Background: Type 2 diabetes mellitus (T2DM) is one of the most rapidly expanding non-communicable diseases in India, with substantial implications for individual disability, healthcare expenditure, and population health. Tertiary care institutions encounter a complex spectrum of T2DM that frequently includes long-standing disease, suboptimal glycaemic control, multiple comorbidities, and established or evolving complications. Objective: The present prospective observational investigation aimed to characterize the clinical profile, glycaemic-control status, comorbidity burden, complication spectrum, treatment patterns, and 6-month outcomes of patients with T2DM attending a tertiary care institution in South India. Methods: A prospective observational study was conducted from June 2016 to February 2017 in the Department of General Medicine, South India. A total of 540 adult patients with T2DM (per ADA criteria) were enrolled. Comprehensive baseline assessment included history, examination, anthropometry, blood pressure, fasting glucose, HbA1c, lipid profile, renal function, urine albumin-creatinine ratio, ECG, and dilated fundus examination. Glycaemic control, comorbidities, microvascular and macrovascular complications, and treatment regimens were documented. Follow-up at 6 months captured glycaemic-control change, hospitalization, and mortality. Results: Mean age was 56.4 ± 11.8 years; 56.7% male; mean diabetes duration 9.6 ± 7.4 years. Baseline mean HbA1c was 8.6 ± 1.8%; only 28.0% achieved HbA1c <7%. Hypertension coexisted in 58.3%, dyslipidaemia in 51.5%, and obesity in 32.4%. Microvascular complications were prevalent: diabetic retinopathy 31.5%, neuropathy 38.7%, nephropathy 26.7%; macrovascular complications: ischemic heart disease 18.7%, cerebrovascular disease 7.4%, peripheral arterial disease 9.4%; and diabetic foot ulcer in 6.9%. Insulin therapy was prescribed in 38.0%. At 6 months, mean HbA1c declined to 7.8 ± 1.5%, with 41.5% achieving HbA1c <7% (p < 0.001). Hospitalization occurred in 14.3%, and overall mortality was 2.4%. Independent predictors of poor outcome included longer diabetes duration, baseline HbA1c ≥9%, microvascular and macrovascular complications, and inadequate adherence. Conclusion: T2DM patients at this tertiary centre exhibit substantial complication burden and suboptimal glycaemic control. Structured comprehensive management improves outcomes, but multidisciplinary care, adherence support, and complication-prevention strategies require sustained strengthening.

Type 2 diabetes mellitus; HbA1c; complications; nephropathy; retinopathy; tertiary care; outcome