Prevalence of microvascular complications and associated factors among diabetes mellitus patients in Ethiopia: Systematic review and meta-analysis

Abstract

Background: Diabetes mellitus (DM) is a metabolic abnormality affecting 537 million people worldwide. Poor glycemic control, longer duration, and poor medication adherence increased the risk of DM complications. Comprehensive evidence on the pooled prevalence of microvascular complications in DM patients in Ethiopia is not available. Furthermore, individual study findings for the prevalence of microvascular complications in DM patients, and associated factors were not consistent.

Objective: This systemic review and meta-analysis aimed to assess the pooled prevalence of microvascular complications in DM patients, and its associated risk factors in Ethiopia.

Methods: Systematic search on Scopus, PubMed, Science Direct electronic database, Google Scholar search engine, and library registration was used to identify relevant studies following reviews and meta-analysis guidelines. Microsoft Excel spreadsheets were used to extract data, and Extracted data was analyzed using STATA software version 17.0. A Sensitivity analysis was conducted to assess the role of each study in the final result and the presence of publication bias was assessed by Egger's test. Heterogeneity across studies was checked by Cochran's Q statistic and I2 statistics and significant heterogeneity was assessed using subgroup analysis.

Results: The pooled prevalence of microvascular complications in DM patients was 32.89 % (95 % CI: 28.17-37.60). In addition, the pooled prevalence of retinopathy, neuropathy, and nephropathy in DM patients was 17.16 % (95 % CI: 12-22 %), 10.49 % (95 % CI: 8-13 %) and 11.52 % (95 % CI: 9-15 %) respectively. Age >60 years old (AOR = 1.08 (95%CI = 1.02-1.15), longer duration of DM (AOR = 1.57 (95 % CI = 1.31-1.84), poor glycemic control (AOR = 2.21 (95 % CI = 1.52-2.91), poor adherence to diabetic medications (AOR = 3.61 (95 % CI = 1.83-5.38) and presence of hypertension (AOR = 2.26 (95 % CI = 1.73-2.80) ware associated risk factors for microvascular complications in DM patients.

Concussion: Around one-third of DM patients had one or more microvascular complications. Patients with advanced age, longer duration of DM, poor glycemic control, poor medication adherence, and comorbidity like hypertension should be targeted to tackle the occurrence and severity of microvascular complications in DM patients.

Protocol registration: The review protocol was developed and was registered with PROSPERO registration number (CRD42023486459).

Keywords: Diabetes mellitus; Ethiopia; Microvascular complication; Nephropathy; Neuropathy; Prevalence; Retinopathy.