Clinical features, complications and mortality in type 2 (non-insulin dependent) diabetic patients in Addis Abeba, Ethiopia, 1976-1990.

Clinical features and prognosis in 1386 consecutively registered Ethiopian Type 2 (non-insulin-dependent) diabetic patients seen between 1976 and 1990 in the Diabetic Clinic in Yekatit 12 Hospital in Addis Abeba, Ethiopia, are described. Of the 1386, 52% (95% confidence interval CI 2%) were diagnosed diabetic between the ages of 40 and 59, and only 7% CI 1.4%) at age 60 or more. 51% have always been treated with oral hypoglycaemic agents, 5% with diet alone, 8% (CI 1.4%) with insulin within one year of diagnosis, and 26% (CI 2%) after varying durations on tablets. In marked contrast to the leanness of the general Ethiopian population, 53% (CI 5%) of the 408 women who knew their previous body weight had body mass index (BMI) of > 29.9 kg/m2 before the onset of diabetes, and a further 35% (CI 5%) BMI of 25.0 to 29.9; corresponding figures for 568 men were 14% (CI 3%) and 52% (CI 4%). Of the 1386, 23% (CI 3%) knew of at least one diabetic relative. Hypertension was present in 24%, in a quarter of whom it was associated with nephropathy. At last visit, 15% (CI 1%) were known to have diabetic retinopathy, 9.2% (CI 1.5%) nephropathy and 10.5% (CI 1.6%) neuropathy, all three commoner with long duration of diabetes. During the 15 years, 12% of these patients have died, with mean duration of known diabetes at death of 12.5 (CI 1.5) years. Mean age at death was 56.1 (CI 3.3) in women and 57.6 (CI 2.6) in men. The overall mortality rate was 14.9 per 1000 person-years of diabetes. Multivariate survival time analysis found 5 year survival from diagnosis of diabetes of 97% (CI 6%), 12 year survival of 65% (CI 9%) and 20 year survival of 70% (CI 7%).