Glycaemic control and its determinants in diabetic patients in Ethiopia

Gebre-Yohannes, Asfawesen; Rahlenbeck, Sibylle I.

doi:10.1016/s0168-8227(96)01367-8

Cited by 15 publications

(12 citation statements)

References 15 publications

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“…Only 28% of Kenyan children and adolescents with T1DM had reasonable control. This result is partially in agreement with the few studies in African children showing the mean HbA1c above 10.5% [ 10 – 13 ] with a study having the mean HbA1c as high as 12.5% [ 14 ]. Our data compare to those of a study from Ethiopia where reasonable control was found in 22% of patients [ 13 ] and are better than those obtained in Sudan where reasonable control was found in only 12.5% of patients [ 10 , 11 ].…”

Section: Discussionsupporting

confidence: 91%

Glycemic Control in Kenyan Children and Adolescents with Type 1 Diabetes Mellitus

Ngwiri

Were

Predieri

et al. 2015

International Journal of Endocrinology

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Background. Type 1 diabetes mellitus (T1DM) is the most common endocrine disorder in children and adolescents worldwide. While data about prevalence, treatment, and complications are recorded in many countries, few data exist for Sub-Saharan Africa. The aim of this study was to determine the degree of control in patients with T1DM aged 1–19 years over a 6-month period in 3 outpatient Kenyan clinics. It also sought to determine how control was influenced by parameters of patient and treatment. Methods. Eighty-two children and adolescents with T1DM were included in the study. Clinical history regarding duration of illness, type and dose of insulin, and recent symptoms of hypoglycemia/hyperglycemia were recorded. Glycaemia, HbA1c, and ketonuria were tested. HbA1c of 8.0% and below was defined as the cut-off for acceptable control. Results. The median HbA1c for the study population was 11.1% (range: 6.3–18.8). Overall, only 28% of patients had reasonable glycemic control as defined in this study. 72% therefore had poor control. It was also found that age above 12 years was significantly associated with poor control. Conclusions. African children and with T1DM are poorly controlled particularly in adolescents. Our data strongly support the necessity of Kenya children to receive more aggressive management and follow-up.

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Section: Discussionsupporting

confidence: 91%

Glycemic Control in Kenyan Children and Adolescents with Type 1 Diabetes Mellitus

Ngwiri

Were

Predieri

et al. 2015

International Journal of Endocrinology

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“…After screening the titles and abstracts of all references, 262 potentially eligible articles were read full text. Fifty‐five studies met the inclusion criteria of this review . As 2 studies examined identical associations within the same sample, we only included 1 paper in our study .…”

Section: Resultsmentioning

confidence: 99%

“…There were 24 studies on the association between income and HbA 1c levels . A random‐effects meta‐analysis of 8 studies revealed that people with the lowest income level have a 0.20% (95% CI, −0.05,0.46) or 2.36 mmol/mol (95%CI −0.61,5.33) higher mean HbA 1c level, compared with people with the highest income level.…”

Section: Resultsmentioning

confidence: 99%

Socio‐economic status and HbA_1c in type 2 diabetes: A systematic review and meta‐analysis

Bijlsma-Rutte

Rutters

Elders

et al. 2018

Diabetes Metabolism Res

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Up until now, differences in HbA levels by socio-economic status (SES) have been identified, but not yet quantified in people with type 2 diabetes. The aim of this study was therefore to assess the difference in HbA levels between people with type 2 diabetes of different SES in a systematic review and meta-analysis. A systematic literature search was conducted in MEDLINE, Embase, Ebsco, and the Cochrane Library until January 14, 2018. Included studies described adults with type 2 diabetes in whom the association between SES and HbA levels was studied. Studies were rated for methodological quality and data were synthesized quantitatively (meta-analysis) and qualitatively (levels of evidence), stratified for type of SES variable, i.e., education, income, deprivation, and employment. Fifty-one studies were included: 15 high, 27 moderate, and 9 of low methodological quality. Strong evidence was provided that people of low SES have higher HbA levels than people of high SES, for deprivation, education, and employment status. The pooled mean difference in HbA levels between people of low and high SES was 0.26% (95% CI, 0.09-0.43) or 3.12 mmol/mol (95% CI, 1.21-5.04) for education and 0.20% (95% CI, -0.05 to 0.46) or 2.36 mmol/mol (95%CI, -0.61 to 5.33) for income. In conclusion, our systematic review and meta-analysis showed that there was an inverse association between SES and HbA levels in people with type 2 diabetes. Future research should focus on finding SES-sensitive strategies to reduce HbA levels in people with type 2 diabetes.

