title: Frequency and predictors of suboptimal glycemic control in an African diabetic population.
abstract: BACKGROUND
  Persistent suboptimal glycemic control is invariably associated with onset and progression of acute and chronic diabetic complications in diabetic patients. In Uganda, studies documenting the magnitude and predictors of suboptimal glycemic control in adult ambulatory diabetic patients are limited. This study aimed at determining the frequency and predictors of suboptimal glycemic control in adult diabetic patients attending three urban outpatient diabetic clinics in Uganda.
  
  
  METHODS
  In this hospital-based cross-sectional study, eligible ambulatory adult diabetic patients attending outpatient diabetic clinics of three urban hospitals were consecutively enrolled over 11 months. Suboptimal glycemic control was defined as glycated hemoglobin (HbA1c) level ≥7%. Multivariable analysis was applied to determine the predictors.
  
  
  RESULTS
  The mean age of the study participants was 52.2±14.4 years, and the majority of them were females (283, 66.9%). The median (interquartile range) HbA1clevel was 9% (6.8%-12.4%). Suboptimal glycemic control was noted in 311 study participants, accounting for 73.52% of the participants. HbA1clevels of 7%-8%, 8.1%-9.9%, and ≥10% were noted in 56 (13.24%), 76 (17.97%), and 179 (42.32%) study participants, respectively. The documented predictors of suboptimal glycemic control were metformin monotherapy (odds ratio: 0.36, 95% confidence interval: 0.21-0.63,p<0.005) and insulin therapy (odds ratio: 2.41, 95% confidence interval: 1.41-4.12,p=0.001).
  
  
  CONCLUSIONS
  Suboptimal glycemic control was highly prevalent in this study population with an association to metformin monotherapy and insulin therapy. Strategies aimed at improving glycemic control in diabetes care in Uganda should be enhanced.
authors.affiliation: Department of Medicine/Diabetic and Hypertension Clinics, Our Lady of Consolota Hospital, Kisubi.
authors.forename: Davis
authors.initials: D
authors.lastname: Kibirige
authors.affiliation: Baylor College of Medicine, Children's Foundation.
authors.forename: George Patrick
authors.initials: GP
authors.lastname: Akabwai
authors.affiliation: Infectious Diseases Research Collaboration, Kampala.
authors.forename: Leaticia
authors.initials: L
authors.lastname: Kampiire
authors.affiliation: Nephrology Unit, Mulago National Referral and Teaching Hospital, Kampala.
authors.forename: Daniel Ssekikubo
authors.initials: DS
authors.lastname: Kiggundu
authors.affiliation: Department of Medicine and Diabetes/Endocrine Unit, Mengo Hospital, Mengo, Uganda.
authors.forename: William
authors.initials: W
authors.lastname: Lumu
keywords: Africa; Uganda; frequency; predictors; suboptimal glycemic control