title: Glycaemic control status among type 2 diabetic patients and the role of their diabetes coping behaviours: a clinic-based study in Tripoli, Libya.
abstract: BACKGROUND
  Achieving good glycaemic control is important in diabetes management. However, poor glycaemic control is widely reported. This article assessed the prevalence of uncontrolled and poor glycaemic control among Libyans with type 2 diabetes and examined the relative contribution of diabetes coping behaviours to their glycaemic control status.
  
  
  METHODS
  A cross-sectional study was undertaken in 2013 in a large diabetes centre in Tripoli. The study included 523 respondents. Diabetes coping behaviours were measured using the revised version of the Summary of Diabetes Self-Care Activities measure (SDSCA) and the eight-item Morisky Medication Adherence Scale (MMAS-8(©)), while glycaemic control status was based on the HbA1c level.
  
  
  RESULTS
  Mean HbA1c was 8.9 (±2.1), and of the 523 patients, only 114 (21.8%) attained the glycaemic control target of HbAc1 of less than 7.0%. Females (OR=1.74, 95% CI=1.03-2.91), patients on insulin and oral hypoglycaemic agents (OR=1.92, 95% CI=1.05-3.54), patients on insulin (OR=3.14, 95% CI=1.66-6.03), and low-medication adherents (OR=2.25, 95% CI=1.36-3.73) were more likely to have uncontrolled and poor glycaemic control, while exercise contributed to glycaemic control status as a protective factor (OR=0.85, 95% CI=0.77-0.94).
  
  
  CONCLUSIONS
  The findings from this study showed the considerable burden of uncontrolled and poor glycaemic control in one of the largest diabetes care settings in Libya. Medication adherence as well as exercise promotion programs would help in reducing the magnitude of poor glycaemic control.
authors.affiliation: Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Sana Taher
authors.initials: ST
authors.lastname: Ashur
authors.affiliation: Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Shamsul Azhar
authors.initials: SA
authors.lastname: Shah
authors.affiliation: National Centre for Diabetes and Endocrinology, Tripoli, Libya.
authors.forename: Soad
authors.initials: S
authors.lastname: Bosseri
authors.affiliation: Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Tong Seng
authors.initials: TS
authors.lastname: Fah
authors.affiliation: Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia; Khadijah@ppukm.ukm.edu.my.
authors.forename: Khadijah
authors.initials: K
authors.lastname: Shamsuddin
mesh_terms: D015190:Blood Glucose Self-Monitoring; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008002:Libya; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D057566:Self Report
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents
keywords: HbA1c; Libya; blood glucose testing; diabetes mellitus; diet care; exercise; foot care; glycaemic control; medication adherence; self-care activities