{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T17:58:29Z","timestamp":1780941509222,"version":"3.54.1"},"reference-count":68,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We searched Medline, EMBASE, CINAHL, Cochrane Library, and Africa Journal Online databases from 25\n                      <jats:sup>th<\/jats:sup>\n                      May 2024\u201329\n                      <jats:sup>th<\/jats:sup>\n                      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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                    <jats:p>\n                      For the microvascular diabetes complications, the pooled prevalence of diabetic neuropathy, retinopathy, and nephropathy was 56.8% (95% CI 44.9\u201368.7, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200998.56%, p\u2009&lt;\u20090.001), 19.5% (95% CI 3.9\u201335.2, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200999.60%, p\u2009&lt;\u20090.001), and 17.7% (95% CI 7.3\u201328.0, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200999.36%, p\u2009&lt;\u20090.001), respectively. For the macrovascular diabetes complications, the pooled prevalence of peripheral arterial disease and diabetic foot disease was 32.2% (95% CI 15.8\u201348.7, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200997.67%, p\u2009&lt;\u20090.001) and 5.5% (95% CI 1.7\u20139.2, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200990.22%, p\u2009&lt;\u20090.001), respectively.\n                    <\/jats:p>\n                    <jats:p>\n                      Hypertension comorbidity, physical inactivity, family history of diabetes, body mass index \u226430 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , and pregnancy were associated with diabetic nephropathy in three studies. In two studies, a history of a foot ulcer and age\u2009&gt;\u200960 years were associated with diabetic neuropathy, while female sex, hypertension comorbidity, and use of glibenclamide were associated with peripheral arterial disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0312792","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T17:22:16Z","timestamp":1780939336000},"page":"e0312792","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and factors associated with microvascular and macrovascular diabetes complications in adult Ugandans: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5127-3031","authenticated-orcid":true,"given":"Davis","family":"Kibirige","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Olum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Turyamureeba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethan","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9002-4510","authenticated-orcid":true,"given":"Andrew Peter","family":"Kyazze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yakobo","family":"Nsubuga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4160-6418","authenticated-orcid":true,"given":"Jerom","family":"Okot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Lumu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4515-8517","authenticated-orcid":true,"given":"Felix","family":"Bongomin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"pone.0312792.ref001","volume-title":"International diabetes federation diabetes atlas 10th Editi","author":"IDF","year":"2021"},{"issue":"11","key":"pone.0312792.ref002","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1111\/tmi.13819","article-title":"Availability and affordability of essential medicines and diagnostic tests for diabetes mellitus in Africa","volume":"27","author":"D Kibirige","year":"2022","journal-title":"Trop Med Int Health"},{"issue":"11","key":"pone.0312792.ref003","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-060786","article-title":"Indicators of optimal diabetes care and burden of diabetes complications in Africa: a systematic review and meta-analysis","volume":"12","author":"D Kibirige","year":"2022","journal-title":"BMJ Open"},{"issue":"1","key":"pone.0312792.ref004","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s10020-024-00824-9","article-title":"An update on chronic complications of diabetes mellitus: from molecular mechanisms to therapeutic strategies with a focus on metabolic memory","volume":"30","author":"T Yang","year":"2024","journal-title":"Mol Med"},{"issue":"3","key":"pone.0312792.ref005","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/tmi.12663","article-title":"Prevalence and correlates of diabetes mellitus in Uganda: a population-based national survey","volume":"21","author":"S Bahendeka","year":"2016","journal-title":"Trop Med Int Health"},{"key":"pone.0312792.ref006","author":"WHO","year":"2024"},{"issue":"1","key":"pone.0312792.ref007","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1186\/s12913-019-4535-x","article-title":"Quality and barriers of outpatient diabetes care in rural health facilities in Uganda - a mixed methods