Prevalence and determinants of poor glycaemic control amongst patients with diabetes followed at Vanga Evangelical Hospital, Democratic Republic of the Congo

• Published in: African journal of primary health care & family medicine Vol. 13; no. 1; pp. e1 - e6
• Main Authors: Cedrick, Lino Masingo, Fina Lubaki, Jean-Pierre, Francois, Lepira Bompeka, Gboyega, Ogunbanjo Adebola, Philippe, Lukanu Ngwala
• Format: Journal Article
• Language: English
• Published: South Africa African Online Scientific Information Systems (Pty) Ltd t/a AOSIS 30-04-2021; AOSIS (Pty) Ltd; AOSIS
• Subjects: Data collection; determinants; Developing countries; Diabetes; Diabetes therapy; Diabetics; Disease; Education; Ethics; glycaemic control; Health care reform; Hospitals; Hypoglycemic agents; LDCs; Low income groups; Medical research; Medicine, Experimental; Original Research; Patient compliance; Patients; poor; prevalence; rural; Rural areas; Sample size; Smoking; Sociodemographics; Software; Type 2 diabetes; Congo (Kinshasa); Sub-Saharan Africa; United States > US; Africa; prevalence; determinants; poor; diabetics; patients; rural; glycaemic control
• ISSN: 2071-2928; 2071-2936
• DOI: 10.4102/phcfm.v13i1.2664

The prevalence of diabetes mellitus is increasing dramatically in developing countries, where diabetic patients usually present with poor glycaemic control, leading to complications and worsening the prognosis.
The aim of this study was to determine the extent of poor glycaemic control and its determinants in diabetic patients.
The study was conducted in a rural area of the province of Kwilu, Democratic Republic of the Congo.
This research comprised a cross-sectional study involving 300 Type 1 and 2 diabetic patients attending Vanga Evangelical Hospital in the Democratic Republic of the Congo from January 2018 to March 2018. Patients' sociodemographic, clinical and biological characteristics, accessibility to the health structure and treatment were described. The determinants of poor glycaemic control were identified using multivariate logistic regression at the p 0.05 level of statistical significance.
The mean age of participants was 46.9 ± 16.3 years, 68.4% were men, and 62.3% had Type 2 diabetes mellitus. Poor glycaemic control was present in 78% of patients. The independent determinants of poor glycaemic control were tobacco use (adjusted odds ratio [aOR]: 2.01 [1.77-5.20], p = 0.015), the presence of comorbidities (aOR: 2.86 [1.95-6.65], p = 0.007), the presence of a factor contributing to hyperglycaemia (aOR: 2.74 [1.83-3.67], p = 0.014), missing scheduled appointments (aOR: 2.59 [1.94-7.13], p = 0.006) and non-adherence to treatment (aOR: 4.09 [1.35-6.39], p = 0.008).
This study shows that more than three-quarters of diabetics undergoing treatment are not controlled, with mainly patient-related factors as the main explanatory factors for this poor glycaemic control. Therefore, the establishment of a therapeutic education programme and wider integration of diabetes care services, mainly at the primary level of the healthcare pyramid, should contribute to improved diabetes treatment.