Abstract
Purpose: To determine the status of glycemic control and its associated factors among adult patients with type 2 diabetes mellitus (T2DM) in Hodeidah City, Yemen.
 Methods: This cross-sectional study involved T2DM patients attending an outpatient clinic at the Military Hospital in Hodeidah, from January to March 2017. Relevant socio-demographic characteristics, clinical factors and self-management behaviours were recorded in face-to-face interviews. Blood pressure, body weight, and height measurements were also obtained. Glycosylated hemoglobin (HbA1c) and lipid profile were evaluated. Urine samples were also obtained and analysed by albuminuria assay.
 Results: Of 246 participants, 73.2 % showed poor glycemic control (HbA1c ≥ 7 %). Female patients, those aged ≥ 40 years, the illiterate, and Khat chewers were more likely to have poor glycemic control. Moreover, longer disease duration, insulin administration and albuminuria were significantly associated with poor glycemic control. In contrast, a healthy diet, physical exercise, proper self-monitoring of blood glucose levels and taking medicines as prescribed significantly increased the likelihood of good glycemic control.
 Conclusion: A majority of the Yemeni diabetic patients have poor glycemic control. To achieve better awareness, diabetes educational programs that highlight the benefits of self-management are recommended.
Highlights
Diabetes mellitus (DM) affects more than 422 million people around the world
The American Diabetes Association (ADA) holds that good glycemic control is essential for the management of DM; and that glycated hemoglobin (HbA1c) is the best indicator for the monitoring of blood glucose levels [8]
The findings of the current study showed that the patients who adhered to a healthy diet as suggested by dietitians (OR = 0.4, 95 % CI 0.2 0.7); engaged in physical exercise (OR = 0.5, 95 % CI 0.2 - 1.0); self-monitored their blood glucose levels (OR = 0.5, 95 % CI 0.3 - 0.9); and took medicines as prescribed (OR = 0.6, 95 % CI 0.3 - 1.0) were less likely to have poor glycemic control (Table 4)
Summary
Diabetes mellitus (DM) affects more than 422 million people around the world. By the year 2040, the number of people with diabetes is expected to rise to 642 million, most of who are going to reside in low- or middle-income countries [1]. Type 2 diabetes mellitus (T2DM) accounts for 90 % of diabetes cases worldwide [1] It is considered a major cause of morbidity and mortality especially in low and middle-income countries [7]. HbA1c gives an indication of the average blood glucose levels maintained in the past 3 months [9]. It is important when estimating the risk of complications associated with the disease [10]. This study was intended to determine the factors associated with and the rate of poor glycemic control among T2DM patients in Hodeidah city, Yemen
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