Glycaemic control and associated factors in adult patients with diabetes mellitus, South Sudan, 2021
Introduction: Many patients with diabetes mellitus are not attaining optimal glycaemic control, although the rate is unknown in South Sudan. Maintaining adequate glycaemic control is the most effective means of preventing complications associated with diabetes. This record review assesses the propor...
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| Format: | Article |
| Language: | English |
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Health and Social Sciences Research Institute - South Sudan (HSSRI-SS)
2023-02-01
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| Series: | South Sudan Medical Journal |
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| Online Access: | http://www.southsudanmedicaljournal.com/archive/february-2023/glycaemic-control-and-associated-factors-in-adult-patients-with-diabetes-mellitus-south-sudan-2021.html |
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| author | Joseph Lou K. Mogga Stephen Loro Stephen Gai Moses Anyit Robert Awu Shaza Hadija Jorum Aliti Lawrence Biriwo David Ameh |
| author_facet | Joseph Lou K. Mogga Stephen Loro Stephen Gai Moses Anyit Robert Awu Shaza Hadija Jorum Aliti Lawrence Biriwo David Ameh |
| author_sort | Joseph Lou K. Mogga |
| collection | DOAJ |
| description | Introduction: Many patients with diabetes mellitus are not attaining optimal glycaemic control, although the rate is unknown in South Sudan. Maintaining adequate glycaemic control is the most effective means of preventing complications associated with diabetes. This record review assesses the proportion of patients with diabetes on follow-up not adequately controlled using glycated haemoglobin (HbA1c) and describes associated factors.
Method: This is retrospective cross-sectional review of electronic patient records from a private for-profit health facility in Juba, South Sudan. The study assesses follow-up HbA1c levels of type I (T1DM) and type II (T2DM) patients with diabetes 18 years and older. An HbA1c value of less than 7% was regarded as reflecting adequate control. Logistic regression was used to assess factors associated with inadequate control. From an unadjusted analysis, variables were retained for the adjusted analysis that were significant at the 95% confidence level. Crude and adjusted odds ratios (AOR) were reported.
Results: Of the 291 patients assessed, 62.2% were male, mean age was 54 (SD =12.6) years, and the median body mass index (BMI) was 27.2 (IQR=24.5-30). Those with hypertension were 28.5% and 35% had medical insurance. Overall, 60 patients (20.6%) achieved target HbA1c levels of <7%. One hundred patients had HbA1c levels between 7-10% and 131 had values of >10%. Independent predictors of non-achievement of target HbA1c were female gender, adjusted prevalence ratio, PR (95% CI) =1.18 (1.01-1.32); normal BMI, adjusted PR (95% CI) =1.41 (1.07-1.83) and having no medical insurance cover, adjusted PR (95%CI) =1.13 (1.10-1.29).
Conclusion: About 80% of patients did not attain target HbA1c levels. Diagnosis of diabetes, care and treatment of patients with diabetes is not well organised in South Sudan leading to poor outcomes even in private clinics. Women and those without medical insurance cover are at greater disadvantage. We recommend better diagnosis and classification of patients with diabetes as well as reorganisation of care and treatment. We also recommend initiatives that will increase coverage of services to women and putting more people on medical insurance cover. |
| first_indexed | 2024-04-10T07:28:30Z |
| format | Article |
| id | doaj.art-31c06514c85f4c72bab5f6f45a11ed16 |
| institution | Directory Open Access Journal |
| issn | 2309-4605 2309-4613 |
| language | English |
| last_indexed | 2024-04-10T07:28:30Z |
| publishDate | 2023-02-01 |
| publisher | Health and Social Sciences Research Institute - South Sudan (HSSRI-SS) |
| record_format | Article |
| series | South Sudan Medical Journal |
