Published in PLOS One on 2026-08-28, 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: Abdirahman Ibrahim Said, Mustafe Hussein, Stephen Charles Olet, Abshir Mohamoud Hersi, Amatarahman Ibrahim Said, Said Ibrahim Said
Source: PLOS One • DOI 10.1371/journal.pone.0347799
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Electrolyte disturbances are common among patients with diabetes mellitus and contribute significantly to morbidity. Hypocalcemia, an often-overlooked abnormality, may be influenced by both medical and lifestyle factors, particularly in resource-limited settings. This study aimed to determine the prevalence of hypocalcemia and identify its associated determinants among diabetic patients attending Jinja Regional Referral Hospital in Uganda.
A cross-sectional analytical study was conducted among 374 adult diabetic patients at the medical outpatient clinic of Jinja Regional Referral Hospital. Participants were consecutively enrolled, and data were collected using structured questionnaires and laboratory investigations. Serum calcium levels were measured, with hypocalcemia defined as <2.2 mmol/L. Descriptive statistics were used to determine prevalence, while bivariate and multivariate analyses (modified Poisson regression) identified factors associated with hypocalcemia. Adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) were reported, with statistical significance set at p < 0.05.
The prevalence of hypocalcemia was 28.9% (95% CI: 24.5–33.7). At bivariate analysis, significant associations were observed with occupation, social support, duration of diabetes, BMI, waist circumference, random blood glucose, and medication adherence. However, in multivariate analysis, only occupation remained independently associated with hypocalcemia. Civil servants had a significantly higher prevalence compared to farmers (aPR = 1.91; 95% CI: 1.07–3.43; p = 0.030).
Hypocalcemia is highly prevalent among diabetic patients in this setting. Occupation, particularly indoor-based work such as civil service, is an independent predictor, likely reflecting reduced sunlight exposure and possible vitamin D deficiency. Routine screening for calcium abnormalities and targeted interventions addressing lifestyle factors are recommended to improve comprehensive diabetes care.
Introduction
Diabetes mellitus (DM) continues to be the most prevalent metabolic disorder worldwide, presenting a growing public health challenge [1]. The prevalence has been rising steadily for decades, particularly in low- and middle-income countries [2]. Globally, the number of adults diagnosed with DM nearly quadrupled from 108 million in 1980 to approximately 422 million by 2014, with a corresponding increase in adult prevalence from 4.7% to 8.5% [3,4].
This increasing incidence ensures that diabetes remains a leading cause of morbidity and mortality for the foreseeable future [5]. The severity of diabetes lies in its associated complications, which can be life-threatening and irreversible if not identified and managed promptly [6]. Electrolyte imbalances represent a common and critical complication in patients with DM due to multifactorial pathophysiological factors related to the disease itself, its complications, and certain medications [3]. Electrolytes play a vital role in cellular function, enzymatic reactions, and maintaining overall homeostasis [7]. Studies across different regions highlight the widespread prevalence of these abnormalities; for instance, a study in Bangladesh found electrolyte disturbances in 78% of hospitalized DM patients [8]. Similarly, research in Africa has indicated that more than 40% of DM patients suffer from various electrolyte abnormalities [9].
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 hospital systems 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 Abdirahman Ibrahim Said, Mustafe Hussein, Stephen Charles Olet, Abshir Mohamoud Hersi, Amatarahman Ibrahim Said, Said Ibrahim Said. 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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