Department of Internal Medicine, Yekatit 12 Hospital Medical College, Addis Ababa, Addis Ababa, Ethiopia.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.
BMC Endocr Disord. 2024 Sep 18;24(1):190. doi: 10.1186/s12902-024-01731-0.
Patients with type 2 diabetes mellitus (T2D) have an increased risk of vascular complications. Despite the rise in the prevalence of T2D and its complications throughout the globe, there is a paucity of data regarding the prevalence and determinants of vascular complications of T2D in Ethiopia. Hence, this study aimed to assess the prevalence, patterns, and determinants of the microvascular and macrovascular complications of T2D among adult patients attending a teaching hospital in Addis Ababa, Ethiopia.
A retrospective study was done by reviewing the electronic health records of adult patients with T2D attending the general medical and endocrine referral clinics of Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, from June 1, 2023, to November 30, 2023. Statistical Package for Social Sciences (SPSS), version 25, was used to analyze the data. Descriptive analysis was used to summarize the sociodemographic, clinical, and laboratory profiles as well as the patterns of vascular complications of T2D. Bivariate and multivariate logistic regression models were fitted, and the crude odds ratio (COR) and adjusted odds ratio (AOR), together with the 95% confidence interval (CI), were computed to identify the determinants of microvascular and macrovascular complications of T2D.
A total of 272 patients with T2D were included in this study; 50.5% were females, and the mean (± standard deviation) age was 56.3 ± 12.8 years. The majority of patients (62.5%) had diabetes for ≥ 5 years. More than half (51.5%) had poor glycemic control with glycated haemoglobin (HbA1c) value of ≥ 7%. The overall prevalence of vascular complications was 39%. The prevalence of microvascular complications was 23.5%, the most common being neuropathy (11.8%), and the prevalence of macrovascular complications was 21%, the most common being coronary artery disease (12.1%). The determinants of microvascular complications were age ≥ 60 years (AOR = 2.25, 95% CI: 1.17, 4.33), diabetes duration of ≥ 5 years (5-10 years [AOR = 3.13, 95% CI: 1.37, 7.18], and > 10 years [AOR = 3.88, 95% CI: 1.66, 9.06], and HbA1c value of ≥ 7% (AOR = 2.21, 95% CI: 1.14, 4.28). The odds of developing macrovascular complications were higher with diabetes duration of ≥ 5 to 10 years (AOR = 2.89, 95% CI: 1.37, 6.12) as compared with diabetes duration of < 5 years.
This study demonstrated a high prevalence of microvascular and macrovascular complications in adult patients with T2D. Older age, prolonged duration of diabetes, and poor glycemic control were identified as the determinants for the development of microvascular complications of T2D, while prolonged duration of diabetes was the determining factor for the development of macrovascular complications. Hence, targeted initiatives are required to enhance the prevention and early detection of vascular complications of T2D in resource-limited countries like Ethiopia.
2 型糖尿病（T2D）患者发生血管并发症的风险增加。尽管 T2D 及其并发症在全球范围内的患病率不断上升，但关于埃塞俄比亚 T2D 患者血管并发症的患病率和决定因素的数据仍然很少。因此，本研究旨在评估在埃塞俄比亚亚的斯亚贝巴 Yekatit 12 医院综合医学和内分泌科就诊的成年 T2D 患者的微血管和大血管并发症的患病率、模式和决定因素。
本回顾性研究通过查阅 2023 年 6 月 1 日至 2023 年 11 月 30 日期间在亚的斯亚贝巴 Yekatit 12 医院综合医学和内分泌科就诊的成年 T2D 患者的电子健康记录进行。使用社会科学统计软件包（SPSS）第 25 版分析数据。描述性分析用于总结 T2D 的社会人口统计学、临床和实验室特征以及血管并发症的模式。进行了单变量和多变量逻辑回归模型拟合，并计算了粗比值比（COR）和调整比值比（AOR）以及 95%置信区间（CI），以确定 T2D 微血管和大血管并发症的决定因素。
本研究共纳入 272 例 T2D 患者；50.5%为女性，平均（±标准差）年龄为 56.3±12.8 岁。大多数患者（62.5%）的糖尿病病程≥5 年。超过一半（51.5%）的患者糖化血红蛋白（HbA1c）值≥7%，血糖控制不佳。血管并发症的总患病率为 39%。微血管并发症的患病率为 23.5%，最常见的是神经病变（11.8%），大血管并发症的患病率为 21%，最常见的是冠心病（12.1%）。微血管并发症的决定因素是年龄≥60 岁（AOR=2.25，95%CI：1.17，4.33）、糖尿病病程≥5 年（5-10 年 [AOR=3.13，95%CI：1.37，7.18]，和>10 年 [AOR=3.88，95%CI：1.66，9.06]）和 HbA1c 值≥7%（AOR=2.21，95%CI：1.14，4.28）。与糖尿病病程<5 年相比，糖尿病病程≥5 至 10 年（AOR=2.89，95%CI：1.37，6.12）发生大血管并发症的几率更高。
本研究表明，在埃塞俄比亚成年 T2D 患者中，微血管和大血管并发症的患病率较高。年龄较大、糖尿病病程较长和血糖控制不佳被确定为 T2D 微血管并发症发展的决定因素，而糖尿病病程较长是大血管并发症发展的决定因素。因此，需要采取有针对性的举措，以提高在埃塞俄比亚等资源有限的国家预防和早期发现 T2D 血管并发症的能力。
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