Determinants of Complications of Diabetic Among Adult with Type 2 Diabetic Patients at Hubaal Specialist Hospital and Libaan Hospital in Mogadishu: Case Control Study

Abstract

<i>Background</i>: Diabetes mellitus is a major global health issue characterized by persistently high blood sugar levels due to insufficient insulin production or decreased insulin efficacy. Over 422 million adults have diabetes worldwide, with an expected rise to 642 million by 2040. Type 2 diabetes accounts for about 90% of these cases. Sub-Saharan Africa is seeing a notable rise in type 2 diabetes due to lifestyle changes and an aging population In Somalia, the private-sector-dominated healthcare system, exacerbated by prolonged armed conflicts, struggles with affordable diabetes management, leading to increased diabetic complications. With an estimated 5% prevalence of diabetes in Somalia, the lack of routine screening and limited access to affordable healthcare further elevate the prevalence and complications, particularly among those with type 2 diabetes. <i>Objective</i>: This study aimed to identify socio-demographic, healthcare, lifestyle, and clinical factors associated with diabetic complications among adults with type 2 diabetes at selected hospitals in Mogadishu, Somalia. <i>Methods</i>: A case-control study of 187 type 2 diabetes patients used purposive sampling and structured questionnaires to collect data. Analysis was performed using SPSS version 27.0 with bivariate and logistic regression, and significance was set at p ≤ 0.05. <i>Results</i>: The study found that participants aged over 47 years had significantly higher odds of developing diabetic complications compared to those aged 18-27 years (OR: 3.17, 95% CI: 1.26-7.96, p = 0.014). In the multiple regression analysis, the duration of diabetes significantly influenced the risk of complications, with those diagnosed for 5-10 years (AOR: 3.50, 95% CI: 1.19-10.28, p = 0.029) and more than 10 years (AOR: 3.59, 95% CI: 1.36-9.49, p = 0.011) having increased odds. Uncontrolled blood glucose levels were also a significant predictor of complications (AOR: 3.55, 95% CI: 1.82-6.91, p < 0.001). Other factors, such as marital status and monthly income, were not significant in the multiple regression analysis. <i>Conclusion</i>: This study highlights the importance of early detection and management of diabetes to prevent complications, especially among older adults and those with longer disease duration. Interventions should focus on improving glycemic control and managing comorbid conditions. Targeted education and support for patients, especially those at higher risk, are crucial to mitigating the impact of diabetic complications.