Published in PLOS One on 2026-06-08, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Davis Kibirige, Ronald Olum, William Turyamureeba, Bethan Morgan, Andrew Peter Kyazze, Yakobo Nsubuga, Jerom Okot, William Lumu, Felix Bongomin
Source: PLOS One • DOI 10.1371/journal.pone.0312792
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
The rising prevalence of diabetes in Uganda has led to a disproportionate increase in the burden of diabetes complications. We conducted a systematic review and meta-analysis to document the prevalence and factors associated with five chronic diabetes complications in adult Ugandans with diabetes.
We searched Medline, EMBASE, CINAHL, Cochrane Library, and Africa Journal Online databases from 25th May 2024–29th May 2024. We included studies reporting information on the prevalence and factors associated with the five chronic diabetes complications. We conducted a random-effect meta-analysis to determine the pooled prevalence of each diabetes complication. Using narrative synthesis, we described the factors significantly associated with each diabetes complication.
A total of twenty studies reporting information on 11,400 participants were considered. The pooled mean (standard deviation) age of the participants was 54.8 (3.6) years.
For the microvascular diabetes complications, the pooled prevalence of diabetic neuropathy, retinopathy, and nephropathy was 56.8% (95% CI 44.9–68.7, I2 = 98.56%, p < 0.001), 19.5% (95% CI 3.9–35.2, I2 = 99.60%, p < 0.001), and 17.7% (95% CI 7.3–28.0, I2 = 99.36%, p < 0.001), respectively. For the macrovascular diabetes complications, the pooled prevalence of peripheral arterial disease and diabetic foot disease was 32.2% (95% CI 15.8–48.7, I2 = 97.67%, p < 0.001) and 5.5% (95% CI 1.7–9.2, I2 = 90.22%, p < 0.001), respectively.
Hypertension comorbidity, physical inactivity, family history of diabetes, body mass index ≤30 kg/m2, and pregnancy were associated with diabetic nephropathy in three studies. In two studies, a history of a foot ulcer and age > 60 years were associated with diabetic neuropathy, while female sex, hypertension comorbidity, and use of glibenclamide were associated with peripheral arterial disease.
This study demonstrates a high prevalence of chronic diabetes complications in adult Ugandans with diabetes. Timely screening and optimal management of chronic diabetes complications should be encouraged in Uganda.
Introduction
Globally, there is an increasing burden of diabetes. According to the most recent International Diabetes Federation (IDF) estimates, about 24 million (1 in 22) adult Africans aged between 20 and 79 years live with diabetes [1]. Additionally, among the IDF regions, Africa has the highest proportion of people with undiagnosed diabetes (54%) [1]. Because of the high rates of undiagnosed diabetes in Africa, coupled with low access to essential diabetes medicines and diagnostics and poorly structured healthcare systems, the prevalence of chronic diabetes-related complications in adult Africans with diabetes is considerably high [1–3].
Chronic hyperglycaemia is associated with several chronic microvascular and macrovascular complications, such as diabetic retinopathy, neuropathy, nephropathy, diabetic foot disease, peripheral arterial disease, and stroke [4]. These complications develop due to hyperglycaemia-induced increase in oxidative stress, formation of advanced glycation end-products, and pro-inflammatory state [4].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Davis Kibirige, Ronald Olum, William Turyamureeba, Bethan Morgan, Andrew Peter Kyazze, Yakobo Nsubuga, Jerom Okot, William Lumu, Felix Bongomin. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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