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| LETTER TO THE EDITOR |
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| Year : 2022 | Volume
: 25
| Issue : 3 | Page : 93-94 |
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Letter to editor regarding “Pattern of diabetes mellitus-related complications and mortality rate: Implications for diabetes care in a low-resource setting”
Victor M Oguoma
Health Research Institute, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| Date of Web Publication | 20-Nov-2023 |
Correspondence Address:
Dr. Victor M Oguoma
Health Research Institute, University of Canberra, Canberra, ACT
Australia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/smj.smj_30_21
How to cite this article:
Oguoma VM. Letter to editor regarding “Pattern of diabetes mellitus-related complications and mortality rate: Implications for diabetes care in a low-resource setting”. Sahel Med J 2022;25:93-4 |
How to cite this URL:
Oguoma VM. Letter to editor regarding “Pattern of diabetes mellitus-related complications and mortality rate: Implications for diabetes care in a low-resource setting”. Sahel Med J [serial online] 2022 [cited 2023 Dec 10];25:93-4. Available from: https://www.smjonline.org/text.asp?2022/25/3/93/389945 |
Agofure et al. conducted a study evaluating the pattern of diabetes mellitus (DM)-related complications and mortality rate in a tertiary hospital in Nigeria covering a 7-year period (2012-2018).[1] The publication has many methodological and reporting issues that poses a lot of questions on the reported rates of diabetes-related complications and mortality. The study is not reproducible and do not seem to adhere to the guidelines for reporting observational studies and those from routinely collected health data, which assist in maintaining transparency and guide editors, reviewers, and readers when critically appraising published studies.[2],[3]
First, the study by Agofure et al. reported in the abstract that 78 patients were studied and, in the methods section, that a total of 427 patients were screened for DM during the 7-year period. This discrepancy is reflected on the demographic characteristics presented in [Table 1], which should be for the 427 patients screened rather than the 78 with DM. The demographic characteristics presented should have also reported those of comorbidities with their respective counts and percentages or indicating those in the text rather than just a graph of the percentages alone. This approach enhances reproducibility and clarity for the readership.
Second, it is quite alarming that a total of 427 patients were screened for DM between 2012 and 2018, when Agofure et al. clearly asserts that the hospital runs a weekly diabetes clinic on Tuesdays and Thursdays with the average of 40 DM patients attending each clinic day.[1] From simple arithmetic, it implies that from January 2012 to December 2018, an average of 26,880 patients (320/month or 3840/year) would have been screened for DM. This “427 versus 26880” is a pair of numbers to clarify.
Third, the authors also assert that overall prevalence of DM was 18.3% (78/427). However, in the discussion, they introduced the same prevalence of 18.3% as 183/1000. It is not clear how the entire denominator changed from 427 patients purportedly screened for DM to 1000 and the 78 patients with DM to 183.
Fourth, the aspect of DM-related mortality reported also seems unfounded. Mortality in this instance is the frequency of occurrence of death in the population of patients with DM during the specified period. In cause-specific mortality rate, the numerator is the number of deaths from a specific cause during a given time interval, while the denominator is the size of the population at the midpoint of the time period.[4] The number of DM-related deaths reported on [Table 2] by Agofure et al. is greater than the number of patients with DM, especially in 2013, 2015, 2017, and 2018, which is of great concern.
An understanding of DM-related morbidity and mortality from resource-constrained populations can provide evidence for policy-makers and health practitioners to prioritize interventions and improve the quality of life of patients with DM and related comorbidities. However, studies that lack rigor, correct interpretation of data and reproducibility can potentially lead to waste of resources, especially if used to inform interventions. Therefore, I wish to request that authors provide their data for review in accordance with the open research guidelines.[5]
Financial support and sponsorship
Nil.
Conflicts of interest
VMO is an Investigator on IDF and Eli Lilly and Company funded projects on diabetes management in Southern Nigeria.
| References | |  |
| 1. | Agofure O, Odjimogho S, Okandeji-Barry OR, Efegbere HA, Nathan HT. Pattern of diabetes mellitus-related complications and mortality rate: Implications for diabetes care in a low-resource setting. Sahel Med J 2020;23:206-10.  [Full text] |
| 2. | Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and elaboration. PLoS Med 2007;4:e297. |
| 3. | Benchimol EI, Smeeth L, Guttmann A, Harron K, Moher D, Petersen I, et al. The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement. PLoS Med 2015;12:e1001885. |
| 4. | |
| 5. | Nosek BA, Alter G, Banks GC, Borsboom D, Bowman SD, Breckler SJ, et al. Scientific standards. Promoting an open research culture. Science 2015;348:1422-5. |
[Table 1], [Table 2]
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