Diabetic Patients In Ethiopia Research Articles

Depression and associated factors among patients with type 2 diabetic mellitus in Ethiopia: a cross sectional study.

Depression is a significant public health concern in both developed and developing countries. The burden of depression is particularly high among patients with chronic illnesses in developing countries, creating a dual challenge for both patients and the community. However, depression goes undiagnosed in 50%-75% of patients with chronic conditions such as diabetes mellitus. Additionally, there is limited information about the prevalence of depression among diabetic patients in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of depression among type 2 diabetic patients in Ethiopia. An institution-based cross-sectional study was conducted on 376 randomly selected type 2 diabetic patients. Data were collected through face-to-face interviews and from patients' follow-up records. The data were entered into EpiData version 4.6 and analyzed using STATA 14. Bivariable and multivariate logistic regression analyses were employed to identify associated factors. Variables with a p-value of less than 0.25 in the bivariable analysis were selected for multivariate logistic regression. Model fitness was assessed using Hosmer-Lemeshow's test, and associations were reported using adjusted odds ratios with 95% confidence intervals. In this study, the prevalence of depression among type 2 diabetic patients was found to be 69.72% (95% CI: 64.75, 74.27). Three factors were significantly associated with depression in these patients: the duration of diabetes mellitus since diagnosis [AOR: 1.17; 95% CI (1.02, 1.34)], glycaemic control [AOR: 1.8; 95% CI (1.09, 3.01)] and cigarette smoking [AOR: 2.18; 95% CI (1.07, 4.46)]. The prevalence of depression among type 2 diabetic patients was high. The Federal Ministry of Health, stakeholders, and the Ethiopian Diabetes Association should collaborate to reduce this burden. Mental health assessment and treatment should be integrated into chronic care follow-up services. Additionally, healthcare providers should closely monitor and counsel patients who smoke and those with poor glycemic control.

Predictors of uncontrolled hypertension among type 2 diabetic patients in Ethiopia: Multicenter cross-sectional study

BackgroundHypertension (HTN) is the commonest comorbidity among people with type 2 diabetes mellitus (T2DM). Uncontrolled HTN is a major risk factor for several diseases. This study aimed to determine the magnitude and predictors of uncontrolled HTN among T2DM patients. MethodsA multicenter cross-sectional study was conducted among hypertensive from September 19, 2021 to 17 December 2021. Logistic regression model was conducted to identify predictors of uncontrolled HTN. Uncontrolled BP was defined by systolic BP of ≥130 mmHg and/or diastolic BP of ≥80 mmHg. ResultsA total of 400 study participants were included in the analysis, of which 208 (52 %) were females. The mean age of the participants was 60.6 with SD of 10.25 years. The target blood pressure achieved in 156 (39 %) of participants. Age, non-adherence to medications (OR; 2.0; 95 % CI: 1.1–3.6; P = 0.02), not reducing dietary salt (OR; 2.4; 95 % CI: 1.5–3.8; P < 0.001), uncontrolled blood sugar (OR:2.4; 95 % CI: 1.4–4.3; P = 0.002), obesity (OR; 3.2; 95 % CI:1.2–8.7; P = 0.03) and having every fourth month and above follow up (OR; 2.3; 95 % CI:1.3–4.3; P = 0.049) were significantly associated with uncontrolled blood pressure. ConclusionsThe target blood pressure achieved was suboptimal. Hypertensive T2DM patients who were younger, non-adherent to their medications, not reducing dietary salt, obese, with a longer frequency of follow-up, and with poor glycemic control were more likely to have uncontrolled blood pressure. Improving medication adherence, dietary salt reduction, frequent follow up and glycemic control are important to control hypertension.

Poor treatment outcome and associated factors of hyperglycemic emergencies among diabetic patients in Ethiopia: A systematic review and meta-analysis

BackgroundDespite the fact that hyperglycemic crisis poses a significant threat to the health care systems of developing countries like Ethiopia, there is a dearth of reliable data regarding the poor treatment outcome and associated factors among hyperglycemic emergencies in Ethiopia. Therefore, this review aimed to assess poor treatment outcome and associated factors of hyperglycemic emergencies among diabetic patients in Ethiopia. MethodsPublished articles regarding poor treatment outcome and associated factors of hyperglycemic emergencies among diabetic patients in Ethiopia were extensively searched from PubMed, Google Scholar, Cochrane library, and African journal online. After extraction, data were exported to Stata software version 11 (Stata Corp LLC, TX, USA) for analysis. Statistically, the Cochrane Q-test and I2 statistics were used to determine the presence or absence of heterogeneity. Results3650 duplicates were eliminated from the 4291 papers (PubMed [18], Google scholar (1170), African journal online [21], and Cochrane library (3082)). The pooled estimate of poor treatment outcome among hyperglycemic emergencies in Ethiopia is found to be 16.21% (95% CI: 11.01, 21.41, P < 0.001). Creatinine level >1.2 mg/dl, stroke, sepsis and comorbidity were associated factors of poor treatment outcome. ConclusionPoor treatment outcome from hyperglycemic emergencies among diabetic patients was found to be high. Poor treatment outcome was predicted for those patients who had creatinine level >1.2 mg/dl, stroke, sepsis and comorbidity. As a result, we recommend healthcare providers to monitor thoroughly and have close follow-ups for patients with the identified predictors to improve poor treatment outcome from hyperglycemic crises

