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|Title: ||Predictors of glycemic control in type-2 diabetes mellitus: Evidence from a multicenter study in Ghana|
|Authors: ||Mobula, Linda M.|
Carson, Kathryn A.
Sarfo, Fred Stephen
|Issue Date: ||2018|
|Publisher: ||Translational Metabolic Syndrome Research|
|Citation: ||Translational Metabolic Syndrome Research ,1 (2018) 1e8|
|Abstract: ||Background: The burden of uncontrolled type-2 diabetes (T2DM) sub-Saharan Africa is high, with an
increased risk of developing microvascular and macrovascular complications. We sought to identify
predictors of poor diabetes control among Ghanaians with T2DM.
Methods: A cross-sectional study involving 1226 participants with T2DM enrolled at five health facilities
in Ghana (2 tertiary, 2 district and 1 rural hospital). Data on demographics, medical history, lifestyle
factors, anti-diabetic medications, and treatment adherence were collected. Additional questionnaires on
sources of diabetes treatment medications and challenges with accessing these medications were also
administered. Glycated hemoglobin was measured and a cut-off value of 7.0% used to define poor
control. Predictors of diabetes control were assessed using a multivariate logistic regression model.
Key results: The mean ± SD age of study participants was 57 ± 12.1 years, with a female preponderance
(77.5%). The mean HbA1C among all study participants was 8.9 ± 4.9% of which 70% had HBA1C >7%.
Duration of diabetes diagnosis (aOR ¼ 1.04; 95% CI 1.02e1.06), the absence of the Ghana National Health
Insurance Scheme (aOR ¼ 1.41; 95% CI 1.09e1.82) and the number of diabetes medicines (aOR ¼ 1.73;
95% CI 1.45e2.07) were adversely associated with poor glycemic control while male gender (aOR ¼ 0.66;
95% CI 0.49e0.88), increasing age (aOR of 0.97; 95% CI of 0.96e0.98) and dual diagnosis of diabetes and
hypertension (aOR ¼ 0.69; 95% CI 0.50e0.95) had positive associations with good glycemic control.
Conclusion: 7 out of 10 patients with T2DM in Ghana are poorly controlled. Multidisciplinary interventions
that improve patient education, quality of care, access to antidiabetics including insulin, are
all needed to avert deaths related to diabetes complications associated with uncontrolled T2DM in
|Description: ||An article published in Translational Metabolic Syndrome Research ,1 (2018) 1e8|
|Appears in Collections:||College of Health Sciences|
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