Acute Complications of Diabetes and its Predictors among Adult Diabetic Patients at Jimma Medical Center, Southwest Ethiopia

Abstract

Background

Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia resulting from impairment in insulin secretion, insulin action, or both. It is responsible for a wide range of acute and chronic complications. In this study, we aimed to assess acute complications of diabetes and its predictors among adult DM patients at Jimma Medical Center (JMC), southwest Ethiopia.

Methods

A facility-based cross-sectional study involving 348 diabetic patients was conducted from February to May 31, 2019 at JMC. Logistic regression was conducted to identify predictors of acute complications of diabetes. Variables with P≤0.25 on bivariate logistic regression were considered candidates for multivariate regression. ORs and 95% CIs  with P<0.05 were considered statistically significant.

Results

Of the 348 patients, 225 (64.7%) were male, and the mean age of study participants was 46±15.5 years. Most (281, 80.7%) had type 2 DM. More than two-thirds (240, 69%)had diabetes duration of <5 years. During the study period, 92 (26.4%) patients developed acute complications of diabetes. Of these, 68 (73.9%) had diabetic ketoacidosis, 21 (22.8%) a hyperglycemic hyperosmolar state, and three (3.3%) hypoglycemia. Presence of comorbidity (AOR 5.6, 95% CI 2.80–11.19), type 1 DM (AOR 9.3, 95% CI 4.36–19.82), uncontrolled blood glucose (AOR 1.91, 95% CI 1.05–3.45), and lack of access to a health facility within a reasonable distance (AOR 1.96, 95% CI 1.11–3.45) were independent predictors of acute complications of diabetes.

Conclusion

The magnitude of acute complications among DM patients at JMC was high. Comorbidity, type 1 DM, uncontrolled blood sugar, and lack of access to a health facility within a reasonable distance were independent predictors of acute complications. Clinicians should follow up this subgroup of DM patients closely.

Keywords:

• acute complications
• diabetic ketoacidosis
• hyperglycemic hyperosmolar state
• Ethiopia

Abbreviations

DM, diabetes mellitus; DKA, diabetic ketoacidosis; HHS, hyperglycemic hyperosmolar state; JMC, Jimma Medical Center.

Data-Sharing Statement

The data sets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Acknowledgments

The authors thank the study participants, data collectors, and all staff members of Jimma Medical Center for their kind cooperation in conducting this thesis. We also would like to thank Jimma University for allowing us to conduct this research.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, analysis and interpretation of data, drafting the manuscript, revising the manuscript critically, reading and approving the final draft submission, gave final approval of the manuscript version to be published, and agreed to be accountable for every step of the work.

Disclosure

The authors report no funding and no conflicts of interest for this work.