ArticleSystematic reviews2026
Prevalence of diabetic cardiomyopathy in low- and middle-income countries: a systematic review protocol.
Article in Systematic reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
backgroundThe burden of type 2 diabetes mellitus (T2DM) is rising rapidly in low- and middle-income countries (LMICs). Diabetic cardiomyopathy (DbCM), defined as myocardial dysfunction occurring independently of coronary artery disease, hypertension, or significant valvular disease, is an important complication of T2DM and may progress to overt heart failure if undiagnosed. While well characterised in high-income settings, DbCM prevalence and distribution in LMICs remain poorly defined. This systematic review aims to estimate the pooled prevalence of DbCM among adults with T2DM in LMICs.
methodsThis protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines and the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. A comprehensive search will be conducted in PubMed, Scopus, Web of Science, Embase, AJOL, and EBSCOhost, supplemented by regional databases and grey literature sources. Observational studies conducted in LMICs that report the prevalence of DbCM among adults with T2DM will be considered. DbCM must be diagnosed using objective cardiac imaging after exclusion of alternative causes of myocardial dysfunction. Two reviewers will independently screen, extract data, and assess risk of bias using a tool adapted for prevalence studies. DATA SYNTHESIS AND ANALYSIS: Where data are sufficiently comparable, pooled prevalence estimates will be calculated using random-effects meta-analysis. Prevalence proportions will be modelled using generalised linear mixed models with a logit link function to account for within- and between-study variability. Statistical heterogeneity will be assessed using the I EXPECTED OUTCOMES: This review is expected to report pooled prevalence estimates of DbCM across LMICs and to describe regional variation. Differences in diagnostic approaches, glycaemic control, diabetes duration, age, sex, and geographical region are anticipated to contribute to heterogeneity and will be explored where data permit.
conclusionBy synthesising available evidence on the prevalence of DbCM in LMICs, this review will clarify the burden of disease and provide evidence to inform health system planning and guide future research and prevention efforts aimed at reducing diabetes-related heart failure.
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