Glycaemic control in diabetic patients in Zambia.
BACKGROUND
The glycaemic control status of diabetic patients affects the management of their disorder. We examined the glycaemic control and clinical factors that may influence the achievement of the glycaemic control targets among diabetic out-patients.


METHODS
This was a hospital based cross-sectional study carried out at the University Teaching Hospital diabetic clinic in Lusaka, Zambia. A simple random sample of 198 consenting participants was selected from diabetic out-patients between September and December 2013. A structured interview schedule was used to capture socio-demographic data as well as needed clinical data from clients' medical records and laboratory results. Multivariate binary logistic regression analysis was carried out to examine factors that may be associated with the glycaemic control status of these diabetic patients.


RESULTS
Overall (n = 198), mean (SD) age was 53.19 ± 13.32 years. Majority (61.3%) of the patients had poor glycaemic control status (HbA1c ≥ 49 mmol/mol). Insulin treatment (OR 0.13, 95% CI: 0.01 - 1.41), systolic blood pressure (OR 1.04, CI: 1.00 - 1.08) and fasting plasma glucose (previous; OR 0.81, CI: 0.72 - 0.90 and current; OR 0.85, CI: 0.78 - 0.93) were statistically significantly associated with glycaemic control. The poor glycaemic control observed in this study is similar to that reported in other published studies.


CONCLUSIONS
We found evidence of poor glycaemic control in the study population suggesting need to explore the reasons for this. Association of Insulin, systolic blood pressure and fasting plasma glucose with glycaemic control further suggests the efficiency of traditional basic monitoring parameters which should be exploited in sharpening primary preventive strategies especially those that support lifestyle modification. Such efforts should also be integrated in all information, education and communication strategies that target but not limited to hospital based patients too.
Department of Physiological Sciences, School of Medicine, University of Zambia, Lusaka, Zambia.
Emmanuel Mwila
EM
Musenge
Department of Physiological Sciences, School of Medicine, University of Zambia, Lusaka, Zambia.
Alexey
A
Manankov
Department of Public Health, Section for Epidemiology and Biostatistics, School of Medicine, University of Zambia, Lusaka, Zambia.
Boyd
B
Mudenda
Department of Public Health, Section for Epidemiology and Biostatistics, School of Medicine, University of Zambia, Lusaka, Zambia.
Charles
C
Michelo
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015024:Zambia / Q000453:epidemiology
D001786:Blood Glucose
Diabetes mellitus; Zambia; fasting plasma glucose; glycaemic control status; glycosylated haemoglobin