Alioune Camara1, Naby M Baldé2, Joelle Sobngwi-Tambekou3, André P Kengne4, Mansour M Diallo2, Alain P K Tchatchoua5, Amadou Kaké2, Ngamani Sylvie5, Beverley Balkau6, Fabrice Bonnet7, Eugène Sobngwi8. 1. Department of Endocrinology, University Hospital, Conakry, Guinea; INSERM, CIC 0203, University Hospital of Pontchaillou, Rennes, France. Electronic address: aliounec@gmail.com. 2. Department of Endocrinology, University Hospital, Conakry, Guinea. 3. Catholic University of Central Africa, Yaounde, Cameroon. 4. Non-Communicable Diseases Research Unit, South African Medical Research Council & University of Cape Town, Cape Town, South Africa. 5. Central Hospital and Faculty of Medicine and Biomedical Sciences University, Yaounde, Cameroon. 6. INSERM, U1018, University Paris Sud 11, Paris, France. 7. INSERM, CIC 0203, University Hospital of Pontchaillou, Rennes, France; Departments of Endocrinology, University Hospital, Rennes, France. 8. Central Hospital and Faculty of Medicine and Biomedical Sciences University, Yaounde, Cameroon; Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
Abstract
BACKGROUND: Management of type 2 diabetes remains a challenge in Africa. The objective of this study was to evaluate the prevalence and predictors of poor glycemic control in patients with type 2 diabetes living in sub-Saharan. PATIENTS AND METHODS: This was a cross-sectional study involving 1267 people (61% women) with type 2 diabetes (mean age 58 years) recruited across health facilities in Cameroon and Guinea. Predictors of poor glycemic control (HbA1c ≥7.0% (53 mmol/mol)) were investigated via logistic regressions. RESULTS: The mean body mass index was 27.4 ± 5.8 kg/m(2), and 74% of patients had poor glycemic control. Predictors of poor glycemic control in multivariable regression models were recruitment in Guinea [odd ratio: 2.91 (95% confidence interval 2.07 to 4.11)], age <65 years [1.40 (1.04 to 1.88)], diabetes duration ≥3 years [2.36 (1.74 to 3.21)], treatment with: oral glucose control agents [3.46 (2.28 to 5.26)], insulin alone or with oral glucose control agents [7.74 (4.70 to 12.74)] and absence of a previous HbA1c measurement in Guinea [2.96 (1.30 to 6.75)]. CONCLUSION: Poor control of blood glucose is common in patients with type 2 diabetes in these two countries. Limited access to HbA1c appears to be a key factor associated with poor glycemic control in Guinea, and should be addressed by health policies targeting improvement in the outcomes of diabetes care.
BACKGROUND: Management of type 2 diabetes remains a challenge in Africa. The objective of this study was to evaluate the prevalence and predictors of poor glycemic control in patients with type 2 diabetes living in sub-Saharan. PATIENTS AND METHODS: This was a cross-sectional study involving 1267 people (61% women) with type 2 diabetes (mean age 58 years) recruited across health facilities in Cameroon and Guinea. Predictors of poor glycemic control (HbA1c ≥7.0% (53 mmol/mol)) were investigated via logistic regressions. RESULTS: The mean body mass index was 27.4 ± 5.8 kg/m(2), and 74% of patients had poor glycemic control. Predictors of poor glycemic control in multivariable regression models were recruitment in Guinea [odd ratio: 2.91 (95% confidence interval 2.07 to 4.11)], age <65 years [1.40 (1.04 to 1.88)], diabetes duration ≥3 years [2.36 (1.74 to 3.21)], treatment with: oral glucose control agents [3.46 (2.28 to 5.26)], insulin alone or with oral glucose control agents [7.74 (4.70 to 12.74)] and absence of a previous HbA1c measurement in Guinea [2.96 (1.30 to 6.75)]. CONCLUSION: Poor control of blood glucose is common in patients with type 2 diabetes in these two countries. Limited access to HbA1c appears to be a key factor associated with poor glycemic control in Guinea, and should be addressed by health policies targeting improvement in the outcomes of diabetes care.
Authors: Thomas R Hird; Fraser J Pirie; Tonya M Esterhuizen; Brian O'Leary; Mark I McCarthy; Elizabeth H Young; Manjinder S Sandhu; Ayesha A Motala Journal: PLoS One Date: 2016-08-25 Impact factor: 3.240