Abstract P137: Patient Level Determinants of Glycemic Control Among Patients With Type 2 Diabetes Mellitus in Primary Health Facilities in Ghana

Abstract

Background: Glycemic control among patients with type 2 diabetes mellitus (T2DM) has implications for the risk of complications. Despite the increasing burden of T2DM in sub-Saharan Africa, research on glycemic control remains scanty. Objective: To assess individual-level determinants of glycemic control among patients with T2DM who were on treatment. Methods: A retrospective review of medical records of patients with T2DM in four primary health clinics in the Bono Region of Ghana was conducted. Glycemic control was classified as controlled (fasting blood glucose [FBG] <7.0 mmol/l) and uncontrolled (FBG ≥7 mmol/l) using WHO guidelines for glycemic control. Patient-level characteristics were selected as predictors based on their potential association with glycemic outcomes. A multivariable logistic regression model was fitted to examine the association between patient-level characteristics and glycemic control. Results: Medical records of 637 patients were included, mean age of 61 (±12.2) years, 77% females and 59% farmers. Prevalent complications were Peripheral Neuropathy (17%) and Retinopathy (4%). The mean FBG was 9.7mmol/l (±3.9). Twenty-seven percent (27%) of the patients had glycemic control, with a higher proportion among middle-aged patients (36-65). Patients older than 65 years had higher odds of glycemic control compared to those between 20-35 (adjusted odds ratio OR = 1.83, [95% CI: (1.13 3.54)] p=0.049). Patients without any complications had higher odds of glycemic control compared with those with complications (adjusted OR (AOR) 1.80 [95% CI: 1.07 3.02] p=0.029) (Table) Conclusions: Age and diabetes-related complications were significantly associated with glycemic control. Intensive treatment strategies should be implemented to improve glycemic control among younger adults to reduce the risk of complications. Health system interventions for people with diabetes must recognize the age dimension of glycemic control in Ghana.