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

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.

Determinants of diabetes ketoacidosis among diabetes mellitus patients at North Wollo and Waghimra zone public hospitals, Amhara region, Northern Ethiopia

“…The findings of this study also revealed that type one diabetes mellitus patients were more likely to develop diabetic ketoacidosis than those patients with type two diabetes mellitus. This is supported by different studies conducted at Tertiary hospitals in North east Ethiopia [ 2 ], Debre Markos referral hospital [ 15 ], West Ethiopia [ 18 ], and Jima Medical Center [ 14 ]. This is because patients with type one diabetes mellitus had a deficiency of insulin which causes the breakdown of lipid resulting in diabetic ketoacidosis, whereas type two diabetes mellitus patients had endogenous insulin which prevents lipolysis that can prevent the occurrence of diabetic ketoacidosis.…”

“…The presence of comorbidity was also a determinant factor of diabetic ketoacidosis which is supported by a study done in Hawassa comprehensive specialized hospital [ 12 ], Jima University Specialized Hospital [ 3 ], Shanan Gibe Hospital [ 11 ], and Jima Medical Center [ 14 ]. This might be because diabetes mellitus patients who have comorbidities, such as hypertension, chronic heart failure, gastrointestinal disturbance, renal disease, and others can directly or indirectly disturb the normal functions of insulin and other hormones which might be cause for the occurrence of diabetic ketoacidosis.…”

Determinants of&nbsp;Diabetes Ketoacidosis Among Diabetes Mellitus patients at North Wollo and Waghimra Zone Public Hospitals, Amhara Region, Northern Ethiopia

“…The presence of comorbidity was also a determinant factor of diabetic ketoacidosis which is supported by a study done in Hawassa comprehensive specialized hospital (10), Jima University Specialized Hospital (3), Shanan Gibe Hospital (9), and Jima Medical Center (12). This might be because diabetes mellitus patients who have comorbidities, such as hypertension, chronic heart failure, gastrointestinal disturbance, renal disease, and others can directly or indirectly disturb the normal functions of insulin and other hormones which might be cause for the occurrence of diabetic ketoacidosis.…”

“…Zone public hospitals with diabetes mellitus patients to investigate the determinant factors of diabetic ketoacidosis. The literature identi ed different determinant factors of diabetic ketoacidosis (2,(11)(12)(13).…”

“…Ethiopia (16), and Jima Medical Center (12). This is due to the fact that patients with type one diabetes mellitus had de ciency of insulin which causes breakdown of lipid resulting diabetic ketoacidosis, whereas type two diabetes mellitus patients had endogenous insulin which prevents lipolysis that can prevent the occurrence of diabetic ketoacidosis.…”