Prevalence and complications of diabetes mellitus in Uganda: A systematic review and meta-analysis

• Diabetes prevalence in Uganda is 7% (1 in 14), based on 52,111 participants. • Central Uganda has the highest prevalence at 22%, far above other regions. • Common complications: neuropathy 46%, hypertension 45%, visual impairment 28%. • Uganda needs public health action to reduce diabetes burden and complications. Diabetes mellitus is a growing public health concern in Uganda, with rising prevalence and significant complications. However, the overall burden and regional distribution remain inadequately characterized. This systematic review and meta-analysis determined the pooled prevalence of Diabetes mellitus and its associated complications in Uganda to guide public health interventions. We searched PubMed, Embase, and Scopus databases and Google scholar search engines on the 4 th of September 2024 using the keywords “Diabetes mellitus” and “Uganda” combined using the boolean operators AND and OR. The search was run with no restriction to study type or year of publication. Study identification, selection, and inclusion adhered to the PRISMA guidelines. Study quality was assessed using the Joanna Briggs Institute risk of bias checklist for prevalence studies, and data were synthesized using a random-effects meta-analysis. Heterogeneity was evaluated using the I² statistic, and publication bias was assessed using funnel plots and Egger’s regression test. Thirty-nine (39) Ugandan studies published between 1996 and 2024. All studies reported either prevalence or complications of Diabetes mellitus or both, and cumulatively recruited 52,111 respondents from different regions of the country. The pooled prevalence of Diabetes mellitus in Uganda is 7% (95% CI:5 - 10), 2 times higher than 2023 Uganda NCD Risk Factor STEPS Survey. The central region had the highest prevalence at 22%, 4 and 7 times higher than the pooled prevalence in the eastern and western regions, respectively. Common complications included peripheral neuropathy 46.4% (95% CI: 31.8-61.6), hypertension 45% (95% CI: 30.9-59.6), visual impairment 28% (95% CI: 14.0-49.0), and diabetic foot ulcers 8.73% (95% CI: 3.8-18.8). We conclude that 1 in 14 Ugandans suffers Diabetes mellitus, and is at risk of visual impairment, peripheral neuropathy, hypertension, and diabetic foot ulcers. These findings highlight the urgent need for targeted public health interventions to reduce the burden of Diabetes mellitus and its complications in Uganda.