Background
Diabetes remains poorly controlled in a high proportion of diabetes patients. This study examines the prevalence of poor glycaemic control and associated factors in type 2 diabetes patients in the Beni-Mellal Khenifra region in Morocco.
Methods
A cross-sectional survey was conducted in 2017 among 1456 diabetes patients attending primary health centres. Demographic and clinical data were collected through face-to-face interviews using structured and pre-tested questionnaires. Anthropometric measurements, including body weight, height and waist circumference were taken using standardized techniques and calibrated equipment. Glycaemic control was assessed in terms of the glycated haemoglobin (HbA1c) level and poor glycaemic control was defined as HbA1c ≥7% and a level <7% reflects good glycaemic control.
Results
Of the total participants, 66.3% had poor glycaemic control. Bivariate analysis showed that sex (p=0.010), education level (p=0.013), body mass index (p=0.048), duration of diabetes (p<0.0001) and type of therapeutic regimen (p<0.0001) were significantly associated with HbA1c level. However, multiple logistic regression analyses revealed that only a longer duration of diabetes (OR 1.525 [95% confidence interval {CI} 1.183–1.967], p=0.001) and receiving insulin therapy alone (OR 1.589 [95% CI 1.157–2.183], p=0.004) or a combination of oral antidiabetics with insulin (OR 2.554 [95% CI 1.786–3.653], p<0.001) were significantly associated with inadequate glycaemic control.
Conclusions
Despite the particularities of the region, the findings about glycaemic control and its cross-sectionally associated factors are in line with findings from other regions of Morocco. In this subgroup, the longer duration of diabetes and insulin treatment could constitute a cause leading to poor glycaemic control. However, inverse causality cannot be excluded.
Autoimmune hypothyroidism is a common medical condition. Its revelation by thyrotrophic hyperplasia is an unusual and may be misdiagnosed as a pituitary adenoma. A 35-year-old man is referred to us for endocrinological assessment before surgery of a pituitary macroadenoma with bitemporal hemianopsia. Biological data reveal profound primary hypothyroidism. With thyroid hormone substitution, the thyroid function was normalized. Follow-up magnetic resonance imaging, showed the complete shrinkage of the pituitary mass attesting of a thyrotrophic pituitary hyperplasia. This case highlights the importance of a multidisciplinary assessment of pituitary masses to avoid unnecessary surgery and to prevent consequences of sellar masses.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.