Occupation is a significant independent predictor of hypocalcemia among diabetic patients in Jinja, Uganda

BACKGROUND: Electrolyte disturbances are common among patients with diabetes mellitus and contribute significantly to morbidity. Hypocalcemia, an often-overlooked abnormality, may be influenced by both medical and lifestyle factors, particularly in resource-limited settings. This study aimed to determine the prevalence of hypocalcemia and identify its associated determinants among diabetic patients attending Jinja Regional Referral Hospital in Uganda. METHODS: A cross-sectional analytical study was conducted among 374 adult diabetic patients at the medical outpatient clinic of Jinja Regional Referral Hospital. Participants were consecutively enrolled, and data were collected using structured questionnaires and laboratory investigations. Serum calcium levels were measured, with hypocalcemia defined as <2.2 mmol/L. Descriptive statistics were used to determine prevalence, while bivariate and multivariate analyses (modified Poisson regression) identified factors associated with hypocalcemia. Adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) were reported, with statistical significance set at p < 0.05. RESULTS: The prevalence of hypocalcemia was 28.9% (95% CI: 24.5-33.7). At bivariate analysis, significant associations were observed with occupation, social support, duration of diabetes, BMI, waist circumference, random blood glucose, and medication adherence. However, in multivariate analysis, only occupation remained independently associated with hypocalcemia. Civil servants had a significantly higher prevalence compared to farmers (aPR = 1.91; 95% CI: 1.07-3.43; p = 0.030). CONCLUSION: Hypocalcemia is highly prevalent among diabetic patients in this setting. Occupation, particularly indoor-based work such as civil service, is an independent predictor, likely reflecting reduced sunlight exposure and possible vitamin D deficiency. Routine screening for calcium abnormalities and targeted interventions addressing lifestyle factors are recommended to improve comprehensive diabetes care.