A retrospective database study of the demographic features and glycemic control of patients with type 2 diabetes in Kinshasa, Democratic Republic of the Congo

Abstract

Background The Kin-Antwerp project aimed at improving the quality of care provided to patients with diabetes in Kinshasa, the Democratic Republic of the Congo in Central Africa, including the digitalisation of routine clinical data to improve patients’ follow-up. We aim to analyse the data of a study population of Kin-Antwerp to characterise their demographic features, assess their achievement of glycemic target over time, and identify groups requiring prioritised attention. Methods We performed a secondary database analysis of routinely collected information from primary care patients with type 2 diabetes followed from 1991 to 2019. Data included demographics (age, sex), anthropometrics (weight, height), clinical parameters (blood pressure, plasma glucose), and anti-diabetic treatments. Achievement of glycemic target, defined as fasting plasma glucose < 126 mg/dL, over time was assessed using a multilevel mixed-effects logistic regression model. Results Our study population of patients with type 2 diabetes (N = 8976) comprised a higher proportion of women (67%) and patients between 40 and 65 years old (70.4%). At the first follow-up, most patients were on treatment with insulin (56.5%) and had glycemic levels under the target (79.9%). Women presented more often with obesity (27.4%) and high systolic blood pressure (41.8%) than men (8.6% and 37.0%, respectively). Patients had a median follow-up of 1.8 (interquartile range: 0.5–3.4) years. Overall, the odds of achieving glycemic target increased by 18.4% (odds ratio: 1.184, 95% CI: 1.130 to 1.239; p < 0.001) per year of follow-up. Stratified analyses suggested that the odds of achieving glycemic control over time increased among older patients (> 40 years), but not among younger patients (< 40 years). Conclusion In our study population, an overall poor glycemic control was observed albeit with a modest improvement in the achievement of glycemic target throughout patients’ follow-up. Younger patients may benefit from prioritised attention to achieve glycemic targets. Based on the information provided by the database, continue monitoring and improvement of the project Kin-Antwerp is recommended. Introducing further efforts to improve type 2 diabetes management should include robust glycemia-monitoring tools and haemoglobin A1c, as well as further outlining self-management strategies.

Glycaemic control and associated factors among patients living with type 2 diabetes in Kinshasa, Democratic Republic of the Congo: a Cross-sectional study

“…Female patients represented approximately two-thirds of the participants. A retrospective analysis of the Kinshasa Health Network database conducted by Sagastume et al 11 also found the same-sex prevalence. This high prevalence of type 2 diabetes affects more women than men, due to the higher metabolic risk in the former.…”

“…9 In the DRC, very few studies have investigated poor glycaemic control among persons/patients living with type 2 diabetes, as high as 86% in the nearby province of Kwilu 10 and 79.9% in Kinshasa. 11 Only a few reported factors were found to be associated with glycaemic control among persons living with type 2 diabetes mellitus in the DRC. Sagastume et al 11 This study aimed to assess the extent of glycaemic control and to broaden the knowledge on factors driving poor glycaemic control among patients living with type 2 diabetes in Kinshasa.…”

“…11 Only a few reported factors were found to be associated with glycaemic control among persons living with type 2 diabetes mellitus in the DRC. Sagastume et al 11 This study aimed to assess the extent of glycaemic control and to broaden the knowledge on factors driving poor glycaemic control among patients living with type 2 diabetes in Kinshasa. The results will serve to build an intervention package to improve glycaemic control among patients living with type 2 diabetes in Kinshasa.…”

“…In the DRC, very few studies have investigated poor glycaemic control among persons/patients living with type 2 diabetes, as high as 86% in the nearby province of Kwilu 10 and 79.9% in Kinshasa. 11 Only a few reported factors were found to be associated with glycaemic control among persons living with type 2 diabetes mellitus in the DRC. Sagastume et al 11 found older patients (> 40 years) had increased odds of achieving glycaemic control than younger patients (< 40 years), while Blum et al 10 noticed that abdominal obesity and having a body mass index (BMI) > 25 Kg/m2 have been associated with poor glycaemic control.…”

“…11 Only a few reported factors were found to be associated with glycaemic control among persons living with type 2 diabetes mellitus in the DRC. Sagastume et al 11 found older patients (> 40 years) had increased odds of achieving glycaemic control than younger patients (< 40 years), while Blum et al 10 noticed that abdominal obesity and having a body mass index (BMI) > 25 Kg/m2 have been associated with poor glycaemic control. Moreover, we noticed that no study in our setting had previously assessed the link between psychological factors and poor glycaemic control.…”