Diabetes Complications in Low-Income Countries: A Narrative Review

Wambui Kibibi J.

School of Natural and Applied Sciences Kampala International University Uganda

ABSTRACT

Diabetes has emerged as a major public health challenge in low-income and low- and middle-income countries (LMICs), where its complications contribute disproportionately to morbidity, mortality, and economic burden. This narrative review examines the epidemiology, spectrum, and determinants of diabetes-related complications in low-income settings, with particular emphasis on microvascular and macrovascular outcomes. Drawing on evidence from global and regional studies, the review highlights the high prevalence of diabetic retinopathy, nephropathy, neuropathy, cardiovascular disease, cerebrovascular events, and peripheral artery disease, often presenting at younger ages and more advanced stages than in high-income countries. Structural barriers including weak health system capacity, limited access to essential medicines and diagnostic services, socioeconomic and geographic disparities, and inadequate screening and follow-up-significantly impede prevention and management efforts. The review further explores prevention and management strategies suited to low-resource contexts, including early detection, simplified treatment regimens, integrated complication management programs, community-based education, and task-shifting approaches. Despite growing recognition of the burden of diabetes complications in LMICs, substantial gaps remain in epidemiological data, screening coverage, and long-term outcomes research. Addressing diabetes complications in low-income countries requires coordinated health system reform, equitable access to care, strengthened primary health services, and evidence-informed policy interventions tailored to local contexts.

Keywords: Diabetes complications, Low-income countries, Microvascular complications, Macrovascular complications and Health systems.

 

CITE AS: Wambui Kibibi J. (2026). Diabetes Complications in Low-Income Countries: A Narrative Review. IDOSR JOURNAL OF APPLIED SCIENCES 11(1):89-97. https://doi.org/10.59298/IDOSRJAS/2026/1118997