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Assessment of Diabetes Mellitus Prevalence and Associated Complications among Patients at Jinja Regional Referral Hospital

Al-Busaidy Swalah Suleiman Salim

Faculty of Clinical Medicine and Dentistry Kampala International University Western Campus Uganda.

ABSTRACT

In recent years, Africa has witnessed a notable shift in its disease landscape from acute infectious conditions to chronic non-communicable diseases like diabetes. The economic impact of diabetes and its complications has become a significant concern, affecting individuals, families, healthcare systems, and national economies through direct medical costs and productivity loss. Uganda, in particular, has observed a rising prevalence of diabetes, with the Uganda Diabetes Association reporting a 1.4% prevalence, accounting for approximately 500,000 individuals affected. This surge in diabetes presents a dual challenge as both a public health issue and an economic burden, necessitating vigilant monitoring and stringent management. Recognizing its profound public health implications in terms of morbidity, mortality, and cost, a comprehensive investigation into the prevalence and complications of diabetes mellitus was conducted at Jinja Regional Referral Hospital (JRRH). Using a retrospective facility-based cross-sectional study design encompassing qualitative and quantitative approaches, this research reviewed 784 patient records admitted to JRRH from January 2018 to December 2018. The findings revealed a notably high prevalence of diabetes mellitus at 8.2%. Noteworthy gender disparities were observed, with a higher prevalence among males (12%) than females (6%) within the studied population. Moreover, urban dwellers exhibited a higher susceptibility to diabetes compared to rural counterparts, and the risk was observed to escalate with age. Complications associated with diabetes mellitus were alarmingly prevalent, reaching 89.23%, predominantly characterized by microvascular complications, accounting for 56.90%. Despite the severity of complications, the case fatality rate stood at 1.54%, lower than the documented 4%, possibly influenced by a spectrum of contributing factors both positive and negative. The study underscores the urgency for increased focus on diabetes care in Jinja, emphasizing the imperative for further research, robust health education initiatives, and enhanced funding allocation toward managing this escalating health concern.

Keywords: Diabetes Mellitus, Diseases, Public Health, Complications, Males and Females.

INTRODUCTION

With the lifestyle change that accompanies improvement in earning, the prevalence of Diabetes Mellitus (DM) (especially type 2 DM) has increased in tandem due to an increase in the number of people, especially in Africa, who lead a more sedentary, high-calorie-intake life [1=3]. Diabetes is a group of metabolic diseases characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action, or both [4-6]. For clinical purposes, DM has been classified into Type I and Type II based on several metabolic and clinical criteria, but one thing that is common for both types is chronic hyperglycaemia and the metabolic derangements that accompany it [7, 8]. The chronic hyperglycaemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels [9, 10]. Over the past couple of years, the disease burden in Africa has steadily shifted from acute infectious conditions to chronic non-communicable diseases, Diabetes being one of them. Diabetes has long ceased to be a disease of the obese, old affluent Westerner; it has crept into the young African population and the affected age group gets younger by the day [11, 12]. As a result of the increased prevalence of diabetes, complications also have become more common and physician has to deal with diabetes complications more now than ever before. Possible complications include heart attack, stroke, kidney failure, leg amputation, vision loss and nerve damage [13, 14]. In pregnancy, poorly controlled diabetes increases the risk of foetal death and other complications [15]. Diabetes and its complications cause significant economic loss to people with diabetes and their families, and to health systems and national economies through direct medical costs and loss of work and wages [16, 17]. In Sub-Saharan Africa, the disease burden of DM has increased steadily over the past few decades or so [18]. An estimated 14.2 (9.5–29.4) million people aged 20–79 have diabetes in the sub-Saharan Africa (SSA) region, representing a regional prevalence of 2.1–6.7 %. SSA has the highest proportion of undiagnosed cases of diabetes; over two-thirds (66.7 %) of people with diabetes are unaware of their status. The majority of people with diabetes (58.8 %) live in cities, even though the population in the region (61.3 %) is predominantly rural. With increasing urbanization and population aging, diabetes will pose an even greater threat. It is expected that by 2040 there will be 34.2 million adults in the region living with diabetes, more than double the number in 2015 [19]. Uganda still has to grapple with poor and inadequate diabetes care, especially in rural areas [21]. What makes the situation in Uganda even direr is the fact that regular blood pressure monitoring is only done in about 56% of the diabetics and only a few (26.7%) achieve the recommended target of < 140/90 mmHg, only 11,5% go for the recommended annual eye check-up, 2.2% for the annual foot exam, 4.5% annual dental check-up, 13.9% have their lipid/cholesterol check-up done and only about 32% have their annual kidney function assessment done [22].  This might be so from the high cost incurred in managing diabetes. This makes diabetes in Uganda both a public health and an economic problem that needs close and adequate monitoring with stringent management if Uganda is to progress at the same pace as other countries in the developed world toward the achievement of the Sustainable Development Goals (SDGs) of 2030. Given the increased public health importance, morbidity, and mortality burden, plus the cost implications of DM and its complications in African countries, a study into its prevalence and complications was warranted and the researcher conducted such a study at Jinja Regional Referral Hospital (JRRH), Uganda.

CONCLUSION

The prevalence of Diabetes Mellitus was high. Prevalence in males was higher than in females; the risk of DM is higher in males than females. Urban dwellers are more at risk of DM compared to rural dwellers. The prevalence of complications was high among diabetics. The case-fatality rate of DM was lower than the available values.

Recommendations

Allocate more funding to Diabetes; research, education, care, screening drives, and campaigns. Organize seminars, for a, and continued medical education (CMEs) for health workers particularly those involved in diabetes care to empower them with current trends and developments. Make efforts towards subsidizing or waiving DM care and treatment. Organize regular seminars and conferences on Diabetes management and progress reporting. Regular publications and journals on new trends management protocols and criteria concerning diabetes and making these accessible to medical personnel, the general population, and patients alike.

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CITE AS: Al-Busaidy Swalah Suleiman Salim (2023). Assessment of Diabetes Mellitus Prevalence and Associated Complications among Patients at Jinja Regional Referral Hospital. IDOSR JOURNAL OF BIOCHEMISTRY, BIOTECHNOLOGY AND ALLIED FIELDS 8(3): 38-47. https://doi.org/10.59298/IDOSR/JBBAF/23/14.5311

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