Harerimana, Alexis, and Mchunu, Gugu (2026) Mapping the storm: a scoping review of diabetic emergencies in Africa. Frontiers in Clinical Diabetes and Healthcare, 7. 1822436.

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Abstract

Objective: This scoping review aimed to map the evidence on the patterns and burden of diabetic emergencies among people with diabetes in Africa.

Methods: The review followed the Levac et al. framework and the PRISMA-ScR guidelines. A systematic search was conducted across five electronic databases (CINAHL, Embase, MEDLINE, Scopus, and Web of Science), and manual searches in Google and Google Scholar were conducted for studies published between 2015 and 2025. From 1,207 records, 25 studies met the inclusion criteria. Extracted data were analyzed using thematic analysis and descriptive numerical summaries.

Findings: Of the 25 reviewed studies, diabetic ketoacidosis (DKA) was the most commonly reported emergency, appearing in 17 studies, with proportions ranging from 2.0% to 92.6%. This was followed by hyperosmolar hyperglycemic state (HHS), reported in 11 studies (4.5%–50.6%), and hypoglycemia, reported in 9 studies (0.8%–28.3%). Common determinants included infections and intercurrent illness, poor glycemic control, treatment non-adherence or discontinuation, and limited access to ongoing care. Reported in-hospital mortality ranged from 5% to 17.1%, with DKA case fatality reaching 30% in some studies. Median hospital stay generally ranged from 6 to 9 days.

Conclusion: Diabetic emergencies are a major, yet largely preventable, cause of illness and death among people with diabetes in Africa. Conditions such as DKA place a heavy strain on African healthcare systems. To reduce the rates of these avoidable complications, it is essential to improve primary care for early detection and ensure consistent access to insulin and glucose monitoring.

Item ID:	91982
Item Type:	Article (Research - C1)
ISSN:	2673-6616
Keywords:	acute diabetic complications, Africa, diabetic emergencies, diabetic ketoacidosis, hyperosmolar hyperglycemic state, severe hypoglycemia
Copyright Information:	© 2026 Harerimana and Mchunu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Funders:	Durban University of Technology
Date Deposited:	18 May 2026 22:53
FoR Codes:	42 HEALTH SCIENCES > 4202 Epidemiology > 420207 Major global burdens of disease @ 60% 42 HEALTH SCIENCES > 4206 Public health > 420699 Public health not elsewhere classified @ 40%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200101 Diagnosis of human diseases and conditions @ 50% 20 HEALTH > 2004 Public health (excl. specific population health) > 200404 Disease distribution and transmission (incl. surveillance and response) @ 50%
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