Diabetes, Metabolic Syndrome and Obesity (Dec 2021)
Diabetic Complications and Associated Factors: A 5-Year Facility-Based Retrospective Study at a Tertiary Hospital in Rwanda
Abstract
Angelique Iradukunda,1 Shallon Kembabazi,1 Nelson Ssewante,1 Andrew Kazibwe,2 Jean Damascene Kabakambira3 1School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; 2Department of Internal Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; 3Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali, RwandaCorrespondence: Angelique IradukundaSchool of Medicine, College of Health Sciences, Makerere University, Kampala, UgandaEmail [email protected]: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia resulting from defects in insulin production, insulin action, or both. Despite advances in DM diagnosis and management, the incidence of DM-related complications remains high. This study aimed to determine patterns of common complications and associated factors among hospitalized patients in Rwanda.Methods: A cross-sectional study, with retrospective chart review, was conducted at CHUK from July to August, 2021. Charts for DM patients admitted from January 2016 to December 2020 were considered while those inaccessible at the time of data collection were excluded. Linear regression model was used to assess the relationship between dependent and independent variables with a p < 0.05 considered statistically significant.Results: A total of 246 charts were reviewed. The median age was 56 years (IQR: 14– 90). More than half of participants (n = 135; 54.9%) were females; majority from the Central region (n = 138; 56.7%). Recorded DM risk factors included alcohol intake (n = 81; 48.5%); smoking (n = 40; 24.2%), obesity (n = 43; 52.4%), and family history of DM (n = 27; 56.3%). Majority (n = 153; 84.5%) had type 2 DM and (n = 147; 69%) had known their diagnosis for at least 6 years. Hypertension (n = 124, 50.4%), acute hyperglycemic state (n = 59, 24%), nephropathy (n = 58, 23.6%), and stroke (n = 38, 15.4%) were frequently reported complications. Nearly all participants (n = 81, 95.2%) with complications had poor glycemic control. Alcohol intake, age ≥ 45 years, and T1DM were associated with higher odds of DM complications (aOR = 8, 95% CI = 2– 32.6, p = 0.003, aOR = 6.2, 95% CI = 1.4– 27.6, p = 0.016 and aOR = 14.1, 95% CI = 1.2– 161.5, p = 0.034, respectively). Duration of DM (p = 0.001) was significant at bivariate analysis.Conclusion: DM complications were prevalent among the studied population with poor glycemic control mainly influenced by alcohol consumption and duration of DM. Expansion of integrated DM and hypertension screening services to lower-level centers is needed to reduce the associated morbidity and mortality.Keywords: diabetes mellitus, microvascular, macrovascular, complications, non-communicable disease
