Determinants of glycemic control among diabetes mellitus patients in a tertiary clinic in Gaborone, Botswana: findings and implications

Godfrey M. Rwegerera, Anthony Masaka, Yordanka Piña-Rivera, Thato Moshomo, Marea Gaenamong, Brian Godman, Taibat Aderonke Oyewo, Amos Massele, Dereje Habte

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2 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)34-41
Number of pages8
JournalHospital Practice
Volume47
Issue number1
Early online date5 Nov 2018
DOIs
Publication statusPublished - 1 Feb 2019

Keywords

  • diabetes mellitus
  • glycosylated hemoglobin A1c
  • HIV
  • cross-sectional study
  • antidiabetic drugs
  • insulin
  • Botswana

Cite this

Rwegerera, G. M., Masaka, A., Piña-Rivera, Y., Moshomo, T., Gaenamong, M., Godman, B., Oyewo, T. A., Massele, A., & 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), 34-41. https://doi.org/10.1080/21548331.2018.1535977