Original Research

Prevalence and determinants of poor glycaemic control amongst patients with diabetes followed at Vanga Evangelical Hospital, Democratic Republic of the Congo

Lino Masingo Cedrick, Jean-Pierre Fina Lubaki, Lepira Bompeka Francois, Ogunbanjo Adebola Gboyega, Lukanu Ngwala Philippe
African Journal of Primary Health Care & Family Medicine | Vol 13, No 1 | a2664 | DOI: https://doi.org/10.4102/phcfm.v13i1.2664 | © 2021 Lino Masingo Cedrick, Jean-Pierre Fina Lubaki, Lepira Bompeka Francois, Ogunbanjo Adebola Gboyega, Lukanu Ngwala Philippe | This work is licensed under CC Attribution 4.0
Submitted: 12 July 2020 | Published: 30 April 2021

About the author(s)

Lino Masingo Cedrick, Department of Family Medicine, Faculty of Medicine, Protestant University of Congo, Kinshasa, Congo, the Democratic Republic of the
Jean-Pierre Fina Lubaki, Department of Family Medicine and Primary Health Care, Faculty of Medicine, Protestant University of Congo, Kinshasa, Congo, the Democratic Republic of the
Lepira Bompeka Francois, Department of Nephrology, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo, the Democratic Republic of the
Ogunbanjo Adebola Gboyega, Department of Family Medicine and Primary Health Care, Faculty of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Lukanu Ngwala Philippe, Department of Family Medicine and Primary Health Care, Faculty of Medicine, Protestant University of Congo, Kinshasa, Congo, the Democratic Republic of the


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Abstract

Background: The prevalence of diabetes mellitus is increasing dramatically in developing countries, where diabetic patients usually present with poor glycaemic control, leading to complications and worsening the prognosis.

Aim: The aim of this study was to determine the extent of poor glycaemic control and its determinants in diabetic patients.

Setting: The study was conducted in a rural area of the province of Kwilu, Democratic Republic of the Congo.

Methods: This research comprised a cross-sectional study involving 300 Type 1 and 2 diabetic patients attending Vanga Evangelical Hospital in the Democratic Republic of the Congo from January 2018 to March 2018. Patients’ sociodemographic, clinical and biological characteristics, accessibility to the health structure and treatment were described. The determinants of poor glycaemic control were identified using multivariate logistic regression at the p < 0.05 level of statistical significance.

Results: The mean age of participants was 46.9 ± 16.3 years, 68.4% were men, and 62.3% had Type 2 diabetes mellitus. Poor glycaemic control was present in 78% of patients. The independent determinants of poor glycaemic control were tobacco use (adjusted odds ratio [aOR]: 2.01 [1.77–5.20], p = 0.015), the presence of comorbidities (aOR: 2.86 [1.95–6.65], p = 0.007), the presence of a factor contributing to hyperglycaemia (aOR: 2.74 [1.83–3.67], p = 0.014), missing scheduled appointments (aOR: 2.59 [1.94–7.13], p = 0.006) and non-adherence to treatment (aOR: 4.09 [1.35–6.39], p = 0.008).

Conclusion: This study shows that more than three-quarters of diabetics undergoing treatment are not controlled, with mainly patient-related factors as the main explanatory factors for this poor glycaemic control. Therefore, the establishment of a therapeutic education programme and wider integration of diabetes care services, mainly at the primary level of the healthcare pyramid, should contribute to improved diabetes treatment.


Keywords

determinants; diabetics; glycaemic control; rural; poor; prevalence; patients

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