scholarly journals Magnitude and predictors of poor glycemic control among patients with diabetes attending public hospitals of Western Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247634
Author(s):  
Adugna Oluma ◽  
Muktar Abadiga ◽  
Getu Mosisa ◽  
Werku Etafa
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Diabetes Complications ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Blood Glucose Test ◽  
Patients With Diabetes ◽  
Glucose Test ◽  
Western Ethiopia

Background Diabetes is one of the most prevalent non-communicable diseases globally, which rapidly is increasing in developing countries. Ethiopia is also facing growing morbidity and mortality related to diabetes complications. Thus, dealing with glycemic control is essential for controlling the development of devastating acute and chronic complications related to diabetes. Therefore, this study aims to assess the magnitude and predictors of poor glycemic control among diabetic patients in western Ethiopia. Methods The cross-sectional study design was employed on a sample of 423 diabetic patients. A systematic random sampling method was employed. An interviewer-administered structured questionnaire was used. The data entered into Epi data version 3.1 and exported into Statistical Package for the Social Sciences window version 24 for analysis. All variables significant at p-<0.25 in bivariate were entered into multivariate analysis. The multivariable logistic regressions were used to determine predictors’ poor glycemic control by considering the Adjusted Odds Ratio at CI 95% and the significance level was set at p <0.05. Results The magnitude of poor glycemic control was 64.1%. Being females (AOR = 1.684,95%CI = 1.066,2.662), duration of diabetes >8years (AOR = 2.552,95%CI = 1.397, 4.665), presence of diabetes complication (AOR = 2.806,95%CI = 1.594,4.941), negligence of blood glucose test at home (AOR = 1.720, 95%CI = 1.078, 2.743), poor self-care behavior (AOR = 1.787, 95%CI = 1.083,2.959) and poor self-efficacy (AOR = 1.934, 95%CI = 1.078,3.469) were significant predictors of poor glycemic control. Conclusion The proportion of poor glycemic control was high which was nearly comparable to that reported from many countries. This could be due to factors that were significantly associated with poor glycemic control like lack of home blood glucose test, increased duration of diabetes, presence of diabetes complications, poor self-efficacy, and poor self-care behaviors. Each were significant independent predictors of poor glycemic control. Thus, we recommend patients with diabetes and health care providers enhancing self-monitoring practices, and preventing potential complications should be a priority concern to improve blood glucose levels. Further studies are also recommended to explore important factors which were not identified by the current study.

Characteristics of monitored diabetic patients by glycated haemoglobin (HbA1c)

2016 ◽  
Vol 5 (05) ◽  
pp. 4563
Author(s):  
Tariq A. Zafar
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Glycated Haemoglobin ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Age Group ◽  
Hba1c Test ◽  
Significant Difference ◽  
Tract Infections ◽  
The Impact

Glycated haemoglobin (HbA1c) test indicates the blood glucose levels for the previous two to three months. Using HbA1c test may overcome many of the practical issues and prevent infections such as urinary tract infections (UTIs). The study aimed to evaluate the impact of glycemic control using HbA1c test to understand patient characteristics and UTIs prevalence. Glycemic control was evaluated by measuring HbA1c for a total of 208 diabetes patients who were regularly attending diabetes center in Al-Noor specialist hospital in Makkah.  The results showed that good and moderate glycemic controlled patients were 14.9% and 16.9% respectively while the poor glycemic patients were 68.3%. Among the good improved glycemic control, 83.9% were females, 48.4% were from age group (15-44y). Among the moderately improved glycemic control, 68.4% were females, 54.3% were from age group (45-64 y) with no significant difference. The total number of the patients with positive UTIs was 55 (26.4%) while the total number of patients with negative was UTIs 153 (73.6%). Among the positive UTIs, 76.3% were with poor glycemic control while only 12.3% and 11% were moderate and good improved glycemic control respectively. Among the negative UTIs, 65.3% were with poor glycemic control while only 19% and 15.7% were with moderate and good improved glycemic control respectively.  Prevalence of UTIs among diabetic patients was not significant (p > 0.05). It was concluded that HbA1c was useful monitoring tool for diabetes mellitus and may lead to improved outcomes. Using a HbA1c test may overcome many of the practical issues that affect the blood glucose tests.

scholarly journals Systemic association of newly diagnosed proliferative diabetic retinopathy among type 2 diabetes patients presented at a tertiary eye hospital of Nepal

2015 ◽  
Vol 7 (1) ◽  
pp. 26-32
Author(s):  
R Thapa ◽  
S Bajimaya ◽  
S Sharma ◽  
B B Rai ◽  
G Paudyal
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Blood Sugar ◽  
Proliferative Diabetic Retinopathy ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Newly Diagnosed ◽  
Duration Of Diabetes ◽  
Case Series Study

