Status of anemia and its associated factors in patients with Type 2 Diabetes Mellitus at a tertiary hospital in Nepal: An Observational Cross Sectional Study

BackgroundAnemia is a common but under-recognized comorbidity among patients with type 2 diabetes mellitus (T2DM). Data on its prevalence and determinants in Nepal are limited. This study assessed the prevalence of anemia and its associated factors among T2DM patients attending a tertiary hospital. MethodsA cross-sectional study was conducted in the Endocrinology Outpatient Department of KIST Medical College, Lalitpur, Nepal, from October 15, 2024, to January 15, 2025. The required sample size was 380, calculated using Cochrans formula; 342 consecutive adults with T2DM on anti-diabetic medication were enrolled (90% of the planned 380, with negligible impact on precision). Data were obtained from structured interviews, medical records, and laboratory reports. Anemia was defined using WHO criteria. Bivariate associations were examined using the Chi-square test (crosstabulation). Multivariate binary logistic regression was used to identify independent factors and sensitivity analysis was conducted to confirm robustness of findings; model fit was assessed with Hosmer-Lemeshow test. ResultsOf 342 participants, 73 (21.3%) had anemia, with higher prevalence in females (22.9%) than males (19.6%). Most cases were mild (75.3%). Anemia prevalence increased with longer duration of diabetes and was more frequent in vegetarians, hypertensive patients, and those with thyroid disorders. In multivariate analysis, thyroid disorder (AOR=2.579, 95% CI: 1.307-5.086, p=0.006), longer diabetes duration (AOR=1.004 per month, 95% CI: 1.001-1.008, p=0.007), vegetarian diet (AOR=2.830, 95% CI: 1.286-6.228, p=0.01) and hypertension (p=0.008) were independently associated with anemia. ConclusionAnemia affected approximately one-fifth of T2DM patients, predominantly of mild severity. Thyroid disorders, longer disease duration, vegetarian diet, and hypertension were significant predictors. Routine screening and targeted management of anemia may improve outcomes in this population.