Glucose Control in Diabetic Patients Attending Parirenyatwa Group of Hospitals in Zimbabwe

Abstract

Background: Diabetes mellitus is a non-communicable disease whose prevalence is increasing even in low-income countries like Zimbabwe. It is usually diagnosed late when complications are already present mainly due to slow onset of disease, low accessibility to healthcare facilities and socio-economic hardships. Poor glycaemic control in diabetics is associated with the development of long-term microvascular and macrovascular complications such as nephropathy, neuropathy, retinopathy, cardiovascular disease and diabetic foot syndrome. Therefore, good glycaemic control is essential to prevent complications, to improve the quality of life of diabetic patients and to reduce healthcare costs. Objectives: This study sought to find the status of glycaemic control and to identify factors that are associated with poor glycaemic control among diabetic patients attending Parirenyatwa Group of Hospitals Diabetic Clinic in Harare, Zimbabwe. Method: A cross-sectional study involving a total of 182 diabetic patients was carried out. Demographic data (age and gender) and clinical information (hypertension, duration, height, weight and lipid therapy) were retrieved from patients’ clinical records. Blood samples from participating diabetic patients were analysed for HbA1c on the Mindray® BS 400 Analyser. Measurement of HbA1c was done enzymatically using the International Federation of Clinical Chemists (IFCC) method. Result and Discussion: A total of 182 patients (30.2% men, 69.8% women) were enrolled whose mean (SD) age in years was 55 (9.0). The glycaemic status was generally poor with a prevalence of poor glycaemic control as high as 58.2%. This prevalence is higher than that previously obtained at the same hospital in 2013 thus presenting a major health challenge. This also means the burden of diabetic complications is likely to increase. Poor glycaemic control was significantly associated with gender and duration of diabetes mellitus. Conclusion: We conclude that in order to improve glycaemic control among diabetic patients, primary healthcare facilities need to focus on patient education and should facilitate early diagnosis through routine medical check-ups.