study","volume":"19","author":"C Birabwa","year":"2019","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0312792.ref008","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1186\/s12939-017-0651-6","article-title":"Access to medicines and diagnostic tests integral in the management of diabetes mellitus and cardiovascular diseases in Uganda: insights from the ACCODAD study","volume":"16","author":"D Kibirige","year":"2017","journal-title":"Int J Equity Health"},{"issue":"1","key":"pone.0312792.ref009","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s12939-019-0934-1","article-title":"Challenges to hypertension and diabetes management in rural Uganda: a qualitative study with patients, village health team members, and health care professionals","volume":"18","author":"H Chang","year":"2019","journal-title":"Int J Equity Health"},{"issue":"7","key":"pone.0312792.ref010","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"PRISMA Group","year":"2009","journal-title":"PLoS Med"},{"key":"pone.0312792.ref011","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group","year":"2024","journal-title":"Kidney Int"},{"issue":"1","key":"pone.0312792.ref012","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1038\/s41572-019-0092-1","article-title":"Diabetic neuropathy","volume":"5","author":"EL Feldman","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"pone.0312792.ref013","doi-asserted-by":"crossref","first-page":"16012","DOI":"10.1038\/nrdp.2016.12","article-title":"Diabetic retinopathy","volume":"2","author":"TY Wong","year":"2016","journal-title":"Nat Rev Dis Primers"},{"issue":"3","key":"pone.0312792.ref014","doi-asserted-by":"crossref","DOI":"10.1002\/dmrr.3654","article-title":"Definitions and criteria for diabetes-related foot disease (IWGDF 2023 update)","volume":"40","author":"JJ van Netten","year":"2024","journal-title":"Diabetes Metab Res Rev"},{"issue":"3","key":"pone.0312792.ref015","doi-asserted-by":"crossref","DOI":"10.1002\/dmrr.3686","article-title":"The intersocietal IWGDF, ESVS, SVS guidelines on peripheral artery disease in people with diabetes and a foot ulcer","volume":"40","author":"R Fitridge","year":"2024","journal-title":"Diabetes Metab Res Rev"},{"key":"pone.0312792.ref016","volume-title":"The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses","author":"GA Wells","year":"2021"},{"issue":"1","key":"pone.0312792.ref017","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s12874-025-02527-z","article-title":"Overcoming challenges in prevalence meta-analysis: the case for the Freeman-Tukey transform","volume":"25","author":"J Abdulmajeed","year":"2025","journal-title":"BMC Med Res Methodol"},{"key":"pone.0312792.ref018","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/2046-4053-2-80","article-title":"Meta-analysis and The Cochrane Collaboration: 20 years of the cochrane statistical methods group","volume":"2","author":"JE McKenzie","year":"2013","journal-title":"Syst Rev"},{"issue":"12","key":"pone.0312792.ref019","first-page":"14","article-title":"Prevalence and factors associated with peripheral neuropathies among patients with diabetes attending Jinja Regional Referral Hospital: A retrospective open cohort study","volume":"3","author":"V Alimwenda","year":"2022","journal-title":"Student\u2019s Journal of Health Research Africa"},{"issue":"2","key":"pone.0312792.ref020","article-title":"Diabetic retinopathy screening program in southwestern Uganda: DR Uganda","volume":"24","author":"S Arunga","year":"2021","journal-title":"J Ophthalmol Eastern Central and Southern Africa"},{"issue":"3","key":"pone.0312792.ref021","first-page":"91","article-title":"Morbidity and mortality among diabetic patients admitted to Mulago Hospital, Uganda","volume":"15","author":"MH Bateganya","year":"2003","journal-title":"Malawi Med J"},{"issue":"1","key":"pone.0312792.ref022","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/2251-6581-13-40","article-title":"Suboptimal glycaemic and blood pressure control and screening for diabetic complications in adult ambulatory diabetic patients in Uganda: a retrospective study from a developing country","volume":"13","author":"D Kibirige","year":"2014","journal-title":"J Diabetes Metab Disord"},{"issue":"1","key":"pone.0312792.ref023","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1186\/s13104-023-06500-1","article-title":"Burden and predictors of diabetic kidney disease in an adult Ugandan population with new-onset diabetes","volume":"16","author":"D Kibirige","year":"2023","journal-title":"BMC Res Notes"},{"key":"pone.0312792.ref024","doi-asserted-by":"crossref","first-page":"3534260","DOI":"10.1155\/2019\/3534260","article-title":"Microalbuminuria and traditional serum biomarkers of nephropathy among diabetic patients at Mbarara regional referral hospital in South Western Uganda","volume":"2019","author":"R Kiconco","year":"2019","journal-title":"J Diabetes