Determinants of diabetic nephropathy among diabetic patients in Ethiopia: Systematic review and meta-analysis.

Diabetic nephropathy (DN) is a long-term kidney disease among diabetic patients. It is the leading cause of end-stage renal failure. In Ethiopia, DN affects the majority of diabetic populations, but there were inconsistent findings about the determinant factors across the studies. We have accessed studies using PubMed, Embase, EBSCO, Web of Science, OVID, and search engines including Google and Google Scholar published up to June 2023. The study populations were diabetic patients with nephropathy. The quality of each included article was assessed using the Newcastle-Ottawa quality assessment scale. The odds ratios of risk factors were pooled using a random-effect meta-analysis model. Heterogeneity was assessed using the Cochrane Q statistics and I-Square (I2). The publication bias was detected using the funnel plot and/or Egger's test (p< 0.05). Trim and fill analysis was carried out to treat the publication bias. The protocol has been registered with the reference number CRD42023434547. A total of sixteen articles were used for this reviewed study. Of which, eleven articles were used for advanced age, ten articles for duration of diabetic illness, ten articles for poor glycemic control, and eleven articles for having co-morbid hypertension. Diabetic patients with advanced age (AOR = 1.11, 95% CI: 1.03-120, I2 = 0.0%, p = 0.488), longer duration of diabetic illness (AOR = 1.23, 95% CI = 1.05-1.45, I2 = 0.0%, p = 0.567), poor glycemic control (AOR = 2.57, 95% CI: 1.07-6.14; I2 = 0.0%, p = 0.996), and having co-morbid hypertension (AOR = 4.03, 95% CI: 2.00-8.12, I2 = 0.0%, p = 0.964) were found to be factors associated with DN. The findings of the study revealed that diabetic patients with advanced age, longer duration of diabetic illness, poor glycemic control status, and co-morbid hypertension were the determinant factors of DN. Therefore, treatment of co-morbid hypertension and high blood glucose and regular screening of renal function should be implemented to detect, treat, and reduce the progression of DN. Furthermore, healthcare workers should give due attention to diabetes with advanced age and a longer duration of diabetes illness to prevent the occurrence of DN.

Prevalence and associated factors of foot deformity among adult diabetic patients on follow-up at Debre Markos comprehensive specialized hospital, Northwest Ethiopia, 2022, cross-sectional study

IntroductionDiabetes foot deformity is among the major causes of diabetic foot ulceration, resulting in lower limb amputation. However, the study on the distribution of foot deformity and its risk factor among diabetic patients in Ethiopia is limited. This study determined the overall prevalence and associated factors of foot deformity among adult diabetic patients on follow-up at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.MethodsHospital-based cross-sectional study was conducted among 392 diabetic patients using a systematic random sampling technique at Debre Markos Comprehensive Specialized Hospital. Data were collected by pre-tested, semi-structured questionnaires and diabetic foot assessment format. Multivariable binary logistic regression was used to determine the association between dependent and independent variables. Adjusted odds ratios (AOR) with their 95% confidence interval (CI) were used to determine the strength of the association, and a variable with a p-value < 0.05 was statistically significant factors of diabetes foot deformity.ResultThe overall prevalence of foot deformity was 33.4% [95% CI: 28.9–38.3]. In the final logistic regression analysis, rural residency [AOR = 2.64, 95% CI: 1.31, 5.31], poor glycemic control [AOR = 2.41; 95% CI: 1.34, 4.33], diabetes duration ≥ 10 years [AOR = 2.74; 95% CI: 1.50, 5.02], inadequate footwear [AOR = 2.11; 95% CI: 1.17, 3.82] and presence of peripheral neuropathy [AOR = 8.21; 95% CI: 4.54, 14.84] were statistically significant associated factors with diabetes foot deformity.ConclusionThe prevalence of foot deformity among adult diabetic patients was high. It is recommended to incorporate foot deformity screening in routine diabetic patient follow-ups especially for those with poor glycaemic control, rural residency, long diabetes duration, inadequate footwear, and diabetic peripheral neuropathy.

