The clinical pattern of diabetes mellitus in Ethiopians

Records of 849 consecutive diabetic Ethiopians revealed that 171 had type I diabetes, 462 type II nonobese, 210 type II obese, and 4 drug-induced. Undernutrition (BMI less than 18 kg/m2) was present in 12.9% of patients. Forty percent of all patients require insulin; ketoacidosis has occurred in 7.8%. Diabetes was present 10 yr or less in 73%, only 11% have been diabetic more than 15 yr, and none more than 32 yr. During 7 yr, 66 (7.8%) are known to have died. Renal failure caused 30.3% of known deaths, and ketoacidosis 3%. About 4% of those diabetic 6-10 yr have a clinically significant complication. The incidence of "diabetic triopathy" rose rapidly after 10 yr. Of those diabetic 16-20 yr, 27.7% had nephropathy, 27.7% neuropathy, and 33.3% retinopathy. Hypertension was seen in 12.1% of patients without nephropathy. Cataracts were seen in 1.4% of new diabetic patients, rising to 40.7% in those diabetic more than 20 yr. Peripheral vascular disease was uncommon and myocardial infarctions occurred in eight patients. Thus, "diabetic triopathy," hypertension, and cataracts are frequent in and after the second decade of diabetes in Ethiopians.