Determinants of glycaemic control in type 2 diabetes African patients monitored by physicians from 1991 to 2004 in Cote d’Ivoire

Abstract

The aim of this study was to propose determinants of glycaemic control which are useful to adequately manage the healthcare of type 2 diabetes patients attending an out-patient clinic. A retrospective, descriptive research design was implemented at the Centre AntiDiabétique d'Abidjan in 2399 African patients. Glycaemic control was calculated from the average of at least 12 fasting plasma glucose levels measured during at least three years. Logistic and multiple linear regressions were performed at the limit of the glycaemia average of 6.7mmol/l (120mg/dl). The determinants of poor glycaemic control were: long duration of monitoring (odds ratio (OR)=1.66, then 2.68), annual frequency of visits outside the 2-3 per year interval (OR=3.25) and insulin treatment (OR=4.66) in 'non-obese men'; the aforementioned frequency of visits (OR=3.69) and insulin treatment (OR=3.72) in 'non-obese women'; the duration of monitoring reaching the 10-14 year interval (OR=3.48), the aforementioned frequency of visits (OR=2.51), insulin treatment (OR=26.16) and housewife status (OR=1.94) in 'obese women'. In 'obese men', insulin treatment was the sole determinant (r(2)=0.24). Healthcare parameters (treatment, frequency of visits, and duration of monitoring) seemed to be predominant as effective predictors of glycaemic control in our study context. These findings reveal the urgent need for both more concern and further research in diabetes management to improve the quality of care and tackle this health challenge.

Level of Knowledge, Physical Activity and Dietary Behaviour of Type 2 Diabetics at the Abidjan Diabetes Center

“…The increasing prevalence and incidence of the disease in the country and the consequences of the disease are clear evidence of this. It has been well documented in Côte d'Ivoire that the disease is responsible for high morbidity [16,17]. This situation is exacerbated by the fact that the majority of the population, as shown by the sample in this study, has a low level of income.…”

“…The results showed that the diabetics studied came from all social strata and all walks of life (rural and urban), thus demonstrating that the disease affects everyone, regardless of social stratum, professional level, education, etc. Diabetes has thus become a public health issue in Côte d'Ivoire [16,17]. The increasing prevalence and incidence of the disease in the country and the consequences of the disease are clear evidence of this.…”

Epidemiologic Profile of Overweight and Obesity in Abidjan, Ivory Coast: A Cross-Sectional Study

“…Doupa et al in Senegal found a prevalence of dyslipidemia at 63.8% among their population dominated by obese people [31]. In Ivory Coast, Lokrou et al revealed a prevalence of dyslipidemia at 47.4% among the diabetic patients most affected by obesity [36].…”

Determinants of Diabetes and Hypertension Control in Ambulatory Healthcare in Al Ain, United Arab Emirates

“…14 A number of studies have shown the effect of healthcare system and healthcare team as predictors for improved control of diabetes and hypertension, similar to the current study. [15][16][17] A study of African patients monitored by physicians from 1991 to 2004 in Cote d'Ivoire Healthcare showed healthcare system-related parameters such as frequency of visits and duration of monitoring to be effective for improved control of diabetes and hypertension. 17 Furthermore, influence of the healthcare team was found to have a similar effect in another study, 6 where the primary care physician was the most significant predictor of improved diabetic control, even though this study had fewer patients with lower socioeconomic status and more men than the present study; thus, suggests that the primary care physician has an important role in the patient achieving proper diabetes control.…”