Abstract

Diabetes and its complications are responsible for premature death. However, mortality linked to diabetes remains under-estimated because many developing countries do not have data related to this affection. This study aimed to determine  the causes of death in hospitalized diabetic patient in our context. We carried out a retrospective study in the Endocrine and Metabolic Disease Unit of the Yaoundé Central Hospital during a period of 36 months. We included all patients admitted in the unit with a diagnosis of diabetes and/or diabetic complication.Non diabetic patients were excluded. For statistical analysis, Kaplan-Meier cumulative survival plot was used to assess mortality over time and the log rank test to assess differences of the survival functions by group. Hazard ratios (HR) together with their 95% confidence interval (CI) were calculated from the Cox regression. We analyzed a total number of 1005 medical records. The total number of deaths recorded was 73 (40 men and 33 women). The mean age of hospitalized patients was 55 (±16 ) years; and 57 years for deceased patients.The main presenting complain on admission were: poor glycemic control in 653 (65%)  cases followed by diabetes foot wounds: 150 (15%) and fever 85 (8.4%). Mortality rate during this period was 7.3%. Septic shock was the principal cause of death in 42.4% of deceased patients. The other causes were hyperosmolar Non ketotic States (19.1%)  ketoacidosis (16.4%). However, 21.9% of patients died in the first 24 h of admission. In 47.9% of deceased patients diabetes was newly diagnosed. Infection remains a major problem and the principal cause of death in diabetes patients in our African context.

Key words: Infection, diabetes, mortality.