Background: People with type 2 diabetes mellitus (T2DM) may develop micro- and neurovascular complications, but their current prevalence and overlap are unknown.

Objective: To investigate the prevalence and overlap of peripheral neuropathy, retinopathy and nephropathy in patients with T2DM in a secondary care setting in the Netherlands, and to gain insight in their risk factors.

Methods: In this cross-sectional cohort study, 345 patients with T2DM were included. Data was collected through questionnaires, physical examination and analyses of blood- and urine samples. Risk factors were investigated by multivariate logistic regression analysis.

Results: Participants were 64±9 years, mean HbA1c was 57±12 mmol/mol and median duration of diabetes was 11[6-18] years. Peripheral neuropathy was present in 35% of participants, retinopathy in 28%, nephropathy in 43%. Concerning the overlap, 32% had no complications, 34% had one, 27% had two, and 6% had all three. The final predictive models for each complication included the following strongest independent variables: for peripheral neuropathy, the presence of nephropathy (OR 2.09; CI 1.29-3.40) and the presence of peripheral artery disease (OR 2.75; CI 1.26-6.02); for nephropathy, the presence of peripheral neuropathy (OR 1.78; CI 1.10-2.86) and male sex (OR 1.70; CI 1.06-2.72); for retinopathy, insulin use (OR 2.67; CI 1.19-5.96) and the presence of peripheral artery disease (OR 2.97; CI 1.24-7.14).

Conclusion: Micro- and neurovascular complications in patients with T2DM frequently co-occur and they share potential risk factors. However, the overlap is more limited than expected. This suggests that different determinants may play a part in the development of these complications.