Mortality patterns among type 2 diabetes mellitus patients in Ilorin, Nigeria

Objective: People living with diabetes mellitus (DM) are prone to varied forms of complications which often lead to their premature death. The vulnerability has the greatest impact in type 2 DM because of larger numerical strength, insidious onset and late recognition especially in resource-poor nations like Nigeria. This study is designed to provide information on current trends in mortality among type 2 DM patients. Design: The study was a 10-year retrospective analysis of causes of death and contributing factors in type 2 DM patients. Information was obtained from case files and the hospital death register. Setting: It was carried out in adult medical wards and the accident/emergency unit of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Subjects: The study subjects were type 2 DM patients who were admitted from the diabetic clinic and/or accident and emergency units of the hospital. Data analysis was done using SPSS, version 16. Outcome measures: The study is an attempt to provide insight into preventive measures against complications that culminate in the premature death of Nigerians with type 2 DM. The findings may form a basis for future research on characteristics of type 2 DM in our environment Results: The overall mortality rate was 32.5% with mean age at diagnosis and death being 53.43 + 15.07 and 57.07 + 14.29 respectively. Systemic hypertension was present in 50% of the study population with male and female rate of 55% and 43% respectively. The highest number of admissions were due to diabetic hyperglycaemic emergencies, septicaemia and diabetic foot syndrome (DFS). Mortality rates were highest in those that presented with hypoglycaemia, stroke and diabetic foot syndrome. There was gender disparity in the first three major causes as more males died from DFS and stroke while females accounted for the majority of deaths from diabetic ketoacidosis (DKA). Conclusion: Type 2 DM is a common cause of morbidity and mortality in Nigeria. The contributory factors to high mortality were ignorance, poor hygiene, infections, lack of foot care and inadequate glycaemic/blood pressure control. There is a need to improve hygiene and provide education programmes targeted at DM patients on proper foot care and good glycaemic and blood pressure control. We should emphasise the importance of early diagnosis of diabetes and proper management.