Symptomatic Dry Eye Disease and Associated Factors Among Adult Diabetic Patients in Adare General Hospital, Hawassa City, Southern Ethiopia, 2023.

Symptomatic dry eye disease is a multifactorial ocular surface condition caused by disruption of the precorneal tear film and is a common clinical finding in diabetic patients. However, there was no study on the prevalence and associated factors of symptomatic dry eye disease among diabetic patients in Ethiopia or in the study area. This study aimed to investigate the prevalence and associated factors of symptomatic dry eye disease among adult diabetic patients in Adare General Hospital, Hawassa City, Southern Ethiopia, in 2023. A hospital-based cross-sectional study design was conducted on 493 adult diabetic patients who were selected using systematic random sampling, from April 23 to June 8, 2023. Data were collected through a face-to-face interview using an ocular surface disease index questionnaire. Binary logistic regression was performed to identify factors potentially associated with symptomatic dry eye disease. Variable with a P value of <0.05 was considered statistically significant. A total of 488 subjects participated in this study with a response rate of 99%. The prevalence of symptomatic dry eye disease was 34.8% (95% CI = 30.6-39.1). College and university educational status (AOR = 5.88, 95% CI = 2.25-15.38), government employed (AOR = 2.22, 95% CI = 1.05-4.68), use of visual display unit >5 hours (AOR = 4.41, 95% CI = 1.51-12.87), duration of diabetes ≥11 years (AOR = 3.57, 95% CI = 1.28-9.90), poor glycemic control (AOR = 2.13, 95% CI = 1.21-3.75), allergic conjunctivitis (AOR = 1.99, 95% CI = 1.12-3.54), and debris in the tear film (AOR = 3.63, 95% CI = 1.53-8.61) were positively associated with symptomatic dry eye disease. The study revealed a high prevalence of symptomatic dry eye disease. Higher educational status, government employed, use of visual display unit, longer duration of diabetes, poor glycemic control, allergic conjunctivitis, and tear film debris were significantly associated with symptomatic dry eye disease. Breaks in screen use, good glycemic control, and treatment of ocular morbidities such as allergic conjunctivitis and debris in the tear film were recommended for all diabetic patients.

A systematic review and meta-analysis of cardiovascular diseases and associated factors among diabetes mellitus patients in Ethiopia

BackgroundCardiovascular disease (CVD) is the most prevalent complication and the leading cause of death and disability among patients with diabetes mellitus (DM). Over time, diabetes-related cardiovascular disease has become more common worldwide. The aim of this study was to determine the cumulative prevalence of cardiovascular disease and associated factors among diabetic patients in Ethiopia.ObjectiveThe main aim of this review was to estimate the pooled prevalence of cardiovascular disease and its associated factors among diabetic patients in Ethiopia.Methods and materialsThis review was searched using PubMed, Google, and Google Scholar search engines, and was accessed using medical subject heading (MeSH) terms for studies based in Ethiopia. Excel was used to extract the data. With a random-effects model, STATA Version 14 was used for all statistical analyses. The studies' heterogeneity and funnel plot were both examined. The study domain and authors' names were used in the subgroup analysis.ResultsIn this systematic review, 12 studies totaling 2,953 participants were included. The estimated overall prevalence of cardiovascular disease among diabetic patients in Ethiopia was 37.26% (95% CI: 21.05, 53.47, I2 = 99.3%, P ≤ 0.001). Study participants’ age older than 60 years (AOR = 4.74, 95%CI: 1.05, 8.43), BMI > 24.9kg/m2 (AOR = 4.12, 95% CI: 2.33, 5.92), triglyceride > 200mg/dl (AOR = 3.05, 95% CI: 1.26, 4.83), Hypertension (AOR = 3.26, 95% CI: 1.09, 5.43) and duration of DM > 4 years (AOR = 5.49, 95% CI: 3.27, 7.70) were significantly associated with cardiovascular disease.ConclusionsIn conclusion, diabetic patients face a serious public health risk from cardiovascular disease. This review found the following factors, which is independent predictors of cardiovascular disease in diabetic patients: age over 60, BMI > 24.9kg/m2, triglycerides > 200 mg/dl, hypertension, and diabetes duration > 4 years. The results emphasize the need for a prospective study design with a longer follow-up period to assess the long-term effects of CVD predictors in diabetic patients as well as the significance of paying attention to cardiovascular disease in diabetic patients with comorbidity.

Prevalence of urinary tract infections and risk factors among diabetic patients in Ethiopia, a systematic review and meta-analysis.