Res"},{"issue":"2","key":"pone.0312792.ref025","doi-asserted-by":"crossref","first-page":"463","DOI":"10.4314\/ahs.v17i2.21","article-title":"Prevalence, severity and factors associated with peripheral neuropathy among newly diagnosed diabetic patients attending Mulago hospital: a cross-sectional study","volume":"17","author":"T Kisozi","year":"2017","journal-title":"Afr Health Sci"},{"issue":"1","key":"pone.0312792.ref026","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1186\/s12872-022-02718-2","article-title":"Association of body mass index with left ventricular diastolic dysfunction among ambulatory individuals with diabetes mellitus in rural Uganda: a cross-sectional study","volume":"22","author":"BAE Lumori","year":"2022","journal-title":"BMC Cardiovasc Disord"},{"key":"pone.0312792.ref027","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.diabres.2019.04.024","article-title":"Prevalence and severity of diabetic retinopathy in patients attending the endocrinology diabetes clinic at Mulago Hospital in Uganda","volume":"152","author":"T Magan","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"issue":"1","key":"pone.0312792.ref028","first-page":"021","article-title":"Microalbuminuria among newly diagnosed diabetic patients at mulago national referral hospital in Uganda: a cross sectional study","volume":"4","author":"M Martin","year":"2018","journal-title":"J Obes Weight Loss Medicat"},{"issue":"1","key":"pone.0312792.ref029","doi-asserted-by":"crossref","first-page":"21","DOI":"10.5334\/gh.765","article-title":"Prevalence and correlates of cardiovascular autonomic neuropathy among patients with diabetes in Uganda: a hospital-based cross-sectional study","volume":"15","author":"R Migisha","year":"2020","journal-title":"Glob Heart"},{"key":"pone.0312792.ref030","doi-asserted-by":"crossref","first-page":"1001872","DOI":"10.3389\/fcdhc.2022.1001872","article-title":"Prevalence and grade of diabetic peripheral neuropathy among known diabetic patients in rural Uganda","volume":"3","author":"DK Munyambalu","year":"2023","journal-title":"Front Clin Diabetes Healthc"},{"issue":"8","key":"pone.0312792.ref031","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0105211","article-title":"Peripheral arterial disease among adult diabetic patients attending a large outpatient diabetic clinic at a national referral hospital in Uganda: a descriptive cross sectional study","volume":"9","author":"RM Mwebaze","year":"2014","journal-title":"PLoS One"},{"issue":"9","key":"pone.0312792.ref032","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1093\/qjmed\/89.9.705","article-title":"The presentation of newly-diagnosed diabetic patients in Uganda","volume":"89","author":"AP Nambuya","year":"1996","journal-title":"QJM"},{"key":"pone.0312792.ref033","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/1471-2261-14-75","article-title":"Prevalence of lower extremity peripheral artery disease among adult diabetes patients in southwestern Uganda","volume":"14","author":"S Okello","year":"2014","journal-title":"BMC Cardiovasc Disord"},{"issue":"12","key":"pone.0312792.ref034","first-page":"14","article-title":"Clinical presentation and bacteriology of diabetic foot ulcers at Mulago Hospital: a prospective case series study","volume":"3","author":"AJ Pario","year":"2022","journal-title":"Student\u2019s J Health Research Africa"},{"key":"pone.0312792.ref035","doi-asserted-by":"crossref","first-page":"3123","DOI":"10.2147\/DMSO.S321310","article-title":"Poor glycemic control and the contributing factors among type 2 diabetes mellitus patients attending outpatient diabetes clinic at mbarara regional referral hospital, Uganda","volume":"14","author":"NB Patrick","year":"2021","journal-title":"Diabetes Metab Syndr Obes"},{"key":"pone.0312792.ref036","doi-asserted-by":"crossref","first-page":"75","DOI":"10.2147\/OAS.S384235","article-title":"Diabetic foot ulcers: surgical characteristics, treatment modalities and short-term treatment outcomes at a tertiary hospital in South-Western Uganda","volume":"15","author":"MM Sikhondze","year":"2022","journal-title":"Open Access Surgery"},{"issue":"11","key":"pone.0312792.ref037","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-039258","article-title":"Prevalence and factors associated with overweight and obesity among patients with type 2 diabetes mellitus in Uganda-a descriptive retrospective study","volume":"10","author":"S Tino","year":"2020","journal-title":"BMJ Open"},{"issue":"1","key":"pone.0312792.ref038","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1186\/s12889-023-15383-7","article-title":"Factors associated with severity and anatomical distribution of diabetic foot ulcer in Uganda: a multicenter cross-sectional study","volume":"23","author":"BM Vahwere","year":"2023","journal-title":"BMC Public Health"},{"issue":"1","key":"pone.0312792.ref039","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.diabres.2011.10.018","article-title":"Type 2 diabetes control and complications in specialised