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“…One Norwegian study (8) of type 2 diabetics in a general practice found fewer than 50% of the study population had good control. In an Ethiopian study (9), it was observed that 77% of their study population were in poor glycaemic control. While we recognise the difference in standards and test methods used in these studies relative to our study, it is sufficient to appreciate that a significant proportion of the patients in these centers did not attain the set levels that would put them in the category of good glycaemic control.…”

Section: Discussionmentioning

confidence: 99%

Quality of glycaemic control in ambulatory diabetics at the out-patient clinic of Kenyatta National Hospital, Nairobi

2004

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Background: Treatment of diabetes mellitus is based on the evidence that lowering blood glucose as close to normal range as possible is a primary strategy for reducing or preventing complications or early mortality from diabetes. This suggests poorer glycaemic control would be associated with excess of diabetes-related morbidity and mortality. This presumption is suspected to reach high proportions in developing countries where endemic poverty abets poor glycaemic control. There is no study published on Kenyan patients with diabetes mellitus about their glycaemic control as an audit of diabetes care. Objective: To determine the glycaemic control of ambulatory diabetic patients. Design: Cross-sectional study on each clinic day of a randomly selected sample of both type I and 2 diabetic patients. Setting: Kenyatta National Hospital. Methods: Over a period of six months, January 1998 to June 1998. During routine diabetes care in the clinic, mid morning random blood sugar and glycated haemoglobin (HbAI c)were obtained. Results: A total of 305 diabetic patients were included, 52.8% were females and 47.2% were males. 58.3% were on Oral Hypoglycaemic Agent (OHA) only, 22.3% on insulin only; 9.2% on OHA and insulin and 4.6% on diet only. 39.5% had mean HbAlc ≤ 8% while 60.5% had HbAlc ≥ 8%. Patients on diet-only therapy had the best mean HbAlc=7.04% while patients on OHA-only had the worst mean HbAlc=9.06%. This difference was significant (p=0.01). The former group, likely, had better endogenous insulin production. The influence of age, gender and duration of diabetes on the level of glycaemic control observed did not attain statistically significant proportions. Conclusion: The majority of ambulatory diabetic patients attending the out-patient diabetic clinic had poor glycaemic control. The group with the poorest level of glycaemic control were on OHA-only, while best control was observed amongst patients on diet-only, because of possible fair endogenous insulin production. Poor glycaemic control was presumed to be due to sub-optimal medication and deteriorating diabetes. There is need to empower patients with knowledge and resources to enhance their individual participation in diabetes self-care. Diabetes care providers and facilities also need capacity building to improve care of patients with diabetes.

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Glycaemic control and its determinants in diabetic patients in Ethiopia

Cited by 15 publications

References 15 publications

Glycemic Control in Kenyan Children and Adolescents with Type 1 Diabetes Mellitus

Glycemic Control in Kenyan Children and Adolescents with Type 1 Diabetes Mellitus

Socio‐economic status and HbA_1c in type 2 diabetes: A systematic review and meta‐analysis

Quality of glycaemic control in ambulatory diabetics at the out-patient clinic of Kenyatta National Hospital, Nairobi

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Glycaemic control and its determinants in diabetic patients in Ethiopia

Cited by 15 publications

References 15 publications

Glycemic Control in Kenyan Children and Adolescents with Type 1 Diabetes Mellitus

Glycemic Control in Kenyan Children and Adolescents with Type 1 Diabetes Mellitus

Socio‐economic status and HbA1c in type 2 diabetes: A systematic review and meta‐analysis

Quality of glycaemic control in ambulatory diabetics at the out-patient clinic of Kenyatta National Hospital, Nairobi

Contact Info

Product

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Socio‐economic status and HbA_1c in type 2 diabetes: A systematic review and meta‐analysis