Abstract
Background: Results of previous studies on the effect on glycaemic control of anthropometric measures of obesity, some economic status variables and the presence of metabolic syndrome are not consistent and appear to differ among health institutions. The status of glycaemic control and some of its determinants was investigated among adult black patients with type-2 diabetes mellitus (T2DM) at Dr George Mukhari Academic Hospital (DGMAH).Method: A random sample of 176 adult black South African patients with T2DM attending the diabetic clinic at DGMAH was investigated in the current study. Fasting blood glucose, glycated haemoglobin (HbA1c), lipid profile components levels as well as anthropometric measures of obesity were measured using standard measuring procedures for these variables. The presence of metabolic syndrome was assessed according to the International Diabetic Federation criteria. Information related to patients’ socioeconomic status was collected by means of a structured questionnaire. Associations between these factors and poor glycaemic control were assessed by means of binary and multivariate logistic analysis.Results: Glycaemic control was found to be very poor at DGMAH. As low as 16.6% of the study subjects achieved SEMDSA’s 2012 recommended target HbA1c value of less than 7.0%. Whereas binary logistic analysis revealed that marital status, matriculation, increase waist circumference and duration of diabetes 5 years may lead to poor glycaemic control, multivariate logistic regression analysis indicated that only increased waist circumference was independently associated with poor glycaemic control at DGMAH.Conclusions: Central obesity appears to be an independent risk factor for poor glycaemic control among T2DM patients at DGMAH.
Highlights
Evidence from randomised controlled clinical trials suggests that tight glycaemic control reduces the incidence of long-term complications of diabetes.[1,2,3] despite this evidence, sustained glycaemic control remains an elusive goal for many type 2 diabetes (T2D) patients throughout the world.[4,5] In agreement with this observation, a number of previous research studies conducted in South Africa have reported that glycaemic control is very poor in some South African health institutions
This cross-sectional hospital-based study was conducted at Dr George Mukhari Academic Hospital (DGMAH), a tertiary hospital in the Gauteng province of the republic of South Africa that caters for mostly black African patients and serves as a medical training site for Sefako Makgatho Health Sciences University
The current study investigated a total of 176 patients (53 men and 123 women) with type-2 diabetes mellitus (T2DM) aged between 35 and 74 years, with a mean age of 58.95 (± 11.5) years
Summary
Evidence from randomised controlled clinical trials suggests that tight glycaemic control reduces the incidence of long-term complications of diabetes.[1,2,3] despite this evidence, sustained glycaemic control remains an elusive goal for many type 2 diabetes (T2D) patients throughout the world.[4,5] In agreement with this observation, a number of previous research studies conducted in South Africa have reported that glycaemic control is very poor in some South African health institutions In this context, Erasmus et al.[6] assessed long-term glycaemic control in T2DM patients attending the diabetic clinic at a peri-urban community study in Umtata, Eastern Cape province and found that only 19.9% of their study subjects achieved recommended target HbA1c value of less than 7.0%. Conclusions: Central obesity appears to be an independent risk factor for poor glycaemic control among T2DM patients at DGMAH
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