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Int J Gen Med. 2017 Feb 20;10:33-38. doi: 10.2147/IJGM.S124548. eCollection 2017.

Frequency and predictors of suboptimal glycemic control in an African diabetic population.

Author information

1
Department of Medicine/Diabetic and Hypertension Clinics, Our Lady of Consolota Hospital, Kisubi.
2
Baylor College of Medicine, Children's Foundation.
3
Infectious Diseases Research Collaboration, Kampala.
4
Nephrology Unit, Mulago National Referral and Teaching Hospital, Kampala.
5
Department of Medicine and Diabetes/Endocrine Unit, Mengo Hospital, Mengo, Uganda.

Abstract

BACKGROUND:

Persistent suboptimal glycemic control is invariably associated with onset and progression of acute and chronic diabetic complications in diabetic patients. In Uganda, studies documenting the magnitude and predictors of suboptimal glycemic control in adult ambulatory diabetic patients are limited. This study aimed at determining the frequency and predictors of suboptimal glycemic control in adult diabetic patients attending three urban outpatient diabetic clinics in Uganda.

METHODS:

In this hospital-based cross-sectional study, eligible ambulatory adult diabetic patients attending outpatient diabetic clinics of three urban hospitals were consecutively enrolled over 11 months. Suboptimal glycemic control was defined as glycated hemoglobin (HbA1c) level ≥7%. Multivariable analysis was applied to determine the predictors.

RESULTS:

The mean age of the study participants was 52.2±14.4 years, and the majority of them were females (283, 66.9%). The median (interquartile range) HbA1c level was 9% (6.8%-12.4%). Suboptimal glycemic control was noted in 311 study participants, accounting for 73.52% of the participants. HbA1c levels of 7%-8%, 8.1%-9.9%, and ≥10% were noted in 56 (13.24%), 76 (17.97%), and 179 (42.32%) study participants, respectively. The documented predictors of suboptimal glycemic control were metformin monotherapy (odds ratio: 0.36, 95% confidence interval: 0.21-0.63, p<0.005) and insulin therapy (odds ratio: 2.41, 95% confidence interval: 1.41-4.12, p=0.001).

CONCLUSION:

Suboptimal glycemic control was highly prevalent in this study population with an association to metformin monotherapy and insulin therapy. Strategies aimed at improving glycemic control in diabetes care in Uganda should be enhanced.

KEYWORDS:

Africa; Uganda; frequency; predictors; suboptimal glycemic control

Conflict of interest statement

Disclosure DK works in the medical unit of GlaxoSmithKline, Uganda. None of the described work was funded by GSK, and the views expressed here are solely the author’s. The authors report no other conflicts of interest in this work.

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