Introduction: The majority of people with diabetes have type 2 diabetes mellitus (T2DM), a form of disease that is not contagious and has serious health consequences. An important, non-modifiable risk factor for COVID-19 and cardiovascular disease is a family history of diabetes.

Objective: T2DM complications and their relationship to age, family history, consanguinity and COVID-19 in a 12-month cohort study in Khyber Pakhtunkhwa population.

Methods: We enrolled 150 people with type 2 diabetes who were taking the oral anti-diabetic medications metformin, glimepiride and their combination therapy for 12 months. There were 82 women and 68 men in the study, with ages ranging from 30 to 70. The Diabetes Hospital and Research Center Peshawar in Khyber Pakhtunkhwa, Pakistan, hosted the study and the hospital's Ethics Research Committee gave its blessing for its conduct. Clinical study data were collected via questionnaire using a non-probability purposive sampling strategy and analyzed with SPSS-23.

Results: Out of the total number of 150 diabetic subjects enrolled in the study, 57 (38%) had cardiovascular disease, 27 (18%) had diabetic neuropathy, 14 (9%) had retinopathy and 3 (2%) had nephropathy at baseline. In the first follow-up (after 4 months), 61 patients (41% of the total) were diagnosed with CVD, 32 (21%) with diabetic neuropathy, 17 (11%) with retinopathy and 3 (2%) with nephropathy. In the second follow-up (after 8 months), 66 patients (44% of the total) were diagnosed with CVD, 34 (23%) with diabetic neuropathy, 20 (13%) with retinopathy and 3 (2%) with nephropathy. After 12 months, 79 (52.7%) of patients had CVD, 41 (27.3%) had diabetic neuropathy, 24 (16.4%) had retinopathy and 6 (4%) had nephropathy. 48 (32%) had a positive family history of diabetes, 85.3% had diabetes-related complications and 22 (14.7%) in the sample had a history of consanguinity. Only 8 (5.3% of the total) of the study subjects tested positive for COVID-19 via polymerase chain reaction.

Conclusions: The results showed that a significant correlation existed between participants' age and a positive family history of type 2 diabetes (P = 0.041). And a non-significant relationship exists between a positive family history of T2DM and onset age (P = 0.075). In this study, people who had recently been diagnosed with diabetes were monitored to determine their susceptibility to the SARS-CoV-2 infection. Those with T2DM are more likely to acquire the COVID-19 infection and to develop complications, especially cardiovascular complications. Throughout the course of the 12-month cohort study, more than half of the patients were diagnosed with cardiovascular disease. It is likely that comorbidities associated with diabetes can be reduced through the provision of health education, particularly for cardiovascular health and T2DM, such as increasing physical activity and consuming a low-calorie diet to control the glycemic profile.

Index Terms- Family history; T2DM; cardiovascular disease; consanguinity; SARS-CoV-2