Prevalence and Pattern of Short-Term Complications of Diabetes Mellitus in South-Eastern Nigeria: A Multicenter Cross-Sectional Study

Abstract

Acute complications of diabetes mellitus are substantial causes of emergency presentations, hospitalisation and unnecessary mortality, especially in areas where access to key medicines, glucose monitoring and structured self-management support may be limited. This study examined the prevalence and pattern of acute complications among persons with diabetes that were receiving care in selected health institutions across South-Eastern Nigeria. A multicentre descriptive cross sectional study was carried out among 640 persons with physician diagnosed diabetes mellitus attending chosen health facilities across the five states of South Eastern Nigeria. Participants were recruited through a multistage sampling technique. Data were obtained using an interviewer administered questionnaire, a clinical assessment checklist and medical record review. The immediate consequences investigated were diabetic ketoacidosis (DKA), hyperosmolar hyperglycaemic state (HHS) and severe hypoglycaemia Frequencies, percentages and 95% confidence intervals (CIs) were determined to characterise the prevalence and distribution of complications. Overall, 239 out of 640 patients had at least one acute diabetic complication, which corresponded to a prevalence of 37.3% (95% CI: 33.7–41.2). The most common consequence was diabetic ketoacidosis, recorded in 117 patients (18.3%), followed by severe hypoglycaemia (82, 12.8%) and HHS (40, 6.2%). DKA, severe hypoglycaemia and HHS were 49.0%, 34.3% and 16.7% respectively among patients with at least one acute consequence. It was 38.6% in females and 35.7% in males. The highest prevalence by type of facility was observed among people visiting secondary hospitals (45.0%) followed by tertiary hospitals (34.8%) and private clinics (31.7%). In this study, more than a third of individuals with diabetes had at least one acute diabetes complication, with DKA accounting for roughly half of the acute episodes documented. The findings underscore the need for enhanced diabetes care through patient education, consistent medication supply, regular glucose monitoring, early recognition of warning symptoms and improved facility readiness to address acute metabolic emergencies without delay.