title: Cross-sectional study of patients with type 2 diabetes in OR Tambo district, South Africa.
abstract: South Africa has pledged to the sustainable development goal of promoting good health and well-being to all residents. While this is laudable, paucity of reliable epidemiological data for different regions on diabetes and treatment outcomes may further widen the inequalities of access and quality of healthcare services across the country. This study examines the sociodemographic and clinical determinants of uncontrolled type 2 diabetes mellitus (T2DM) in individuals attending primary healthcare in OR Tambo district, South Africa.
  
  
  
  A cross-sectional analytical study.
  
  
  
  Primary healthcare setting in OR Tambo district, South Africa.
  
  
  
  Patients treated for T2DM for 1 or more years (n=327).
  
  
  
  Prevalence of uncontrolled T2DM.
  
  
  
  Determinants of uncontrolled T2DM (glycosylated haemoglobin (HbA1c) ≥7%).
  
  
  
  Out of the 327 participants, 274 had HbA1c≥7% (83.8%). Female sex (95% CI 1.3 to 4.2), overweight/obesity (95% CI 1.9 to 261.2), elevated low-density lipoprotein cholesterol (95% CI 4.4 to 23.8), sedentary habits (95% CI 7.2 to 61.3), lower monthly income (95% CI 1.3 to 6.5), longer duration of T2DM (95% CI 4.4 to 294.2) and diabetes information from non-health workers (95% CI 1.4 to 7.0) were the significant determinants of uncontrolled T2DM. There was a significant positive correlation of uncontrolled T2DM with increasing duration of T2DM, estimated glomerular filtration rate and body mass index. However, a significant negative correlation exists between monthly income and increasing HbA1c.
  
  
  
  We found a significantly high prevalence (83.8%) of uncontrolled T2DM among the patients, possibly attributable to overweight/obesity, sedentary living, lower income and lack of information on diabetes. Addressing these determinants will require re-engineering of primary healthcare in the district.
authors.affiliation: Faculty of Health Sciences, Department of Family Medicine, Walter Sisulu University, East London, South Africa.
authors.forename: Oladele Vincent
authors.identifier: 0000-0003-0216-6701
authors.initials: OV
authors.lastname: Adeniyi
authors.affiliation: Faculty of Health Sciences, Department of Family Medicine, Walter Sisulu University, Mthatha, South Africa.
authors.forename: Parimalaranie
authors.initials: P
authors.lastname: Yogeswaran
authors.affiliation: Faculty of Health Sciences, Department of Family Medicine, Walter Sisulu University, Mthatha, South Africa.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Longo-Mbenza
authors.affiliation: Department of Nursing Science, School of Health Sciences, University of Fort Hare, East London, South Africa.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ter Goon
authors.affiliation: Faculty of Social Sciences & Humanities, Department of Sociology, University of Fort Hare, East London, South Africa.
authors.forename: Anthony Idowu
authors.initials: AI
authors.lastname: Ajayi
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D007722:Health Knowledge, Attitudes, Practice; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D011320:Primary Health Care; D013019:South Africa / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: EDUCATION & TRAINING (see Medical Education & Training); EPIDEMIOLOGY