Mulago National Referral Hospital is reporting a steady and concerning rise in diabetes cases, with more than 100 patients attending the diabetes clinic every Friday, reflecting the growing burden of the chronic disease in Uganda.
Diabetes is a metabolic condition characterized by high blood sugar levels. It occurs when the pancreas does not produce enough insulin or when the body fails to effectively use the insulin it produces.
Insulin is essential for allowing glucose to enter body cells for energy. When this process is disrupted, sugar accumulates in the bloodstream, leading to serious health complications over time.
Although diabetes has no cure, it can be managed through lifestyle changes, medication, and regular monitoring.
At Mulago, uncontrolled hyperglycemia — dangerously high blood sugar levels — is the leading cause of admission among diabetic patients, accounting for 48.3 percent of cases. Infections such as pneumonia and urinary tract infections follow at 27.7 percent.
The mortality rate among admitted diabetic patients stands at approximately 10.8 percent, highlighting the life-threatening consequences of poorly managed disease.
More than half of admitted patients present with long-term complications. Hypertension is the most common, affecting 53.8 percent of patients, while 38.3 percent suffer from peripheral neuropathy, a form of nerve damage that often affects the hands and feet.
Nearly eight in ten patients have low estimated glomerular filtration rates (eGFR) or proteinuria — indicators of advanced kidney disease — suggesting that many patients seek care when the disease has already progressed significantly.
The clinic predominantly serves females, who account for 72.6 percent of patients, and individuals aged over 49 years, who make up 56.1 percent of those seeking care.
In terms of treatment, nearly 66 percent of patients are on oral medication, 36 percent use insulin, and 36 percent are on a combination of both. However, non-adherence to treatment remains a major challenge, contributing to complications and repeated hospital admissions.
The burden is not limited to adults. The pediatric diabetes clinic currently manages roughly 100 children living with Type 1 diabetes, an autoimmune condition that requires lifelong daily insulin therapy.
Diabetes exists in three main forms. Type 1 diabetes occurs when the immune system destroys insulin-producing cells in the pancreas.
Type 2 diabetes, the most common form, develops when the body becomes resistant to insulin or does not produce enough of it and is often linked to weight and lifestyle factors. Gestational diabetes develops during pregnancy and increases the risk of developing Type 2 diabetes later in life.
Common symptoms include increased thirst and frequent urination, unexplained weight loss, extreme hunger, fatigue, blurred vision, and slow-healing sores or frequent infections. Health experts emphasize that early testing and strict adherence to treatment are critical in preventing complications.
The rising numbers at Mulago reflect a broader public health challenge, as diabetes continues to place increasing pressure on families and the health system.
Medical professionals warn that without improved prevention efforts, patient education, and consistent treatment adherence, hospital admissions and complications are likely to continue rising.