Time to optimal glycaemic control and prognostic factors among type 2 diabetes mellitus patients in public teaching hospitals in Addis Ababa, Ethiopia.

Tigist W Leulseged,Birhanu T Ayele

doi:10.1371/journal.pone.0220309

Tigist W Leulseged, Birhanu T Ayele

Open Access

https://doi.org/10.1371/journal.pone.0220309

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Abstract

AimTo estimate time to first optimal glycaemic control and identify prognostic factors among type 2 diabetes mellitus (T2DM) patients attending diabetes clinic of public teaching hospitals in Addis Ababa, Ethiopia.MethodsA retrospective chart review study was conducted at diabetes clinic of Addis Ababa’s public teaching hospitals among a randomly selected sample of 685 charts of patients with T2DMwho were on follow up from January 1, 2013 to June 30, 2017. Data was collected using data abstraction tool. Descriptive statistics, Kaplan Meier plots, median survival time, Log-rank test and Cox proportional hazard survival models were used for analysis.ResultsMedian time to first optimal glycaemic control among the study population was 9.5 months. Factors that affect time to first optimal glycaemic control were age group (HR = 0.635, 95% CI: 0.486–0.831 for 50–59 years, HR = 0.558, 95% CI: 0.403–0.771for 60–69 years and HR = 0.495, 95% CI: 0.310–0.790 for > = 70 years), diabetes neuropathy (HR = 0.502, 95% CI: 0.375–0.672), more than one complication (HR = 0.381, 95% CI: 0.177–0.816), hypertension (HR = 0.611, 95% CI: 0.486–0.769), dyslipidemia (HR = 0.609, 95% CI: 0.450–0.824), cardiovascular disease (HR = 0.670, 95% CI: 0.458–0.979) and hospital patient being treated (HR = 1.273, 95% CI: 1.052–1.541).ConclusionsMedian time to first optimal glycaemic control among T2DM patients is longer than expected which might imply that patients are being exposed to more risk of complication and death.

Highlights

Diabetes is a chronic, progressive disease characterized by elevated levels of blood glucose
Factors that affect time to first optimal glycaemic control were age group (HR = 0.635, 95% Confidence Interval (CI): 0.486–0.831 for 50–59 years, hazard ratio (HR) = 0.558, 95% CI: 0.403–0.771for 60–69 years and HR = 0.495, 95% CI: 0.310–0.790 for > = 70 years), diabetes neuropathy (HR = 0.502, 95% CI: 0.375–0.672), more than one complication (HR = 0.381, 95% CI: 0.177–0.816), hypertension (HR = 0.611, 95% CI: 0.486–0.769), dyslipidemia (HR = 0.609, 95% CI: 0.450–0.824), cardiovascular disease (HR = 0.670, 95% CI: 0.458–0.979) and hospital patient being treated (HR = 1.273, 95% CI: 1.052–1.541)
Median time to first optimal glycaemic control among type 2 diabetes mellitus (T2DM) patients is longer than expected which might imply that patients are being exposed to more risk of complication and death

Summary

Introduction

Progressive disease characterized by elevated levels of blood glucose. There are three types of diabetes: Type 1, Type and gestational diabetes. Type 2 diabetes is the commonest type[1, 2]. Diabetes is one of the largest global health emergencies of the 21st century. Each year more and more people live with this condition and this increase is noted more rapidly in resource limited countries. According to IDF Atlas and WHO, about 45.1% of all adults aged 20–79 years with diabetes in Africa live in four countries including Ethiopia. In Ethiopia, prevalence of diabetes in adults has increased from 2.9% in 2015 to 3.8% in 2016 to 5.2% in 2017[3,4,5]

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