Prevalence and factors associated with smell disorders among patients with Type 2 Diabetes mellitus at Mulago National Referral Hospital

Abstract

Background: Diabetes mellitus continues to present a pressing global challenge, affecting an estimated 537 million adults worldwide, a figure expected to increase to 643 million by 2030. Smell disorders like anosmia and hyposmia are among diabetes mellitus complications. These happen secondary to diabetes mellitus affecting an individual's olfactory ability. The reasons why diabetes mellitus patients present with smell disorders are unclear. However, existing theories suggest that smell disorders arise as a sequel of microvascular hyperglycemic injury. This study aimed to examine the prevalence of smell disorders and associated factors among adults attending the diabetes clinic at Mulago National Referral Hospital. Methods: A cross-sectional study was conducted among adults aged 18 years and above, attending the diabetes clinic of MNRH during the study period. Systematic sampling was done among patients confirmed to have T2DM. Data was collected using interviewer-administered questionnaires. Sniffin’s Sticks test kit was used to identify smell disorders. Results: A total of 369 adults were recruited, with the mean age was 52.2 years (sd 11.8 years) with the majority (67.75%) being middle-aged (36 -59 years), male-to-female ratio was 1:2.18 and majority (75.82%) of the participants had lived with Type 2 Diabetes for less than 10 years. The prevalence of smell disorders was found at 47.43% with 7.86% anosmic and 39.57% hyposmic. Abnormal HbA1C levels (aOR: 2.23; 95% CI: 1.34-3.71; p-value:0.002), oral hypoglycemic medication use (aOR: 1.63 95% CI: 1.03-2.59 p-value 0.038), and Hypertension (aOR: 1.98 95% CI: 1.26-3.11; p-value:0.003) were associated with increased odds of presence of a smell disorder. Conclusion: The prevalence of smell disorders among T2DM patients at Mulago Hospital is high. Higher HbA1c levels, non-insulin hypoglycemic medications and hypertension were significantly associated with smell disorders. Recommendations: Routine screening for smell disorders should be integrated into the clinical care of T2DM patients especially; the hypertensive, those with poor glycemic control, and those taking oral hypoglycemic medications to allow for timely intervention and delay the progression of smell disorders. Further research in the form of Longitudinal studies is recommended to examine the effect of smell disorders over time in T2DM patients, especially those whose kind of work relies on the use of the sense of smell.