EC Nursing and Healthcare

Introduction: Diabetic nephropathy (DN) is one of the most common and complication of diabetes. Good glycemic control and increasing the awareness of diabetic complications will reduce the risk of DN and other diabetic complications. This study aimed to assess the awareness of DN among diabetic patients in Sudan.

Methods: Descriptive cross-sectional facility based study was conducted on total of 226 diabetic patients during the period June 2021 to March 2022. Results were summarized as percentages and frequencies for all variables. Chi-squared test (χ²) was used for analysis of factors associated with awareness of DN, and any P value less than 0.05 was considered statistically significant.

Results: The study included 226 type 2 diabetic patients. They follow their diabetes with internal medicine physician (114, 50.4%), general doctor (60, 26.5%) and family physician (29, 12.8%). Most of the participants use oral hypoglycemic drugs (105, 46.5%) and have controlled diabetes (151, 66.8%). Most of the participants (181, 80.1%) were aware with diabetic nephropathy. Only (25, 11.1%) of the participants were diagnosed with diabetic nephropathy, (14/25, 56.0%) were treated with medical treatment and the rest of (11/25, 44.0%) treated with dialysis. (189, 83.6%) of the respondents received education by about diabetic nephropathy by their doctor.

Conclusion: There is good awareness (80.1%) and low prevalence of DN (11.1%). Patients’ education raises DN awareness. Increasing awareness of DN by the practicing doctors and encouraging of regular follow up is thought to impact positively in control of diabetes. Health insurance coverage encourage regular follow up of DM and facilitate prevention and early detection of the complications.

Keywords: Diabetes; Diabetic Nephropathy; Awareness; Complications; Health Insurance; Poverty; Health Insurance; Filling System; Sudan

1. Samsu N. "Diabetic nephropathy: challenges in pathogenesis, diagnosis, and treatment”. BioMed Research International (2021).
2. Fiseha T and Tamir Z. "Prevalence and awareness of chronic kidney disease among adult diabetic outpatients in Northeast Ethiopia”. BMC Nephrology 1 (2020): 1-7.
3. Gheith O., et al. “Diabetic kidney disease: worldwide difference of prevalence and risk factors”. Journal of Nephropharmacology 1 (2016): 49.
4. Jiang N., et al. “Smoking and the risk of diabetic nephropathy in patients with type 1 and type 2 diabetes: a meta-analysis of observational studies”. Oncotarget 54 (2017): 93209.
5. Oluyombo R., et al. “Awareness, knowledge and perception of chronic kidney disease in a rural community of South‑West Nigeria”. Nigerian Journal of Clinical Practice 2 (2016): 161-169.
6. Shigidi M and Abdelgafar H. "Awareness regarding diabetes control and diabetic nephropathy among Sudanese adults admitted with diabetic foot: a cross-sectional study”. The Pan African Medical Journal 157 (2013).
7. Omar SM., et al. “Prevalence, risk factors, and glycaemic control of type 2 diabetes mellitus in eastern Sudan: a community-based study”. Therapeutic Advances in Endocrinology and Metabolism 10 (2019): 2042018819860071.
8. Thornton Snider J., et al. “Lifetime benefits of early detection and treatment of diabetic kidney disease”. PLoS One5 (2019): e0217487.
9. Obadan NO., et al. “Independent correlates of chronic kidney disease awareness among adults with type 2 diabetes”. Journal of Diabetes and its Complications 6 (2017): 988-991.
10. Hussain S., et al. “Limited knowledge of chronic kidney disease among type 2 diabetes mellitus patients in India”. International Journal of Environmental Research and Public Health 8 (2019): 1443.
11. Kumela Goro K., et al. “Patient awareness, prevalence, and risk factors of chronic kidney disease among diabetes mellitus and hypertensive patients at Jimma University Medical Center, Ethiopia”. BioMed Research International (2019).
12. Hsiao LL. "Raising awareness, screening and prevention of chronic kidney disease: it takes more than a village”. Nephrology 23 (2018): 107-111.
13. Ene-Iordache B., et al. “Chronic kidney disease and cardiovascular risk in six regions of the world (ISN-KDDC): a cross-sectional study”. The Lancet Global Health 5 (2016): e307-e319.
14. Chiang S-C., et al. “Justifying the high prevalence of microalbuminuria for type 2 diabetic patients in taiwan with conditional probability approach-A demand ii study”. Journal of the Chinese Medical Association 1 (2011): 3-10.
15. Mpondo BC., et al. “Prevalence of chronic kidney disease in diabetic adult out-patients in Tanzania”. BMC Nephrology 1 (2016): 1-2.
16. Bansal C., et al. “Awareness of diabetic nephropathy in patients with type 2 diabetes mellitus: the Indian scenario”. Journal of Nephropharmacology 2 (2018): 90-97.
17. Plantinga LC., et al. “Awareness of chronic kidney disease among patients and providers”. Advances in Chronic Kidney Disease 3 (2010): 225-236.
18. Alzahrani B., et al. “Prevalence and risk factors for diabetic nephropathy in type 2 diabetic patients, Taif City, Saudi Arabia”. International Journal of Medicine in Developing Countries 2 (2019): 167-172.
19. Mondal R., et al. “Knowledge attitude and practices towards chronic kidney disease among type-2 diabetic patients in Bangladesh”. International Journal of Education and Health 1 (2021): 17-26.
20. Rahamtalla F., et al. “Prevalence of microalbuminuria among sudanese type 2 diabetic patients at elmusbah center at ombadda-omdurman”. The IOSR Journal of Pharmacy 5 (2012): 51-55.
21. Bamashmoos MA and Ganem Y. "Diabetic nephropathy and its risk factors in type 2-diabetic patients in Sana’a City, Yemen”. World Journal of Medical Sciences 3 (2013): 147-152.
22. Farahat TM., et al. “Prevalence of proteinuria among type 2 diabetic patients in Menoufia governorate, Egypt”. Menoufia Medical Journal 2 (2014): 363.
23. Afifa K., et al. “Screening for nephropathy in diabetes mellitus: is micral-test valid among all diabetics?” International Journal of Chronic Diseases (2016).
24. Al-Rubeaan K., et al. “Diabetic nephropathy and its risk factors in a society with a type 2 diabetes epidemic: a Saudi National Diabetes Registry-based study”. PloS One 2 (2014): e88956.
25. Shahwan MJ., et al. “Prevalence of diabetic nephropathy and associated risk factors among type 2 diabetes mellitus patients in Ramallah, Palestine”. Diabetes and Metabolic Syndrome: Clinical Research and Reviews 2 (2019): 1491-1496.
26. Unnikrishnan R., et al. “Prevalence and risk factors of diabetic nephropathy in an urban South Indian population: the Chennai Urban Rural Epidemiology Study (CURES 45)”. Diabetes Care 8 (2007): 2019-2024.