Introduction: Proliferative diabetic retinopathy (PDR) is the leading cause of blindness among the diabetics. Objective: to study the systemic association of proliferative diabetic retinopathy. Materials and methods: A prospective, case-series study was conducted among the newly diagnosed proliferative diabetic retinopathy cases presenting at the Tilganga Institute of Ophthalmology (TIO) from January 2012 to January 2013. Diabetic retinopathy was classi¿ed using the Early Treatment Diabetic Retinopathy Study criteria. Blood pressure, fasting and postprandial blood sugar, glycosylated hemoglobin, lipid pro¿le, urine for microalbumin, urea, and creatinine were evaluated at the time of diagnosis.Results: A total of 104 type 2 diabetic patients with newly diagnosed PDR presented during the study period. Concurrent macular edema was present in 93 cases (89.42 %). The mean age was 56.96 ± 9.394 (range 32 - 78) years. Males and females comprised of 75.7 % and 24.3 % respectively. The majority (37.5 %) were involved in business, followed by government service (17.30 %), and housewives (16.34 %). Mean duration of diabetes was 11.42 ± 5.356 years (range 1 month - 26 years). Concurrent hypertension was found in 55.76 %, uncontrolled fasting and or postprandial blood sugar in 72.54 %, poor glycemic control (HbA1C > 7 %) in 73.97 %, abnormal lipid profile in 52.56 %, microalbuminuria in 67.85 %, and positive urine albumin in 50 % of the cases.Conclusion: Despite the short duration of diabetes, the concurrent hypertension, poor glycemic control, proteinuria and dyslipidemia were the main systemic associations for PDR at our clinical set-up. Awareness, identification and management of these systemic problems could reduce the rapid progression to PDR.

Young-Adult Perspectives of Insulin-Dependent Diabetes

1995 ◽  
Vol 21 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Patricia L. Dunning
Keyword(s):  
Blood Glucose ◽  
Type I Diabetes ◽  
Insulin Dose ◽  
Type I ◽  
High Blood Glucose ◽  
Duration Of Diabetes ◽  
Pregnancy And Childbirth ◽  
Blood Glucose Test ◽  
Glucose Test ◽  
Insulin Dependent

The purpose of this study was to document the self-care behaviors of patients with type I diabetes, identify their concerns about having diabetes, and measure their level of control (HbAlc). A 20-point questionnaire was mailed to 105 young adults with type I diabetes. Fifty-nine (56%) returned the questionnaire (33 males, mean age 23.2 years; 26 females, mean age 22.7 years). Duration of diabetes was 5 months to 25 years (mean=11.28 years). HbAlc range was 5% to 13.9% (mean=7.85%, normal <6.6%). Sixty-eight percent performed at least one blood glucose test per day and 12% reported not testing at all. The number of insulin injections per day ranged from 2 to 5, and 83% regularly adjusted their insulin dose. Confidence in adjusting insulin was not related to duration of diabetes, age, or sex. Insulin manipulation to control weight was reported by 38% (24 females, 2 males). The long-term complications they were concerned about were eye disease (35%), pregnancy and childbirth (27%), hypoglycemia (13%), and loss of independence (5%). Hypoglycemia was always recognized by 35%, although 50% sometimes confused it with stress, tiredness, and high blood glucose. All subjects reported that hypoglycemia affected their lifestyle.

scholarly journals Is it beneficial to the state to provide insulin-treated diabetic patients with public funds for self-monitoring blood glucose?

10.14341/7077 ◽  
2017 ◽  
Vol 20 (2) ◽  
pp. 108-118
Author(s):  
Larisa Dmitrievna Popovich ◽  
Marina Vladimirovna Shestakova ◽  
Elena Georgievna Potapchik ◽  
Alexander Yur'evich Mayorov ◽  
Olga Konstantinovna Vikulova
Keyword(s):  
Blood Glucose ◽  
Economic Burden ◽  
Economic Benefits ◽  
Diabetic Patients ◽  
Public Funds ◽  
Self Monitoring ◽  
Blood Glucose Test ◽  
Number Of Patients ◽  
Glucose Test ◽  
Two Measures

Background.In Russia, the prevalence of diabetes continues to increase with the growing diabetes epidemic. In recent years, the paradigm of diabetes treatment has been changing, with patients increasingly becoming equal participants in the treatment process, through the introduction of self-monitoring blood glucose (SMBG). Several clinical studies have demonstrated a positive relationship between SMBG and the decline of the epidemiological and economic burden of diabetes. At present, the procurement of public funds for SMBG is below the specified level in Russia. Aims.To investigate the potential macroeconomic benefits of public health resource allocation and the use of planned state investments to fund SMBG in insulin-treated diabetic patients. Materials and methods.This study was conducted with data from insulin-treated diabetic patients. The epidemiological burden of this cohort was determined by the following indicators: the number of patients and the incidence of complications resulting from diabetes, disability, mortality, age and sex. The economic benefits were evaluated by the implementation of two measures: (1) procurement of public funds for the purchase of means for SMBG in patients with insulin-treated diabetes and (2) the use of highly accurate blood glucose metres. To evaluate economic burden, the epidemiological burden was translated into monetary terms using cost-of-illness. Economic benefits were defined as reductions in economic burden. Results.The economic benefits of public-funded blood glucose test strips for insulin-treated diabetic patients exceeded the required additional investments for their purchase by 1.5 fold. A significant reduction in the inaccuracy of blood glucose metres from 20% to 10% may reduce the economic burden by 9.36 billion RUB. The combined state benefits from the implementation of both measures would significantly decrease the economic burden of diabetes to 29.2 billion RUB. Conclusions. Increased procurement of public funds for SMBG in insulin-treated diabetic patients would bring economic benefits that far exceed the required investments.

