Trend of diabetic admissions in Tikur Anbessa and St. Paul's University Teaching Hospitals from January 2005-December 2009, Addis Ababa, Ethiopia.

BACKGROUND: The prevalence of diabetes has been shown to increase especially in developing countries, over the last decades.

OBJECTIVES: We investigated the trend of diabetic admissions, indications, chronic complications, comorbidities and outcomes in Ethiopian diabetic patients.

METHODS: A retrospective study was conducted in all diabetic admissions at the Department of Internal Medicine of Tikur Anbessa and St. Paul's Specialized University teaching hospitals from January 2005-December 2009. Data were collected from medical records, diabetic clinic registries, admissions, discharges and death certificates using structured questionnaires.

RESULTS: Total of 724 admissions, 51.7% males and 48.3%females were analyzed Among them 375 (51.8%) patients were Type-1 diabetes, 345 (47.6%) were Type 2 diabetes and the rest three were associated with Hyperthyroidism, and one with Cushing's syndrome. The median and mean age was 27.5 years, 30.1 +/- 12.6 years and 56.00 years, 55.1 +/- 14.5 yrs (p < 0.001) for Types 1 and 2 Diabetes respectively. The median and mean duration of diabetes for Type 1 before admission was 6.00, 8.7 +/- 7.6 and for Type 2 was 10.00, 11.3 +/- 7.5.years (p < 0.001). The admission rate increased serially from 51 (7.1%) patients in year 2005 to 86 (12.0%) in 2006, 144 (20.0%) in 2007, 193 (26.8%) in 2008 and 245 (34.1%) in 2009. There was no statistical significance difference between the types of diabetes (P = 0. 73, X2 = 2.0). Eleven percent and 3.6% were admitted twice and three times respectively. Commonest cause for admission was Diabetic Ketoacidosis (DKA) (71.1%), followed by who had infections (36.3%). Among those with infection, pneumonia occurred in 67 (9.9%), UTI occurred in 55 (8.1%), diabetic foot ulcer in 70 (9.7%), tuberculosis in 42 (5.5%) other infections in 10 (1.4%) of patients. Cardiovascular diseases (CVD) occurred in 126 (18.4%) and Hypertension was found in 250 (34%), hypoglycemia in 1.2% diabetic patients. Diabetic nephropathy, retinopathy, and neuropathy accounted 32% 15.5% and 12.4% respectively. Of total deaths (10.6%), CVD accounted for 28% infections for 14.8% and DKA for 5.8% In each year of the studied period, DKA persisted to be the leading cause for admission followed by infections.

CONCLUSION: This study showed the serial increment of diabetic admissions over the study period Commonest causes for admission were DKA followed by infection and cardiovascular diseases. Mainly Cardiovascular diseases were the leading causes of death in hospitalized diabetic patients. So we recommend the. health policy makers to be alarmed of the growing magnitude of Diabetes Mellitus and strengthen methods of prevention and control of Diabetes Mellitus and associated cardiovascular diseases.