Clinical features, complications and mortality in type 1 (insulin-dependent) diabetic patients in Addis Ababa, Ethiopia, 1976-1990.

Clinical features, complications and prognosis of 431 consecutively registered Ethiopian Type 1 (insulin-dependent) diabetic patients seen in the Diabetic Clinic in Yekatit 12 Hospital in Addis Ababa, Ethiopia, from 1976-1990 are reported. Male:female ratio was 1.4:1; mean age at diagnosis was 18.1 years (confidence interval (CI) 1.6) in women and 21.4 (CI 1.2) in men. A history of ketoacidosis at some time was present in 38 per cent, in 11 per cent at diagnosis of diabetes. Tuberculosis was the most common complicating illness, occurring at some time in 16.5 per cent of patients. In addition, 9.5 per cent (CI 4 per cent) were known to have diabetic retinopathy, 6.0 per cent (CI 2 per cent) nephropathy and 7.9 per cent (CI 2 per cent) neuropathy at their last clinic visit. During the 15 years of the study, 9.7 per cent of the patients have died, with a mean duration of diabetes at death of 9.2 years (CI 1.8), and an overall mortality rate of 15.5/1000 person-years of diabetes. Five-year survival was 96 per cent (CI 3 per cent), 15-year survival 82 per cent (CI 9 per cent), and 20-year survival 63 per cent (CI 17 per cent), calculated using the Cox proportional hazards model; prognosis was better in those diagnosed at a younger age (p = 0.029) and in those with a body mass index of > 19 kg/m2 on treatment (p = 0.096).