title: Poor glycemic control in type 2 diabetes in the South of the Sahara: the issue of limited access to an HbA1c test.
abstract: BACKGROUND
  Management 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.
  
  
  METHODS
  This 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.
  
  
  RESULTS
  The mean body mass index was 27.4 ± 5.8 kg/m(2), 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)].
  
  
  CONCLUSIONS
  Poor 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.
authors.affiliation: Department of Endocrinology, University Hospital, Conakry, Guinea; INSERM, CIC 0203, University Hospital of Pontchaillou, Rennes, France. Electronic address: aliounec@gmail.com.
authors.forename: Alioune
authors.initials: A
authors.lastname: Camara
authors.affiliation: Department of Endocrinology, University Hospital, Conakry, Guinea.
authors.forename: Naby M
authors.initials: NM
authors.lastname: Baldé
authors.affiliation: Catholic University of Central Africa, Yaounde, Cameroon.
authors.forename: Joelle
authors.initials: J
authors.lastname: Sobngwi-Tambekou
authors.affiliation: Non-Communicable Diseases Research Unit, South African Medical Research Council & University of Cape Town, Cape Town, South Africa.
authors.forename: André P
authors.initials: AP
authors.lastname: Kengne
authors.affiliation: Department of Endocrinology, University Hospital, Conakry, Guinea.
authors.forename: Mansour M
authors.initials: MM
authors.lastname: Diallo
authors.affiliation: Central Hospital and Faculty of Medicine and Biomedical Sciences University, Yaounde, Cameroon.
authors.forename: Alain P K
authors.initials: AP
authors.lastname: Tchatchoua
authors.affiliation: Department of Endocrinology, University Hospital, Conakry, Guinea.
authors.forename: Amadou
authors.initials: A
authors.lastname: Kaké
authors.affiliation: Central Hospital and Faculty of Medicine and Biomedical Sciences University, Yaounde, Cameroon.
authors.forename: Ngamani
authors.initials: N
authors.lastname: Sylvie
authors.affiliation: INSERM, U1018, University Paris Sud 11, Paris, France.
authors.forename: Beverley
authors.initials: B
authors.lastname: Balkau
authors.affiliation: INSERM, CIC 0203, University Hospital of Pontchaillou, Rennes, France; Departments of Endocrinology, University Hospital, Rennes, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bonnet
authors.affiliation: Central Hospital and Faculty of Medicine and Biomedical Sciences University, Yaounde, Cameroon; Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Eugène
authors.initials: E
authors.lastname: Sobngwi
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D015992:Body Mass Index; D002163:Cameroon / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D016701:Guinea / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Glycemic control; Sub-Saharan Africa; Type 2 diabetes