Urinary tract infection (UTI) is a common clinical problem that comprises 1-6% of medical referrals and includes urinary tract, bladder, and kidney infections. UTI is the most commonly occurring infectious disease in diabetic patients. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of urinary tract infection and its associated factors in Ethiopia. The online libraries of PubMed, Google Scholar, Scopus, and Science Direct, were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 16). Forest plots, Begg's rank test, and Egger's regression test were all used to check for publication bias. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region, and publication year. Meta-regression analysis using study-level covariates as predictors of study-level estimates to explore the determinants of potential heterogeneity in our pooled estimates. The pooled odds ratio for related covariates was also calculated. Out of 1128 studies assessed, 14 met our criteria and were included in the study. A total of 3773 people were included in the study. The prevalence of urinary tract infection was estimated to be 15.97% (95% CI: 12.72-19.23). According to subgroup analysis, the highest prevalence was observed in the SNNP region (19.21%) and studies conducted in and after 2018 (17.98%). Being female (AOR = 3.77; 95% CI: 1.88, 5.65), being illiterate (AOR = 5.29; 95% CI: 1.98, 8.61), prior urinary tract infection history (AOR = 3.04; 95% CI: 2.16-3.92) were the predictor of urinary tract infection. The prevalence of urinary tract infections was high in Ethiopia. Female gender, illiteracy, and prior UTI history were associated with urinary tract infections. Since UTIs in diabetic patients has serious medical and public health consequence, screening of UTIs in diabetic patients and early initiation of treatment should become a public health priority.

Epidemiological factors affecting health service utilization in diabetic patients in Ethiopia

Abstract Diabetes-related deaths reached 2 million in 2019. The highest percentage of undiagnosed diabetes (59.7%) was observed in Africa, where accessibility to health services is pivotal to improving the outcome of diabetic patients. The study aims to assess the association between diabetic patients’ epidemiological factors and accessibility to healthcare services in a low-income country. The retrospective cohort study included diabetes-related outpatient department (OPD) visits and hospitalizations from 01/01/2018 to 31/08/2021 at St Luke Hospital (Ethiopia). Potential predictors were sociodemographic factors, COVID-19 cases, mean monthly temperature, and precipitations. The ARIMA method was applied to OPD visits and hospitalizations time series. OPD visits increased over time (p &amp;lt; 0.001) while hospitalizations were stable. The time series model was ARIMA(0,1,1) for OPD visits and ARIMA(0,0,0) for hospitalizations. Diabetes OPD patients were 1,685 (F = 732, 43%). Females had an average of 16% fewer OPD accesses per month (p = 0.002). Patients missing follow-up were 801 (48%). The time between follow-ups was longer as age increased (p &amp;lt; 0.001). There were 57 fewer forecast OPD visits per month on average using COVID-19 cases as ARIMA regressor. OPD visits decreased differently by geographic area as COVID-19 cases increased (p &amp;lt; 0.001). Hospitalized patients for diabetes were 408, 85 (20.8%) newly diagnosed. The odds ratio (OR) of diagnosis at admission was lower as age increased (OR 0.98, p = 0.009). Compared to type 1 diabetes, hospitalized females with type 2 (117-39.7%) were fewer than males (p = 0.019). Readmissions were 52, 10 (19.2%) within 30 days, without OR difference by sex, age, or diabetes type. Despite an increase in OPD visits for diabetic patients over the study period, the number of losses at follow-up and diagnoses at hospitalization remains high. Gender and age influenced service utilization. Females’ access to care is still problematic (concept of “missing women”). Key messages • Primary health care should be implemented to improve access to health services and diabetes management. • Ensuring equity in healthcare accessibility should be a priority in low-income countries.

Prevalence of hypertension among type 2 diabetes mellitus patients in Ethiopia: a systematic review and meta-analysis.

Hypertension among diabetic patients is a worldwide public health challenge and a leading modifiable risk factor for other cardiovascular diseases and death. This study aimed to estimate the prevalence of hypertension among diabetic patients in Ethiopia. The studies were selected using PubMed, Embase, Health InterNetwork Access to Research Initiative and Cochrane Library databases and Google searches. Two independent authors carried out the data extraction using a predetermined and structured method of data collection. R version 3.5.3 and RStudio version 1.2.5003 were used for analysing the data. To assess possible publication bias, funnel plot test methods were used. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used to publish the results. This study was registered in the Prospective Register Systematic Reviews (CRD42020170649). A total of 218 articles were identified but only 6 six full-text abstract papers were included in this systematic review and meta-analysis. The random effects model analysis showed that the pooled prevalence of hypertension among type 2 diabetes mellitus (DM) patients in Ethiopia was 55% (95% confidence interval [CI] 49 to 61). The subgroup analysis of the pooled prevalence of hypertension among type 2 DM patients in the Oromia and Southern regions was 51% (95% CI 42 to 59) and 58% (95% CI 54 to 63), respectively. The pooled prevalence of hypertension among type 2 DM patients was higher among urban residents (60% [95% CI 54 to 67] and 52% [95% CI 41 to 63] among urban and rural residents, respectively). This study showed a high pooled prevalence of hypertension among type 2 DM patients in Ethiopia. Appropriate preventive measures should be implemented to reduce the burden of hypertension among DM patients in Ethiopia.