diabetes care centres of six sub-Saharan African countries: the Diabcare Africa study","volume":"95","author":"E Sobngwi","year":"2012","journal-title":"Diabetes Res Clin Pract"},{"issue":"1","key":"pone.0312792.ref040","doi-asserted-by":"crossref","DOI":"10.4103\/njo.njo_49_20","article-title":"Diabetic retinopathy in Sub-Saharan Africa: a review of magnitude and risk factors","volume":"29","author":"EO Achigbu","year":"2021","journal-title":"Nigerian J Ophthalmol"},{"issue":"4","key":"pone.0312792.ref041","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1111\/j.1464-5491.2012.03756.x","article-title":"Epidemiology of diabetic retinopathy and maculopathy in Africa: a systematic review","volume":"30","author":"PI Burgess","year":"2013","journal-title":"Diabet Med"},{"issue":"5","key":"pone.0312792.ref042","doi-asserted-by":"crossref","first-page":"759","DOI":"10.4239\/wjd.v6.i5.759","article-title":"Diabetic nephropathy in Africa: a systematic review","volume":"6","author":"JJN Noubiap","year":"2015","journal-title":"World J Diabetes"},{"key":"pone.0312792.ref043","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.diabres.2018.05.016","article-title":"Characteristics, prevalence, and outcomes of diabetic foot ulcers in Africa. A systemic review and meta-analysis","volume":"142","author":"M Rigato","year":"2018","journal-title":"Diabetes Res Clin Pract"},{"issue":"1","key":"pone.0312792.ref044","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12902-020-0534-5","article-title":"Prevalence of diabetic peripheral neuropathy in Africa: a systematic review and meta-analysis","volume":"20","author":"WS Shiferaw","year":"2020","journal-title":"BMC Endocr Disord"},{"issue":"6","key":"pone.0312792.ref045","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.4103\/1319-2442.220869","article-title":"Pattern and predictors of urine protein excretion among patients with type 2 diabetes attending a single tertiary hospital in Lagos, Nigeria","volume":"28","author":"BT Bello","year":"2017","journal-title":"Saudi J Kidney Dis Transpl"},{"issue":"1","key":"pone.0312792.ref046","article-title":"Characteristics of patients with diabetic retinopathy in Gaborone, Botswana","volume":"17","author":"AM Blake","year":"2015","journal-title":"Tanzan J Health Res"},{"key":"pone.0312792.ref047","doi-asserted-by":"crossref","first-page":"75","DOI":"10.2147\/DMSO.S185614","article-title":"Glycemic control and diabetes complications among diabetes mellitus patients attending at University of Gondar Hospital, Northwest Ethiopia","volume":"12","author":"A Fasil","year":"2019","journal-title":"Diabetes Metab Syndr Obes"},{"issue":"10","key":"pone.0312792.ref048","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1093\/qjmed\/hcn096","article-title":"Diabetic complications and glycaemic control in remote North Africa","volume":"101","author":"G Gill","year":"2008","journal-title":"QJM"},{"key":"pone.0312792.ref049","doi-asserted-by":"crossref","first-page":"104779","DOI":"10.1016\/j.mvr.2024.104779","article-title":"Prevalence of microvascular complications and associated factors among diabetes mellitus patients in Ethiopia: systematic review and meta-analysis","volume":"158","author":"G Kumie","year":"2025","journal-title":"Microvasc Res"},{"issue":"2","key":"pone.0312792.ref050","doi-asserted-by":"crossref","first-page":"336","DOI":"10.2337\/dc12-0683","article-title":"Ethnic differences in the prevalence of diabetic retinopathy in persons with diabetes when first presenting at a diabetes clinic in South Africa","volume":"36","author":"RL Thomas","year":"2013","journal-title":"Diabetes Care"},{"issue":"4","key":"pone.0312792.ref051","doi-asserted-by":"crossref","first-page":"194","DOI":"10.4103\/jesnt.jesnt_16_21","article-title":"The burden of diabetic kidney disease in Nigeria \u2212 systematic review and meta-analysis","volume":"21","author":"TA Azeez","year":"2021","journal-title":"J Egypt Soc Nephrol Transplant"},{"issue":"1","key":"pone.0312792.ref052","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1186\/s13104-018-3670-5","article-title":"Diabetic nephropathy and hypertension in diabetes patients of sub-Saharan countries: a systematic review and meta-analysis","volume":"11","author":"F Wagnew","year":"2018","journal-title":"BMC Res Notes"},{"key":"pone.0312792.ref053","doi-asserted-by":"crossref","first-page":"1551088","DOI":"10.3389\/fcdhc.2025.1551088","article-title":"Prevalence of nephropathy among patients with diabetes mellitus in Africa: a systematic review and meta-analysis","volume":"6","author":"GI Adebayo-Gege","year":"2025","journal-title":"Front Clin Diabetes Healthc"},{"issue":"6","key":"pone.0312792.ref054","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1001\/jamasurg.2016.0446","article-title":"Peripheral Arterial Disease in Sub-Saharan Africa: A Review","volume":"151","author":"LE Johnston","year":"2016","journal-title":"JAMA