Abstract
IntroductionThe glycaemic control status of diabetic patients affects the management of their disorder. We examined the glycaemic control and clinical factors that may influence the achievement of the glycaemic control targets among diabetic out-patients.MethodsThis was a hospital based cross-sectional study carried out at the University Teaching Hospital diabetic clinic in Lusaka, Zambia. A simple random sample of 198 consenting participants was selected from diabetic out-patients between September and December 2013. A structured interview schedule was used to capture socio-demographic data as well as needed clinical data from clients’ medical records and laboratory results. Multivariate binary logistic regression analysis was carried out to examine factors that may be associated with the glycaemic control status of these diabetic patients.ResultsOverall (n = 198), mean (SD) age was 53.19±13.32 years. Majority (61.3%) of the patients had poor glycaemic control status (HbA1c≥49 mmol/mol). Insulin treatment (OR 0.13, 95% CI: 0.01 - 1.41), systolic blood pressure (OR 1.04, CI: 1.00 - 1.08) and fasting plasma glucose (previous; OR 0.81, CI: 0.72 - 0.90 and current; OR 0.85, CI: 0.78 - 0.93) were statistically significantly associated with glycaemic control. The poor glycaemic control observed in this study is similar to that reported in other published studies.ConclusionWe found evidence of poor glycaemic control in the study population suggesting need to explore the reasons for this. Association of Insulin, systolic blood pressure and fasting plasma glucose with glycaemic control further suggests the efficiency of traditional basic monitoring parameters which should be exploited in sharpening primary preventive strategies especially those that support lifestyle modification. Such efforts should also be integrated in all information, education and communication strategies that target but not limited to hospital based patients too.
Highlights
The glycaemic control status of diabetic patients affects the management of their disorder
This report indicates that 19.8 million of the 382 diabetics were adults living in sub-Saharan Africa which is nearly double the number previously estimated by Sicree et al [7] 5 years earlier who had estimated a 12.1 million people in sub-Saharan Africa living with diabetes and had projected the number to rise to be over 23.9 million by 2030 [6,8]
This study revealed that the patients on insulin were less likely to achieve good glycaemic control compared to those who were on diet/none
Summary
The glycaemic control status of diabetic patients affects the management of their disorder. Association of Insulin, systolic blood pressure and fasting plasma glucose with glycaemic control further suggests the efficiency of traditional basic monitoring parameters which should be exploited in sharpening primary preventive strategies especially those that support lifestyle modification. Such efforts should be integrated in all information, education and communication strategies that target but not limited to hospital based patients too. In 2013, 382 million (8.3%) adults worldwide were living with DM and a further 316 had impaired glucose tolerance Most of these were aged between 40 and 59 years [5,6]. These reports signify the continuing increase and it is estimated that the diabetic population in Africa will double from that of 2013 by 2035 [5]
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