Determinants of glycemic control among diabetes mellitus patients in a tertiary clinic in Gaborone, Botswana: findings and implications
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Date
2019
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Publisher
Hospital Practice
Abstract
Background and aims: Glycemic control among patients with diabetes mellitus is associated
with a marked reduction of both macrovascular and microvascular complications; however,
glycemic control remains an elusive goal worldwide. The aim of this study was to determine
factors associated with glycemic control among patients attending a tertiary clinic in Botswana
as limited information to date.
Methods: Cross-sectional study in a tertiary clinic in Gaborone, Botswana. Patients were
recruited between 21 July 2015 and 21 September 2015. The majority of the randomly recruited
patients (368/380–96.8%) had documentation of glycemic control (HbA1c) within three months
of study recruitment and were subsequently included in the analysis. Glycemic control was
categorized as desirable, suboptimal and poor if HbA1c was <7%, 7–9% and >9%, respectively.
Data were analyzed using SPSS for descriptive statistics including both bivariate and
multinomial logistic regression. A value of p < 0.05 was considered statistically significant.
Results: The analyzed study population consisted of 258/368 (70.1%) females with a mean age
(SD) of 56.7 ± 13.6 years. Means (SDs) for diabetes duration and glycated hemoglobin were
7.2 ± 7.1 years and 7.97 ± 2.02%, respectively. Of the 368 patients, 136 (36.95%) and 132/368
(35.86%) had desirable and suboptimal glycemic control, respectively. Older age, attending the
clinic for more or equal to 3 years and not being on insulin were associated with both desirable
and suboptimal glycemic control whereas duration of diabetes between 5 and 10 years was
associated with poor glycemic control.
Conclusions: The majority of patients had poor glycemic control. Older age and not being on
insulin were associated with better glycemic control. The fact that patients on insulin had poor
glycemic control calls for more research to determine the timing of insulin initiations and dosing
schedule factors as these will help to improve overall glycemic control in Botswana and
elsewhere.
KEYWORDS: Diabetes mellitus glycosylated hemoglobin A1c HIV cross-s
Description
Keywords
Diabetes mellitus, Glycosylated hemoglobin A1c, HIV
Citation
Rwegerera, G.M., Masaka, A., Pina-Rivera, Y., Moshomo, T., Gaenamong, M., Godman, B., Oyewo, T.A., Massele, A. and Habte, D., 2019. Determinants of glycemic control among diabetes mellitus patients in a tertiary clinic in Gaborone, Botswana: findings and implications. Hospital Practice, 47(1), pp.34-41.