Incidence and Predictors of Chronic Kidney Disease among Diabetes Mellitus Patients: A Retrospective Follow-Up Study at a Tertiary Health-Care Setting of Ethiopia.

BackgroundChronic kidney disease (CKD) is one of the most common microvascular complications of diabetes mellitus (DM) and it is a major health burden worldwide. Despite the increasing trend of microvascular complications in developing countries, there is limited evidence on predictors of CKD among diabetic patients in Ethiopia. Therefore, this study was aimed to assess the incidence and predictors of CKD among DM patients.MethodsA retrospective follow-up study was conducted among type 1 and type 2 DM patients in Southwest Ethiopia. A total of 437 newly-diagnosed diabetes patients were selected using a simple random sampling technique. Data were extracted from patients’ medical records. Cox proportional hazard model was fitted and a 95% confidence interval was used to select significant variables.ResultsOverall, 15.56% of patients developed CKD, with an incidence rate of 2.29 per 1,000 person-month (PM) (95% CI=1.79–2.93). Female sex (AHR=0.51, 95% CI=0.27–0.94) was found to be a protective factor of CKD, while positive proteinuria (AHR=2.85, 95% CI=1.48–5.55), having hypertension (HTN) (AHR=2.31, 95% CI=1.03–5.56), and high-density lipoprotein cholesterol (HDL-C) <40 mg/dL (AHR=3.19, 95% CI=1.73–5.98) were significant predictors of CKD.ConclusionCKD among DM patients continues to be a significant public health problem in health-care settings of Ethiopia. The current study found being female was protective, while positive proteinuria, HTN, and HDL-C <40 mg/dL were risk factors for CKD. We recommend health professionals to give more attention to DM patients with the identified risk factors.

The impact of diabetes on visual acuity in Ethiopia, 2021.

Diabetes mellitus is a complex metabolic disorder characterized by hyperglycemia that results from defects in insulin secretion, insulin action, or both. Glaucoma is the ocular complication of diabetic illness. In addition to this, retinopathy, maculopathy, ischemic optic neuropathy, extra-ocular muscle palsy, iridocyclitis, and rubeosis iridis were other complications. This study aims to determine the impact of diabetes on visual impairment and blindness among diabetic patients in Ethiopia. This hospital-based cross-sectional study includes 401 samples of diabetic patients in the University of Gondar Comprehensive Specialized Hospital from January 2017 to January 2019. The multinomial logistic regression model was employed to identify significant differences among the factor variables. The magnitude of blindness was 32.17%, and the burden of severe visual impairment was 12.46%. Of the total patients, 120(29.9%) were have diabetic retinopathy of whom, 113(94.2%) were blind either in the right, left, or both eyes and 3 (2.5%) had severe visual impairment. One hundred twenty-six (31.42%) patients developed diabetic maculopathy of whom, 117 (92.85%) were blind either in the right or left eye, and one (0.8%) had severe visual impairment. From the whole diabetic patients, the magnitude of glaucoma was 186(46.38%), and from the patients who developed glaucoma was blind visual impairment 127(68.27%) either in the right or left eye. Thirty-eight (20.34%) had severe visual impairment. Glaucoma was significantly associated with severe visual impairment and blindness (p<0.001). Glaucoma, diabetic retinopathy, maculopathy, and type of diabetes are factors for visual impairment. We found that visual impairment in the category of severe and blindness are frequent in Ethiopian diabetic patients. Glaucoma, diabetic retinopathy, maculopathy are the main predictive factors that determine the occurrence of blindness.

Incidence and Predictors of Cardiovascular Disease among Type 1 and Type 2 Diabetes Mellitus in a Tertiary Health Care Setting of Ethiopia: 8-Year Retrospective Follow-Up Study.