Surg"},{"issue":"1","key":"pone.0312792.ref055","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s12872-020-01395-3","article-title":"Peripheral arterial disease and its correlates in patients with type 2 diabetes mellitus in a teaching hospital in northern Nigeria: a cross-sectional study","volume":"20","author":"OF Agboghoroma","year":"2020","journal-title":"BMC Cardiovasc Disord"},{"key":"pone.0312792.ref056","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.2147\/DMSO.S254537","article-title":"Hypertension and Its Associated Factors Among Type 2 Diabetes Mellitus Patients at Debre Tabor General Hospital, Northwest Ethiopia","volume":"13","author":"Y Akalu","year":"2020","journal-title":"Diabetes Metab Syndr Obes"},{"issue":"1","key":"pone.0312792.ref057","doi-asserted-by":"crossref","first-page":"74","DOI":"10.2174\/1573399814666180125100917","article-title":"Prevalence of chronic diabetic complications in newly diagnosed versus known type 2 diabetic subjects in a sample of alexandria population, Egypt","volume":"15","author":"SA Khalil","year":"2019","journal-title":"Curr Diabetes Rev"},{"issue":"1","key":"pone.0312792.ref058","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1258\/td.2009.090086","article-title":"Dyslipidaemia and hypertension among adults with diabetes in rural Uganda","volume":"40","author":"NT Kamara","year":"2010","journal-title":"Trop Doct"},{"key":"pone.0312792.ref059","doi-asserted-by":"crossref","first-page":"215","DOI":"10.2147\/TCRM.S120423","article-title":"Statin therapy reduces the likelihood of suboptimal blood pressure control among Ugandan adult diabetic patients","volume":"13","author":"W Lumu","year":"2017","journal-title":"Ther Clin Risk Manag"},{"issue":"1","key":"pone.0312792.ref060","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1186\/s12913-019-4535-x","article-title":"Quality and barriers of outpatient diabetes care in rural health facilities in Uganda - a mixed methods study","volume":"19","author":"C Birabwa","year":"2019","journal-title":"BMC Health Serv Res"},{"issue":"4","key":"pone.0312792.ref061","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0250421","article-title":"Understanding the diagnostic delays and pathways for diabetes in eastern Uganda: a qualitative study","volume":"16","author":"FX Kasujja","year":"2021","journal-title":"PLoS One"},{"key":"pone.0312792.ref062","doi-asserted-by":"crossref","first-page":"30","DOI":"10.12688\/openreseurope.13286.2","article-title":"Hypertension and diabetes patients\u2019 perspective of challenges and their coping mechanisms in Mukono and Buikwe districts in Uganda - a qualitative study","volume":"1","author":"R Ndejjo","year":"2023","journal-title":"Open Res Eur"},{"issue":"1","key":"pone.0312792.ref063","article-title":"Effects of physical activity on the progression of diabetic nephropathy: a meta-analysis","volume":"41","author":"Z Cai","year":"2021","journal-title":"Biosci Rep"},{"issue":"4","key":"pone.0312792.ref064","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1159\/000516391","article-title":"Meta-analysis of the relationship between abdominal obesity and diabetic kidney disease in type 2 diabetic patients","volume":"14","author":"Q Zhao","year":"2021","journal-title":"Obes Facts"},{"issue":"7","key":"pone.0312792.ref065","first-page":"536","article-title":"Diabetes in rural South Africa--an assessment of care and complications","volume":"92","author":"AP Rotchford","year":"2002","journal-title":"S Afr Med J"},{"issue":"1","key":"pone.0312792.ref066","doi-asserted-by":"crossref","first-page":"3844","DOI":"10.1038\/s41598-024-53951-y","article-title":"Diabetic peripheral neuropathy among adult type 2 diabetes patients in Adama, Ethiopia: health facility-based study","volume":"14","author":"Y Mekuria Negussie","year":"2024","journal-title":"Sci Rep"},{"issue":"1","key":"pone.0312792.ref067","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.123.031780","article-title":"Prevalence of and risk factors for peripheral artery disease in rural South Africa: a cross-sectional analysis of the HAALSI cohort","volume":"13","author":"ET Beidelman","year":"2024","journal-title":"J Am Heart Assoc"},{"issue":"2","key":"pone.0312792.ref068","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.ejvs.2012.05.019","article-title":"Epidemiology of peripheral artery disease in elder general population of two cities of Central Africa: Bangui and Brazzaville","volume":"44","author":"M Guerchet","year":"2012","journal-title":"Eur J Vasc Endovasc Surg"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312792","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T17:22:26Z","timestamp":1780939346000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312792"}},"subtitle":[],"editor":[{"given":"Yee Gary","family":"Ang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":68,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0312792","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]}}}