Background: Type 2 diabetes mellitus (T2DM) is a global health concern associated with complications that significantly impact patients' quality of life and place significant burdens on healthcare systems. While the prevalence of T2DM is rising in Ethiopia, the scope and factors contributing to its complications remain understudied. Hence, this study aimed to assess the burden and identify associated factors of chronic complications among Type 2 diabetes mellitus patients attending Wolaita Sodo University Comprehensive Specialized Hospital in Southern Ethiopia.  Methods: A facility-based cross-sectional quantitative study was conducted from May to July 2024, involving 404 systematically sampled T2DM patients. Data on sociodemographic characteristics, clinical profiles, self-care practices, and chronic complications were collected through structured interviews and medical record reviews. Descriptive statistics summarized patient characteristics, while General Poisson regression identified factors associated with chronic complications. Results were reported as Adjusted Prevalence Ratios (APRs) with 95% Confidence Intervals (CIs), and a p-value < 0.05 was considered statistically significant. Results: Of the 404 participants, 45.54% (95% CI: 40.61 - 50.54)  had at least one chronic complication. Among these, 20.05% experienced one complication, 14.60% had two, 8.42% had three, and 2.48% had four. Peripheral neuropathy (14.85%) and nephropathy (9.65%) were the most common microvascular complications, while congestive heart failure (14.11%) and cerebrovascular disorders (11.39%) were the leading macrovascular complications. Multivariable Poisson regression identified older age (APR = 2.30; 95% CI: 1.23–4.28), longer diabetes duration (APR = 1.87; 95% CI: 1.28–2.76), elevated blood pressure (APR = 2.02; 95% CI: 1.21–3.37), and higher Body Mass Index (APR = 2.63; 95% CI: 1.43–4.81) as significant factors associated with increased prevalence of chronic complications. Conclusion: The study reveals a substantial burden of chronic complications among T2DM patients, driven by modifiable and non-modifiable risk factors such as age, diabetes duration, blood pressure, and body mass index. These findings emphasize the urgent need for targeted interventions, including improved disease management, regular monitoring, and lifestyle modifications, to mitigate complications and enhance patient outcomes.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Not Applicable

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was granted by the Institutional Review Board of Arba Minch University College of Medicine and Health Sciences (IRB/23166/2024). Consent was obtained from each participant after explaining the study objectives. Confidentiality was maintained by omitting personal identifiers from the questionnaire, and all data were securely stored and accessible only to the research team.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Not Applicable

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Not Applicable

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Not Applicable

The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.