BackgroundCardiovascular disease (CVD) is a major cause of death and disability among people with diabetes in the world and it is proving to be a major barrier to sustainable human development. Despite CVD continuing to devastate human survival, few studies in Ethiopia have focused on its prevalence which alone are insufficient to assess the risk of incident cardiovascular events. Therefore, we determined the incidence and predictors of cardiovascular disease among diabetic patients in a selected tertiary healthcare setting of Ethiopia.MethodsA retrospective cohort study using secondary data was conducted on 399 randomly selected diabetes patients. Data were entered using Epi-Data and analyzed using Stata version 14. Multivariable Weibull proportional hazards regression analysis was used to identify the predictors of CVDs (namely, coronary heart disease (CHD), stroke, and peripheral arterial disease (PAD)) at 5% level of significance.ResultsAfter a median follow-up of 5.9 years, the overall incidence rate of CVD per 100 person–years (PY) was 2.71 (95% CI=16.9–17.6). The multivariable Weibull proportional hazard regression analysis showed a significant association of chronic kidney disease (CKD); (adjusted hazard ratio (AHR) [95% CI]=2.53 [1.36–4.72]), systolic blood pressure (SBP)≥140; (AHR [95% CI]=4.30 [2.12–8.73]) and triglyceride (TG)≥200 mg/dL; (AHR [95% CI[=5.10 [2.02–12.89]) with risk of incident CVD.ConclusionCVD is a public health problem among diabetic patients in Ethiopia. SBP≥140, chronic kidney disease, and high triglyceride were independent predictors of new CVD among diabetic patients. These findings emphasize the need of attention for CVD patients with CKD and hypertension (HTN) comorbidities and a longer follow-up period using a prospective study design to determine the long-term effects of predictors of CVD among diabetic patients.

Burden and Determinants of Chronic Kidney Disease Among Diabetic Patients in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Chronic kidney disease (CKD) among diabetic patients is becoming a global health burden with a high economic cost to health systems. The incidence of CKD is higher in low-income countries such as Ethiopia. In Ethiopia, there is no national representative evidence on the burden and determinants of CKD among patients with diabetes. Therefore, this review aimed to estimates the pooled burden and determinants of CKD among patients with diabetes. Methods: Published articles from various electronic databases such as Pub Med, Google Scholar, CINAHL, Scopes, Cochrane library, the Web of Science, and African Journals Online were accessed. Also, unpublished studies from Addis Ababa digital library were identified. We included all observational studies (cross-sectional, case-control, and cohort) in the review. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled estimate with a 95% confidence interval (CI). Forest plots were used to visualize the presence of heterogeneity and estimate the pooled burden and determinants of chronic kidney disease among diabetic patients. The presence of publication bias was assessed by funnel plots and Egger’s statistical tests. Results: Published (297) and unpublished (2) literature were identified from several databases and digital libraries, of which twelve articles were selected for final meta-analysis. Significant heterogeneity was observed across studies (I2 = 85.2%), which suggests a random-effects model to estimate pooled burden. The analysis found that the pooled burden of CKD among patients with diabetes was 18.22% (95% CI: 15.07–21.38). Factors such as hypertension (OR = 2.65, 95%, CI: 1.38, 5.09), type of DM (OR = 0.33, 95%, CI: 0.14–0.76), and duration of DM (OR = 0.51, 95%, CI: 0.34–0.77) were found to have significant association with CKD. Conclusion: The current review revealed a higher burden of CKD among patients with diabetes in Ethiopia. The presence of hypertension, type II diabetes, and duration of diabetes for a longer duration were found to be independent determinants of CKD among patients with diabetes. For better control of chronic kidney disease, integrated management of hypertension and DM should be designed with a special focus on chronic diabetic patients.

Systematic Review and Meta-Analysis of Good Self-Care Practice among People Living with Type 2 Diabetes Mellitus in Ethiopia: A National Call to Bolster Lifestyle Changes.

Background Self-care practice is the mainstay of management for good glycemic control. Despite the presence of a few pocket studies, no comprehensive study was conducted in Ethiopia to demonstrate the overall good self-care practice among diabetic patients in Ethiopia. Therefore, we intended to conduct this systematic review and meta-analysis to estimate the overall good self-care practice among people living with type 2 diabetes mellitus (T2DM) in Ethiopia. Methods We systematically searched PubMed, Scopus, Science Direct, Cochrane library, Google scholar, and direct Google to retrieve relevant studies. Forest plot was used to present the pooled estimate of good self-care practice using DerSimonian and Laird's random-effects model. We checked publication bias using Egger's test and funnel plot. Potential heterogeneity was tested using the I-squared statistic. Moreover, subgroup and sensitivity analyses were performed. Results In this review, 12 primary studies (with a total sample size of 4030) were included. Because of the presence of heterogeneity, we employed a random-effects model. After running the random-effects model, the pooled estimate of overall good self-care practice was 51.12% (95% CI: 41.90–60.34). Furthermore, the pooled estimate of good dietary practice was 50.18% (95% CI: 32.75–67.60), good physical exercise practice was 48.29% (95% CI: 34.14–62.43), the good footcare practice was 63.61% (95% CI: 45.56–81.66), and appropriate self-monitoring of the blood glucose level was 31.89% (95% CI: −4.62–68.41). In this meta-analysis, there was serious interstudy variation, but there was no publication bias. Conclusions The overall good self-care practice among people living with T2DM was low which necessitates the need for designing strategies to increase the self-care practice. The health sector has to bolster awareness creation to allow better plasma glucose control and preventing diabetes-related complications. This trial is registered with CRD42019147694.

