Glycemic Control and Its Determinants Among Type 2 Diabetes Mellitus Patients at the Limbe Regional Hospital, Limbe, Southwestern Cameroon

Abstract

BACKGROUND: Diabetes mellitus remains a global public health threat with a rising trend in morbidity and mortality. Poor glycemic control (GC) among patients with type 2 diabetes mellitus is a determinant of diabetes-related complications. Therefore, the aim of this study was to assess glycemic control and identify its contributing factors among type 2 diabetic patients attending the Limbe Regional Hospital in Cameroon. METHODS: A hospital-based cross-sectional study was conducted from February to July 2022. Glycated hemoglobin (HbA1c) in diabetic patients was measured using ion-exchange chromatography. Socio-demographic, clinical, and lifestyle data were collected using a structured and pretested questionnaire. Data were entered into an Excel sheet and exported to Statistical Package for Social Sciences (SPSS) version 22 for analysis. A multivariate logistic regression analysis was done to assess the association between explanatory variables and glycemic control. The level of significance was set at a p-value of <0.05. RESULTS: A total of 131 patients were included in the study with a mean ± SD age of 56 (± 5.1) years. Eighty-eight (67.2%) of them were females. The mean (±SD) HbA1c was 8.8 ±1.8%. Poor GC, inadequate GC, and good GC were registered in 83 (63.4%), 23 (17.6%) and 25 (19.1%) participants, respectively, using the American Diabetes Association standard cutoffs for HbA1c. The factors associated with poor and inadequate glycemic control were age (AOR: 0.140, 95% CI: 0.033 – 0.595; p = 0.008), self-home glucose monitoring (AOR: 0.228, 95% CI: 0.071 – 0.737; p = 0.014), and adherence to diet/eating plan (AOR: 0.252, 95% CI: 0.069 – 0.917; p = 0.036). CONCLUSIONS: The proportion of type 2 diabetic patients with poor and inadequate glycemic control was noticeably high. The absence of self-glucose monitoring at home, age group (40-49 years), and non-adherence to diet/eating plan contributed to the huge number of patients diagnosed with poor and inadequate glycemic control at the Limbe Regional Hospital. Behavioral programs for diabetic patients, particularly those aged 40-49 years, should be strengthened and disseminated during routine follow-up visits in order to prevent or mitigate complications of poor glycemic control.