Factors affecting glycemic control among Egyptian people with diabetes attending primary health care facilities in Mansoura District

Abstract

Background Diabetes is a rapidly growing health problem worldwide. In 2019, the International Diabetes Federation (IDF) estimates that Egypt is the 9th country worldwide with about 8,850,400 cases and a prevalence of 15.2% in adults. By 2045, Egypt is expected to be the 7th country worldwide. Several factors affecting glycemic control are related to patients, physicians, and the infrastructure of primary health care facilities (PHCFs). The effect of health care infrastructure and resources is not well studied. This cross-sectional study aims to explore factors affecting glycemic control among subjects with diabetes visiting PHCFs in the Mansoura District. A questionnaire was done to assess these factors among subjects with diabetes, primary care physicians (PCPs), and PHCFs infrastructure and resources. Three hundred and two subjects with diabetes attending PHCFs in the Mansoura District underwent a detailed clinical history. Also, HbA1c was obtained. Results Factors in patients that affect diabetic control include patient’s education and occupation and their smoking status. Practicing physical exercise is important for diabetes control. Physicians can affect diabetes control by their rural residence, older age, participation in diabetes training, early graduation year, longer durations since started dealing with subjects with diabetes, and following guidelines. Resources of infrastructure have a role in diabetes control. Metformin and investigation availability has a positive association with diabetes control. Conclusion Patients, physicians, and resources of infrastructure have a role in diabetes control.

Glycemic Control for Type 2 Diabetes Mellitus Patients: A Systematic Review

“…The study showed that the education, occupation, and smoking status of patients affected diabetic control. The study further reported factors affecting glycemic control, but these factors were related to the primary healthcare physicians, and they included rural residence, participation in diabetes training, older age, longer duration since starting to deal with diabetic patients, as well as the status of following the guidelines [ 1 ].…”

“…Diabetes mellitus (DM) is a rapidly growing public health crisis globally with a huge burden of disease [1]. It is a prevalent metabolic disorder characterized by a deficiency in the secretion of insulin or in its effect or both [2].…”

“…For the management of all diabetic patients, the key therapeutic goal is to maintain good glycemic control (GC) in order to prevent macro and microvascular complications [ 1 ]. GC is the optimal blood sugar level in a DM patient [ 6 ].…”

Current gaps in management and timely referral of cardiorenal complications among people with type 2 diabetes mellitus in the Middle East and African countries: Expert recommendations

“…Unavailability of medications in the public sector, insufficient care, and disparities of services contribute to patient flow to the private sector 47 . Nearly 60% of patients with T2DM are not assessed by a specialist in MENA and AFR, with PCPs being the main first‐line treating physician 152,153 . Absence of electronic medical records (EMRs) may hinder sharing of patients' status and current therapies, leading to duplication of T2DM and other concomitant therapies.…”

“… 47 Nearly 60% of patients with T2DM are not assessed by a specialist in MENA and AFR, with PCPs being the main first‐line treating physician. 152 , 153 Absence of electronic medical records (EMRs) may hinder sharing of patients' status and current therapies, leading to duplication of T2DM and other concomitant therapies. User resistance, lack of awareness, and gaps in strategic implementation are the common barriers for adopting EMRs in developing countries.…”