Эндокринология и метаболический синдром
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Major Micro vascular Complications and Associated Risk Factors among Diabetic Outpatients in Southwest Ethiopia

Tilahun AN, Waktola C, Tewodros GM, Sadik GT, Amare DW, Yohannis M, Solomon T, Eshetu M, Shewatatek G and BZ

Background: Diabetic complications and comorbidities, mainly due to poorly controlled diabetes, are the common causes of hospital admissions and mortalities among diabetic populations. Although studies from Ethiopia show high incidence of complications, data on associated risk factors is scarce. The current study was aimed to assess the potential risk factors contributing to microvascular diabetic complications in the study area.

Methods: Hospital-based, cross-sectional study was conducted during October and December of 2015 among systematically selected diabetic patients, at outpatient clinic of Jimma University Specialized Hospital (JUSH), Southwest Ethiopia. At recruitment, 5 ml of venous blood was collected without any prior special preparation such as fasting, and used for HbA1C level determination. Data on sociodemographic and diabetic complications was documented for each patient on the format prepared for this study. Binary logistic-regression analysis was used to identify the risk factors associated with the microvascular complications. A p-value <0.05 was considered significant.

Results: The sample analyzed consisted of 236 diabetic patients: 53.4% male, 58.5% Type 2 diabetics, 40% overweighed, and 75.0% younger than 60 years and with diabetes for less than 7 years. The mean ± SD of HbA1C was 9.1 ± 2.8%. Nearly two-third (65%) of the patients had HbA1C greater than 8.0%, indicating poor glycemic control. Self-reported genetic risk factors were evident in almost 20% of the study population. At least one major microvascular complication was recorded in 41.5% of the sampled population. The overall prevalence of the major microvascular complications was associated with high HbA1C level (> 8.0%), female sex and genetic risk factors, as evidenced by adjusted odds of 2.7, 2.2 and 3.2, respectively.

Conclusions and recommendation: The overall prevalence of microvascular complications was high. To reduce the risk of the costly complications, new diabetes care policies objectively targeting a stringent glycemic goal of HbA1C <8.0% should be implemented.