Are Ethiopian diabetic patients protected from financial hardship?

Globally, diabetes mellitus exerts an economic burden on patients and their families. However, the economic burden of diabetes mellitus and its associated factors were not well studied in Ethiopia. Therefore, the aim of this study is to assess the economic burden of diabetes mellitus and its associated factors among diabetic patients in public hospitals of Bahir Dar city administration, Ethiopia. Across sectional study was conducted on 422 diabetic patients. The patients were selected by simple random sampling method. The prevalence-based model was used to estimate the costs on patients' perspective. Bottom up and human capital approaches were used to estimate the direct and indirect costs of the patients respectively. Wealth index was constructed using principal component analysis by SPSS. Forty percent of nonfood threshold level was used to measure catastrophic diabetic care expenditure of diabetic patients. Whereas, the World Bank poverty line (the $1.90-a-day poverty line) was used to measure impoverishment of patients due to expenses of diabetes mellitus care. Data were entered by Epi data version 3.1and exported to SPSS version 23 for analysis. Simple and multiple logistic regressions were used. Four hundred one respondents were interviewed with response rate of 95%. We found that 239 (59.6%) diabetic patients incurred catastrophic diabetic care expenditure at 40% nonfood threshold level. Whereas, 20 (5%) diabetic patients were impoverished by diabetic care spending at the $1.90-a-day poverty line. Educational status of respondent, educational status of the head of household, occupation and wealth status were statistically associated with the catastrophic diabetic care expenditure. The study revealed that the economic burden of diabetic care is very disastrous among the less privileged populations: the less educated, the poorest and unemployed. Therefore, all concerned stakeholders should design ways that can reduce the financial hardship of diabetic care among diabetic patients.

Magnitude and factors associated with anemia among diabetic patients in Ethiopia: A systematic review and meta-analysis.

Background:In Ethiopia, diabetes is estimated to affect about half a million people. About 35% of individuals with diabetes are complicated by microvascular diseases like retinopathy, nephropathy, cardiovascular, and anemia. Even though there are some studies conducted on prevalence and associated factors of anemia in diabetic patients, their findings were variable. Therefore, this meta-analysis is aimed to determine the pooled prevalence and factors associated with anemia among diabetic patients.Methods:PubMed, CINAHL, POPLINE, ScienceDirect, African Journals Online, and Google Scholar were systematically searched to identify related studies. The heterogeneity of studies was assessed using Cochran’s Q test and I2 tests. A random-effects model was used to estimate the pooled prevalence of anemia among diabetic patients in Ethiopia. Publication bias was evaluated by employing Egger’s tests.Results:After reviewing 503 articles, 6 articles fulfilled inclusion criteria and remained for the final meta-analysis. The pooled prevalence of anemia among diabetic patients was 24.81% (95% confidence interval: 19.38–30.25). Age greater than 60 years old (pooled odds ratio, 95% confidence interval: 3.73 (2.23–6.77)), glomerular filtration rate less than 60 mL/min/1.73 m2 (pooled odds ratio, 95% confidence interval: 12.65 (8.71–18.37)), and being diabetic for more than 10 years (pooled odds ratio, 95% confidence interval: 10.21 (7.00–15.04)) were found to be determinants of anemia among diabetic patients in Ethiopia.Conclusion:Overall, one in four diabetic patients develops anemia in Ethiopia. Age, glomerular filtration rate, and duration of being diabetic are factors significantly associated with the occurrence of anemia in diabetic patients.

Prevalence and associated factors of depression among diabetic outpatients attending diabetic clinic at public hospitals in Eastern Ethiopia: A cross-sectional study

