Sociodemographic and Clinical Characteristics Associated with Diabetes Complications in South Eastern Nigeria

Abstract

Complications of diabetes are the sum of demographic, disease-related and cardiometabolic variables. Identifying patient features related with problems may facilitate risk classification and focused screening, particularly in resource-poor settings. In this study, the sociodemographic and clinical characteristics of persons with and without diabetic problems in South-Eastern Nigeria were compared. A descriptive cross-sectional multi-center study was undertaken among 640 persons with physician diagnosed diabetes attending chosen health facilities in the five states of South-Eastern Nigeria. The participants were selected via multistage sampling. Data were obtained by an interviewer-administered questionnaire, a clinical assessment checklist, and a review of medical records. The overall diabetes complication status by age, sex, duration of diabetes, diabetes type, comorbidity and facility type was compared using Pearson’s chi-square test. Unadjusted odds ratios (ORs) and 95% confidence intervals (CIs) were derived from the reported contingency data Overall, 481 (75.2%) participants reported at least one diabetes complication. Complication prevalence increased considerably with age, from 48.0% among those aged 18 to 39 years, to 74.3% among those aged 40 to 59 years, and 90.6% among those aged ≥60 years (p<0.001). The risks of complications were substantially greater in persons with diabetes duration of 5–10 years (OR=3.28; 95% CI: 2.15–5.00) and >10 years (OR=13.07; 95% CI: 7.03–24.29) compared with patients with <5 years of diabetes duration. Participants with type 2 diabetes were more likely to have complications compared to those with type 1 diabetes (OR=4.94; 95% CI: 3.12-7.81). The presence of hypertension, obesity and both hypertension and obesity were each substantially linked with an increased likelihood of complications compared to lack of these comorbidities (all p<0.001). Complication status was not substantially linked with sex and type of facility. Diabetes complications were relatively widespread and were more concentrated in older patients, those with longer diabetes duration, those with type 2 diabetes, and those with cardiometabolic comorbidities. In South-Eastern Nigeria, diabetes care services should give priority to risk-based screening for complications and increase integrated management of hypertension and obesity in an effort to reduce the burden of diabetes-related morbidity.