered from degenerative complication after diabetes diagnosis; controls were type 2 diabetic’s patients with no complications of diabetes at the time of inclusion in the cohort. The analysis was performed separately for women and men in order to determine the specificity of each sex factor. Results:732 patients with or without complications were identified. Retinopathy is the most frequent (41.2%) followed by diabetic neuropathy (28.4%) and cardiovascular complications (26.2%). For women, low economic level (ORadj = 11.36, 95% CI 5.59 - 23.25), forget the treatment (ORadj = 3.42, 95% CI 1.29 - 9.09), urban environment (ORadj = 3.97, 95% CI 0.04 - 0.17), very high level of stress (ORadj = 2.94, 95% CI 1.00 - 8.63), and overweight(ORadj = 2.50, 95% CI 1.12 - 5.53), remained significant with the risk of degenerative complications after adjustment.However, in unadjusted analysis for men, the low socioeconomic level and the patients without professional activities increased the degenerative complication risk. The patients with overweight [5.96 (95% CI: 1.61 - 22.10)], with dyslipidemia [3.09 (95% CI: 1.51- 6.33)] and patients treated by a general physician [4.57 (95% CI: 1.24 - 16.82)] were a higher risk for degenerative complication. Conclusion: These findings suggest that some risk factors of degenerative complication of type 2 diabetes are strongly linked with the Moroccan context. This study highlighted important areas for health care intervention and provided a reminder for vigilance when known risk factors for complications are present.