Prevalence of hyperglycaemic crisis among diabetes mellitus patients in Ethiopia, systematic review and meta-analysis
Keywords:
diabetes mellitus, diabetic ketoacidosis, Ethiopia, hyperglycaemic crisis, hyperosmolar hyperglycaemic state, risk factorsAbstract
Introduction: One of the most severe and potentially life-threatening acute metabolic complications of diabetes mellitus is hyperglycaemic crises. The two most common types are diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS). Because these crises often recur, patients experiencing them face a high risk of overall mortality. This study aimed to evaluate the prevalence of hyperglycaemic crises among diabetic patients in Ethiopia.
Methods: Several databases were searched to retrieve available articles. The data were extracted and sorted in Microsoft Excel and exported to Stata/MP 17.0 for analysis. A weighted inverse variance random-effects model with a 95% confidence interval was used to pool the data. Egger’s test and Cochrane I2 statistics were used to evaluate heterogeneity and publication bias, respectively. To determine the cause of heterogeneity, subgroup analysis was performed.
Result: The pooled prevalence of hyperglycaemic crisis was 45.37% (95% CI 35.24–55.51). Research conducted in the Tigray region revealed the highest prevalence of hyperglycaemic crises: 72.64% (95% CI 60.88–84.40). Hyperglycaemic crisis was more prevalent among Type 2 diabetes (T2DM) patients at 64.6% (56.82–72.39). DKA accounts for 40.77% (95 CI 27.97–53.57) of hyperglycaemic cases, while HHS accounts for only 0.8.56% (95 CI 03.13–13.98) of cases. The most commonly identified risk factor for hyperglycaemic crisis is poor glycaemic control (40.53%, 95% CI 31.72–49.34), followed by poor medication adherence (33.55%, 95% CI 13.34–53.75).
Conclusion: Ethiopia encounters a notably higher burden from hyperglycaemic crises. Individuals with Type 2 diabetes mellitus often face such crises, largely due to factors like inadequate medication adherence and suboptimal glycaemic control. Early identification and management of diabetes can substantially reduce the likelihood of these crises. Furthermore, ongoing follow-up is essential to track medication adherence and monitor blood glucose levels.
