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Poor glycemic control in type 2 diabetes in the South of the Sahara: the issue of limited access to an HbA1c test

Abstract : BackgroundManagement of type 2 diabetes remains a challenge in Africa. The objective of this study was to evaluate the prevalence and predictors of poor glycemic control in patients with type 2 diabetes living in sub-Saharan.Patients and methodsThis was a cross-sectional study involving 1267 people (61% women) with type 2 diabetes (mean age 58 years) recruited across health facilities in Cameroon and Guinea. Predictors of poor glycemic control (HbA1c ≥7.0% (53 mmol/mol)) were investigated via logistic regressions.ResultsThe mean body mass index was 27.4 ± 5.8 kg/m2, and 74% of patients had poor glycemic control. Predictors of poor glycemic control in multivariable regression models were recruitment in Guinea [odd ratio: 2.91 (95% confidence interval 2.07 to 4.11)], age <65 years [1.40 (1.04 to 1.88)], diabetes duration ≥3 years [2.36 (1.74 to 3.21)], treatment with: oral glucose control agents [3.46 (2.28 to 5.26)], insulin alone or with oral glucose control agents [7.74 (4.70 to 12.74)] and absence of a previous HbA1c measurement in Guinea [2.96 (1.30 to 6.75)].ConclusionPoor control of blood glucose is common in patients with type 2 diabetes in these two countries. Limited access to HbA1c appears to be a key factor associated with poor glycemic control in Guinea, and should be addressed by health policies targeting improvement in the outcomes of diabetes care.
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Submitted on : Friday, October 24, 2014 - 3:32:21 PM
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Alioune Camara, Naby M. Baldé, Joelle Sobngwi-Tambekou, P André, André P. Kengne, et al.. Poor glycemic control in type 2 diabetes in the South of the Sahara: the issue of limited access to an HbA1c test. Diabetes Research and Clinical Practice, Elsevier, 2015, 108 (1), pp.187-192. ⟨10.1016/j.diabres.2014.08.025⟩. ⟨hal-01077373⟩

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