Etiologic Types and Complications of Diabetes Mellitus in Newly Diagnosed Patients at Health Institutions in Bulawayo, Zimbabwe - Protocol for a Cross-Sectional and Prospective Observational Study

Sep 29, 2026

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Rising diabetes prevalence across sub-Saharan Africa has outpaced evidence in Zimbabwe, where etiologic diabetes types and complication burdens at diagnosis remain poorly characterized. This protocol study in Bulawayo aims to define diabetes etiologic types among newly diagnosed adult and adolescent patients, quantify chronic complications at diagnosis, and assess 2-year incidence and risk factors for complications in type 2 diabetes patients without baseline complications, using cross-sectional phase 1 and prospective phase 2 follow-up.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

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Abstract

Background

Objective

Methods

Results

Conclusions

Introduction

JMIR RESEARCH PROTOCOLS Gwini et al Protocol Etiologic Types and Complications of Diabetes Mellitus in Newly Diagnosed Patients at Health Institutions in Bulawayo, Zimbabwe: Protocol for a Cross-Sectional and Prospective Observational Study | Rudo Gwini 1* , MSc, MMed, MD; Elopy Sibanda1 , MD, PhD; Desmond Mwembe2* , BSc (Hons), MSc, PhD; Fraser James Pirie3* , MBChB; Ayesha A Motala3* , MBChB, MD | | --- | | 1Department of Medicine, Faculty of Medicine, National University of Science and Technology Zimbabwe, Bulawayo, Zimbabwe
2Department of Statistics and Operations Research, Faculty of Applied Sciences, National University of Science and Technology, Bulawayo, Zimbabwe
3Department of Diabetes and Endocrinology, School of Clinical Medicine Nelson R Mandela, University of KwaZulu-Natal, Durban, South Africa *these authors contributed equally
Corresponding Author:
Rudo Gwini, MSc, MMed, MD Department of Medicine
Faculty of Medicine, National University of Science and Technology Zimbabwe Vera Road, Mzilikazi, P.O. Box AC939 Ascot
Bulawayo
Zimbabwe
Phone: 263 772119623
Email: [rudogwini003@gmail.com](rudogwini003@gmail.com)
Abstract | Background: The prevalence of diabetes mellitus is increasing in sub-Saharan Africa. Data on the prevalence of diabetes in Zimbabwe are scarce, and the etiologic types of diabetes are not well characterized. Classification of diabetes in Zimbabwe relies on clinical criteria at the time of diagnosis, and more detailed phenotype data are lacking. Furthermore, the prevalence of complications at diagnosis of diabetes and the incidence of complications during follow-up are not well documented in Zimbabwe. Objective: The primary aim of this study is to characterize the etiological types of diabetes in adult and adolescent patients with newly diagnosed diabetes in Bulawayo, Zimbabwe. The secondary objectives are to determine the prevalence of chronic complications of diabetes among adult and adolescent patients with newly diagnosed diabetes and to determine the incidence and risk factors for the development of diabetes complications after a 2-year follow-up in patients with type 2 diabetes who are free of complications at baseline. Methods: This is a cross-sectional and prospective observational study. The cross-sectional (phase 1) study was conducted in patients presenting for the first time to the diabetes service at 2 referral hospitals and 2 diabetes clinics in Bulawayo, Zimbabwe. Data collected from consenting participants included demographic data, social and medical history, and clinical examination. Laboratory tests included serum urea, creatinine and electrolytes, liver function tests, lipids, plasma glucose, glycated hemoglobin, serum C-peptide, spot urine (dipstick, albumin, and creatinine), and β-cell antibodies (antiglutamic acid decarboxylase, anti-islet antigen, anti-insulin antibodies, anti-islet cell antibodies, and antizinc transporter 8 antibodies) . All patients had retinal photography, a 12-lead electrocardiograph, and measurement of carotid intima-media thickness and arterial stiffness. Determination of the incidence of diabetes complications will be conducted through a 2-year follow-up (encompassing 6-mo review) of a subgroup of patients with type 2 diabetes and no diabetes complications at the time of enrollment. At each 6-month visit, in addition to all variables collected at baseline, data on diabetes management and drug therapy compliance will be obtained. Results: Data collection commenced in October 2021, with 323 participants recruited. Data analysis for phase 1 is ongoing. The study will be completed in October 2026. The results will describe the spectrum of diabetes and complications found at diagnosis (phase 1) and the incidence and risk factors associated with the development of complications of diabetes (phase 2) . [https://www.researchprotocols.org/2026/1/e74186](https://www.researchprotocols.org/2026/1/e74186) JMIR Res Proto

FAQs

What is the primary objective of this study protocol?

To characterize etiologic types of diabetes in adult and adolescent patients with newly diagnosed diabetes in Bulawayo, Zimbabwe.

How is the study designed, and what do phase 1 and phase 2 involve?

It uses a cross-sectional and prospective observational design. Phase 1 evaluates newly presenting patients at selected hospitals and clinics, while phase 2 follows a subgroup for 2 years to measure incident complications and risk factors.

Which outcomes will be used to assess diabetes complications?

The protocol measures chronic complications at diagnosis and, during follow-up, the incidence of complications at 6-month review visits, along with baseline management and drug therapy compliance in the follow-up phase.

Sep 29, 2026

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