TITLE:
Abnormally Long QTC Interval and Associated Factors among Individuals Attending Diabetic Clinic at Lira Regional Referral Hospital in Northern Uganda: A Cross-Sectional Study
AUTHORS:
Jimmy Odongo Ogwal, Victor Muyambi, Cleophas Mugumya, Kenneth Kwenya, Naome Aryem, Edward Ojuka, Rebecca Awili, Samuel Okello, Jolly Joe Enyang, Abel Obeny, Edmand Kabaterine, Caleb Angulu
KEYWORDS:
QT Interval, Prevalence, Diabetes Mellitus, QTc Prolongation, Uganda, Cardiovascular Risk
JOURNAL NAME:
Open Access Library Journal,
Vol.13 No.8,
August
26,
2026
ABSTRACT: Background: Heart rate-corrected QT (QTc) interval prolongation is associated with increased risk of cardiovascular events and mortality among individuals with diabetes mellitus (DM). However, limited data exist on the epidemiology of abnormally long QTc among people with DM in northern Uganda. Objectives: We determined the prevalence and factors associated with abnormally long QTc intervals among individuals attending the diabetic clinic at Lira Regional Referral Hospital (LRRH) in northern Uganda. Methods: We conducted a cross-sectional study among individuals attending the diabetic clinic at LRRH from July to December 2025. Twelve-lead electrocardiogram recordings were performed on all participants. We collected clinical and laboratory data related to diabetes disease status and treatment. QTc was calculated using Bazett’s formula for heart rates 60 - 100 beats/minute and Fredericia’s formula for extremes, then categorized using standardized sex-adjusted thresholds. Borderline and prolonged categories were combined as “abnormally long QTc” for analysis. Modified Poisson regression with robust variance was used to identify factors associated with abnormally long QTc intervals. Results: We recruited 338 participants with a mean age of 52.4 years (SD ± 10.2) and a mean HbA1c of 9.2% (SD ± 2.8); 63.0% were female. The prevalence of abnormally long QTc interval was 22.5% (76/338, 95% CI: 18.3% - 27.3%). In multivariate analysis, factors independently associated with a higher prevalence of abnormally long QTc included elevated mean arterial pressure (aPR = 1.16, 95% CI: 1.05 - 1.28, p = 0.002) and use of furosemide-containing antihypertensive regimens (aPR = 1.32, 95% CI: 1.11 - 1.57, p = 0.002). Protective factors included adequate physical activity (≥150 minutes/week) (aPR = 0.85, 95% CI: 0.77 - 0.94, p = 0.002) and use of oral hypoglycemic agents alone (aPR = 0.62, 95% CI: 0.55 - 0.70, p Conclusions: Approximately one in five individuals with diabetes in routine care at LRRH has an abnormally long QTc interval, representing a substantial burden of potential arrhythmic risk. Elevated mean arterial pressure, furosemide use, insulin-only therapy, and physical inactivity were independently associated with abnormally long QTc. These findings support routine ECG screening in diabetic clinics and careful consideration of antihypertensive and hypoglycemic agent selection in this population.