Prevalence, Patient Predictors, and Referral Patterns for Diabetes-Related Complications Treated at a Central Hospital in KwaZulu Natal

Purpose: Poor diabetes control can result in short-and long-term neuropathic, microvascular, and macrovascular complications. In addition to the socioeconomic impact that diabetes and its complications has on patients, incremental financial costs are added to health-care systems. This study aimed to assess prevalence, patient-related factors, and referral patterns for patients with diabetes-related complications managed at Inkosi Albert Luthuli Central Hospital (IALCH) betweenJanuary 1, 2014 and December 31, 2015. Methods: The retrospective cross-sectional study was done on all adult patients (aged >18 years) with diabetes consulted at IALCH. Primary outcome measures were the proportion with diabetes-related complications and the source of referrals. Logistic regression analysis was done to identify predictors of diabetes complications. Results: Of all adult diabetes patients consulted, 7,761 (47.4%) presented with one or more diabetes-related complications and 56% (4,321) had experienced macrovascular complications. Cardiovascular complications (2,576, 33%) were the most common complications, followed by peripheral vascular disease (1,755, 23%). Microvascular complications included retinopathy (1,656, 21%), nephropathy (118, 14%), and neuropathy (702, 9%). After multivariate analysis, all four factors (age >58 years, male sex, Indian ancestry, and non-insulin dependent diabetes mellitus remained statistically significant for an increased likelihood of developing cardiovascular complications. Indian ancestry was not associated with increased odds of peripheral vascular disease. Conclusion: Macrovascular diseases were the main complications. Older age, male sex, Indian ancestry, and non-insulin dependent diabetes mellitus were associated with macro vascular complications. A combination of health-promotion and behaviour-modification programs is required prior to or early in the disease course. Appropriate and more aggressive management at primary-care level using evidence-based clinical guidelines is essential to prevent complications.

Automated summary

The study assessed prevalence, patient-related factors, and referral patterns for diabetes-related complications at IALCH. Results showed that 47.4% of adult diabetes patients had one or more complications, with 56% experiencing macrovascular complications. Older age, male sex, Indian ancestry, and non-insulin dependent diabetes mellitus were associated with an increased likelihood of developing cardiovascular complications.