Early detection of poor glycemic control in patients with diabetes mellitus in sub-Saharan Africa: a cohort study in Mozambique

Abstract

Introduction: WHO estimates 422 million cases of diabetes mellitus worldwide. Mozambique has the second-highest mortality related to DM in the African region.
 Objectives: To provide data about a DM care service in Mozambique and to evaluate early outcomes of treatment.
 Methods: The new patients diagnosed with DM in a two-years period in a health centre in Maputo (Mozambique) were included in a retrospective cohort study. Fasting blood glucose (FBG), waist circumference (WC) and BMI were collected at baseline and after three months.
 Results: 188 patients were enrolled. Median BMI, WC and FBG at baseline were respectively 28 kg/m2(Inter Quartile Range [IQR]23.4-31.8), 98cm (IQR 87-105) and 209mg/dL (IQR 143-295). A non-pharmacological intervention was prescribed for six patients, while 182 patients received metformin 500 mg b.i.d. FBG was significantly reduced at control (226[±103.7]mg/dL vs 186[±93.2]mg/dL, p<0.000); however, glycemic control was reached in 74 patients (39.4%); not controlled patients changed regimen. Elderly patients had a higher glycemic control (adjusted Odds Ratio 2.50, 95% CI 1.11-5.06, p=0.002).
 Conclusion: Strategies for early detection of scarce glycemic control are feasible in Mozambique and could lead to prompt regimen switch; an invasive therapeutic approach could be preferable in selected cases to achieve control.
 Keywords: Diabetes Mellitus; Non-Communicable Diseases; Health Care.

Editorial: Non-communicable diseases; sexual reproductive issues; infectious diseases and health systems challenges

“…In this issue we bring you a salad of sorts! This includes papers on cancer 1 – 12 ; diabetes mellitus 13 – 16 ; surgery 15 – 25 ; other non-communicable diseases 26 – 33 , as well as sexual reproductive health 34 – 46 . The menu continues with HIV /AIDS papers 47 – 54 .…”