Introduction:Depression is one of the most common comorbid psychiatric disorders among diabetic patients. Depression among diabetic people has led to poor treatment adherence, defective treatment outcomes, and consequently worsened quality of life. However, there is a limited study conducted to assess the magnitude and factors associated with depression among diabetic patients in Ethiopia including this study area.Objective:This study aimed to assess the prevalence and factors associated with depression among adult diabetic outpatients attending diabetic clinic in Eastern Ethiopia.Methods:An institution-based cross-sectional study was conducted among 407 adult diabetic outpatients on treatment in Ethiopia in 2020. Patient Health Questionnaire-9 was used to assess depression among randomly selected samples. Bivariate and multivariate logistic regression was fitted to identify factors associated with depression among diabetic outpatients. A p value less than 0.05 with a 95% confidence interval was considered statistically significant.Results:The overall prevalence of depression among diabetic outpatients was found to be 48.9% (95% confidence interval: 44.2%, 53.4%). Being female (adjusted odds ratio = 1.50, 95% confidence interval: 1.39, 2.73), Khat chewing (adjusted odds ratio = 1.88, 95% confidence interval: 1.22, 2.93), having poor and moderate social support (adjusted odds ratio = 1.79, 95% confidence interval: 1.07, 2.98 and adjusted odds ratio = 1.90, 95% confidence interval: 1.14, 3.17, respectively), taking both oral hypoglycemic agents and insulin medication (adjusted odds ratio = 1.33, 95% confidence interval: 1.13, 2.80) and duration of diabetes mellitus for more than 6 years (adjusted odds ratio = 5.40, 95% confidence interval: 3.42, 8.14) were significantly associated with depression.Conclusion:This study revealed a relatively high prevalence of depression in diabetic outpatients. A lesser level of social support, taking oral and insulin treatment regimes, longer duration of illness, using Khat, and being female were associated with depression among diabetic outpatients. Therefore, early screening and identification of such factors could help ameliorate some of the deleterious effects of depression in diabetic outpatients.

Erectile Dysfunction among Diabetic Patients in a Tertiary Hospital of Southwest Ethiopia

Background: Erectile Dysfunction (ED) is defined as the persistent inability to achieve and/or maintain penile erection sufficient for satisfactory sexual performance. Few studies have examined the prevalence of ED among men diabetic patients in Ethiopia. The aim of this study was to determine the prevalence and predictors of ED among diabetic patients in a tertiary hospital of Southwest Ethiopia. Methods: A hospital-based cross-sectional study was conducted on male diabetic patients on follow-up at the diabetic clinic of Jimma Medical Center (JMC), Southwest Ethiopia. Results: 350 male diabetic patients were enrolled in the study. The mean (+SD) age of the study participants was 47.9 (+12.2) years. The majority, 212 (60.4%) of the diabetic patients had varying degrees of ED and almost all, 207 (97.6%) of the patients were not treated for ED. Independent predictors of ED were older age (AOR: 4.6; 95%CI: [2.84, 7.55]; p&lt;0.001) and longer duration of diabetes (AOR: 3.5; 95%CI: [2.12, 5.70]; p&lt;0.001). Conclusion: This study confirmed a high prevalence of ED in diabetic male patients in Jimma Medical Center (JMC). Periodic assessment and management of ED should be a routine part of the diabetic care, particularly for those aged above 40 years and living with diabetes mellitus for many years.

Diabetic health literacy and its association with glycemic control among adult patients with type 2 diabetes mellitus attending the outpatient clinic of a university hospital in Ethiopia.

BackgroundDespite how much effect of low health literacy is on diabetic treatment cannot be accurate, it has an impact on controlling blood glucose level. Less is known about diabetic health literacy in Ethiopian diabetic patients which can affect patient medication adherence, self-care, and glycemic control.ObjectiveThis study was aimed to assess the diabetic health literacy level and its association with glycemic control among adult patients with type 2 diabetes mellitus attending the outpatient clinic of University of Gondar Comprehensive Specialized Hospital (UOGCSH): Northwest Ethiopia.MethodsA cross-sectional study was employed at the outpatient clinic of the University of Gondar Comprehensive Specialized Hospital from May, 1 –May 30, 2019. The comprehensive 15-items diabetic health literacy questions with a 5-point Likert scale used to measure diabetic health literacy. The mean score calculated and switched to the percentage (5 points as 100%) to determine the level of diabetic health literacy. Morisky Green Levine Scale 4 item adherence assessment tool was used to assess the diabetic patient's level of adherence. Binary and multivariable logistic regression analysis was used to assess the association between sociodemographic, clinical variables, diabetic-related literacy, and glycemic control. Independent samples t-test and One-way ANOVA test was employed to compare the mean literacy score difference in different groups.Result400 respondents were included in the study. Of all the respondents, 17.3%, 26.3%, and 56.5% had low, medium and high diabetic-related health literacy, respectively. The proportions of patients with low, medium and high adherence to medication were 9.8%, 56.3%, and 34% respectively. Patients with high diabetes literacy are 1.85 times more likely to achieve target glycemic control than lower diabetic literacy patients with 95% CI Adjusted Odds Ratio (AOR). 1.85(1.09–3.40). While patients with good adherence 1.61 times more likely to achieve target glycemic control than patients with low adherence; 95% CI AOR 1.61(1.04–4.79). Diabetic patients with morbidity have 67% less likelihood to achieve the target glycemic control; 95% CI AOR 0.33(0.15–0.73).ConclusionAdequate diabetic health literacy and better glycemic control are highly correlated. Adjusting all variables; younger age, high diabetic health literacy and good adherence are associated with achieving the target glycemic control.