Co-morbidities among People with Diabetes on Follow-up at Public Hospitals in Eastern Ethiopia: A Multicenter Study

Abstract

Background: Diabetes co-morbidities are the presence of one or more chronic illnesses besides diabetes. Having a better awareness of diabetic co-morbidities helps to reduce diabetes complications and enhance the quality of life. Despite its public health and clinical relevance, evidence on the extent and drivers of diabetes related co-morbidities in Eastern Ethiopia remains limited. Therefore, this study aimed to assess the prevalence of diabetes comorbidities and associated factors in the Eastern Hararghe Zone, Eastern Ethiopia.

Methods: A multi-center hospital-based cross-sectional study was conducted among 455 systematically selected peo­ple with diabetes at public hospitals in eastern Ethiopia from June 1-30, 2022.  A face-to-face interview using a struc­tured questionnaire was employed. Diabetes co-morbidities and biochemical data were extracted from medical rec­ords. A generalized Poisson regression model with robust variance estimation was used to investigate the association of independent variables with the outcome. An adjusted prevalence ratio with a 95% confidence interval (CI) was used to report a statistically significant association at a p < 0.05.

Results: The prevalence of diabetes co-morbidities was found to be 71.1% (95% CI: 67.2%, 75.6%). Hypertension (68%) and depression (44%) were the most prevalent concordant and discordant co-morbidities, respectively. Duration since diagnosis ≥5 years (APR=1.46; 95% CI: 1.26, 1.71), type 2 diabetes (APR= 1.28; 95% CI: 1.01, 1.62), poor gly­cemic control (APR= 1.19; 95% CI: 1.04, 1.37), non-adherence to diabetes medications (APR=1.55; 95% CI: 1.20, 2.01) and low self-efficacy (APR=1.28; 95% CI: 1.08, 1.49) were factors significantly associated with diabetes co-morbidities.

Conclusion: The prevalence of diabetes-related comorbidities was substantially high, with nearly seven in ten people with diabetes having at least one comorbidity. Hypertension and depression were the most common concordant and discordant diabetes comorbidities, respectively. Tailored behavioral interventions for people with diabetes, focusing on treatment adherence, optimal glycemic control, and self-efficacy, could reduce complications and improve quality of life.