| spelling | doaj.art-31c06514c85f4c72bab5f6f45a11ed162023-02-24T02:21:53ZengHealth and Social Sciences Research Institute - South Sudan (HSSRI-SS)South Sudan Medical Journal2309-46052309-46132023-02-01161511Glycaemic control and associated factors in adult patients with diabetes mellitus, South Sudan, 2021Joseph Lou K. Mogga0Stephen Loro 1Stephen Gai2Moses Anyit3Robert Awu4Shaza Hadija5Jorum Aliti6Lawrence Biriwo7David Ameh8South Sudan Physicians Association, Juba, South SudanEvidence Based ClinicEvidence Based Clinic, Juba, South SudanEvidence Based Clinic, Juba, South SudanEvidence Based Clinic, Juba, South SudanEvidence Based Clinic, Juba, South SudanEvidence Based Clinic, Juba, South SudanEvidence Based Clinic, Juba, South SudanEvidence Based Clinic, Juba, South SudanIntroduction: Many patients with diabetes mellitus are not attaining optimal glycaemic control, although the rate is unknown in South Sudan. Maintaining adequate glycaemic control is the most effective means of preventing complications associated with diabetes. This record review assesses the proportion of patients with diabetes on follow-up not adequately controlled using glycated haemoglobin (HbA1c) and describes associated factors. Method: This is retrospective cross-sectional review of electronic patient records from a private for-profit health facility in Juba, South Sudan. The study assesses follow-up HbA1c levels of type I (T1DM) and type II (T2DM) patients with diabetes 18 years and older. An HbA1c value of less than 7% was regarded as reflecting adequate control. Logistic regression was used to assess factors associated with inadequate control. From an unadjusted analysis, variables were retained for the adjusted analysis that were significant at the 95% confidence level. Crude and adjusted odds ratios (AOR) were reported. Results: Of the 291 patients assessed, 62.2% were male, mean age was 54 (SD =12.6) years, and the median body mass index (BMI) was 27.2 (IQR=24.5-30). Those with hypertension were 28.5% and 35% had medical insurance. Overall, 60 patients (20.6%) achieved target HbA1c levels of <7%. One hundred patients had HbA1c levels between 7-10% and 131 had values of >10%. Independent predictors of non-achievement of target HbA1c were female gender, adjusted prevalence ratio, PR (95% CI) =1.18 (1.01-1.32); normal BMI, adjusted PR (95% CI) =1.41 (1.07-1.83) and having no medical insurance cover, adjusted PR (95%CI) =1.13 (1.10-1.29). Conclusion: About 80% of patients did not attain target HbA1c levels. Diagnosis of diabetes, care and treatment of patients with diabetes is not well organised in South Sudan leading to poor outcomes even in private clinics. Women and those without medical insurance cover are at greater disadvantage. We recommend better diagnosis and classification of patients with diabetes as well as reorganisation of care and treatment. We also recommend initiatives that will increase coverage of services to women and putting more people on medical insurance cover. http://www.southsudanmedicaljournal.com/archive/february-2023/glycaemic-control-and-associated-factors-in-adult-patients-with-diabetes-mellitus-south-sudan-2021.htmlglycated haemoglobindiabetessouth sudan |
| spellingShingle | Joseph Lou K. Mogga Stephen Loro Stephen Gai Moses Anyit Robert Awu Shaza Hadija Jorum Aliti Lawrence Biriwo David Ameh Glycaemic control and associated factors in adult patients with diabetes mellitus, South Sudan, 2021 South Sudan Medical Journal glycated haemoglobin diabetes south sudan |
| title | Glycaemic control and associated factors in adult patients with diabetes mellitus, South Sudan, 2021 |
| title_full | Glycaemic control and associated factors in adult patients with diabetes mellitus, South Sudan, 2021 |
| title_fullStr | Glycaemic control and associated factors in adult patients with diabetes mellitus, South Sudan, 2021 |
| title_full_unstemmed | Glycaemic control and associated factors in adult patients with diabetes mellitus, South Sudan, 2021 |
| title_short | Glycaemic control and associated factors in adult patients with diabetes mellitus, South Sudan, 2021 |
| title_sort | glycaemic control and associated factors in adult patients with diabetes mellitus south sudan 2021 |
| topic | glycated haemoglobin diabetes south sudan |
| url | http://www.southsudanmedicaljournal.com/archive/february-2023/glycaemic-control-and-associated-factors-in-adult-patients-with-diabetes-mellitus-south-sudan-2021.html |
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