Long-standing diabetes mellitus in Ethiopia: a survey of 105 patients.

In 7 years, 809 Ethiopian patients have been seen in a diabetic clinic in Addis Ababa, of whom 105 have had diabetes for more than 15 years (none more than 30 years). Of those with "long term" diabetes 13 were Type 1 (insulin-dependent), 68 Type 2 (non-insulin-dependent) non-obese and 24 Type 2 obese; 28% had always taken insulin, and a further 19% required insulin after some years of oral therapy. Diabetic retinopathy was found in 38%, 27% had normal fundi, and 14% had cataracts so dense the fundi were obscured; for 21% fundal examination was not recorded. Cataracts were or had been present in 40% of patients, and caused more visual handicap than retinopathy. Thirty percent of patients had nephropathy. Diabetic peripheral neuropathy was found in 47%. Cardiac, foot and miscellaneous vascular complications were seen, but were much less common. Thirty-one patients (30%) died during the 7 years, the commonest cause of death being renal failure, but an encouraging proportion (61%) had no severely handicapping complications and were independent after more than 15 years of diabetes.