scholarly journals Prevalence of microalbuminuria and its association with glycemic control in type 2 diabetic patients: a cross sectional study at Kathmandu Medical College

2019 ◽  
Vol 9 (1) ◽  
pp. 2-7
Author(s):  
Prabin Kumar Karki ◽  
Santosh Timalsina ◽  
Sanat Chalise ◽  
Anita Yadav ◽  
Ashish Kumar Bhattarai
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Venous Blood ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Duration Of Diabetes ◽  
Medical College ◽  
Type 2 Diabetic

Background: Diabetes mellitus has become one of the biggest health problems of this era. The resultant microvascular and macrovascular complications add to significant amount of morbidity and mortality. Urine microalbumin is considered as an early marker for microvascular compli­cations among diabetic patients. The aim of this study was to find out the prevalence of microalbuminuria among type 2 diabetic patients attending Kathmandu Medical College and its relation with glycemic control, age, sex, duration of diabetes. Methods: A total of 208 previously diagnosed type 2 diabetic patients at­tending medical outpatient department of Kathmandu Medical College, Sinamangal were included in the study over a period of 1 year (October 2017 - September 2018). Fasting and 2-hour postprandial venous blood for blood glucose and HbA1c measurement and early morning urine sam­ple (after overnight fast) was collected for detection of microalbuminuria. Statistical analysis was done using SPSS version 23. Results: The prevalence of microalbuminuria among the study population (mean age: 54.22 ± 11.76 years, mean HbA1c: 7.62 ± 1.53 %) was 42.8%. Microalbuminuria had significant correlation with HbA1c and duration of diabetes (p<0.001), but not with age, sex and type of medication. There was positive correlation between urine microalbumin and fasting and post-prandial blood glucose. Conclusions: Our present study found high prevalence of microalbumin­uria among diabetic patients with poor glycemic control. It is suggested that tighter glycemic control with regular urine microalbumin testing should be integral part of diabetic management plan to prevent long term complications such as diabetic nephropathy

scholarly journals Study of the Glycemic Control and the Biochemical Profile in the Gabonese Diabetic Patient

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Glycemic Control ◽  
Diabetic Patient ◽  
Hepatic Steatosis ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Biochemical Profile ◽  
Patients With Diabetes ◽  
Hba1c Control ◽  
Sub Saharan

Background: Management of diabetes remains a challenge in Africa. Objective: The aim of this study was to evaluate the glycemic control in diabetics patients with diabetes in Gabon sub-Saharan country. Methods: This study involving 87 diabetic patients (Men25 ; Women : 62) were investigated anthropometric parametres, glycemic control and biochemical profil. Results: All our results show that with an average age of 53±11.02 years diabetic Gabonese patients present a poor glycemic control (P <0.0001): Glycemia (Control: 4.95 ± 1.16 mmol/l vs Diabetic : 10.27 ± 4.47 mmol/l) ; HbA1c (Control : 5.05 ± 0.46% vs Diabetics : 7.40 ± 2.36%) associated with a hepatic steatosis : Alat ( Alat : Control: 17.25 ± 13.7u/l vs Diabetic: 25.84 ± 13.19 u/l), Asat (Control: 18 ± 13.20 u/l vs Diabetic: 36.93 ± 17.87 u/l). Conclusion: Is evidence, a high proportion of patients with diabetes remains poorly controlled. This is the case in Gabon diabetic patients.

scholarly journals Evaluation and follow up patients with diabetes mellitus who attended Sabratha diabetic center

2020 ◽  
Vol 8 (2) ◽  
pp. 340-343
Author(s):  
Khaled Ali ALawaini ◽  
Hanen Daw Sweed ◽  
Khalod Mohamed Sawesi ◽  
Fatma Abdusalam Kamoka ◽  
Sara Abugalel Alakrme ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Blood Glucose Concentration ◽  
Microvascular Disease ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Diabetes Incidence ◽  
Patients With Diabetes ◽  
Public Health Challenge ◽  
The Mean ◽  
Mean Blood Glucose

Background: Diabetes is a public health challenge facing the world. Awareness and long term diabetes have an enormous effect, including cardiovascular disease and microvascular disease. Objective: This study aimed to estimate diabetes incidence and it is complications. Methods: A hundred diabetic patients who attended Galil diabetic center in Sabratha city had participated in this study in May 2013. Results: The mean age was 56 years old. Diabetes was more prevalent in females than in males (62%vs38%). The mean blood glucose concentration was 168 mg/dl, reflecting poor glycemic control, as 16% of diabetic patients moved to treatment with insulin. Conclusion: Poor glycemic control means of fasting plasma glucose was 168 mg/dl, and 16% started to use insulin therapy, along with 15% had hypertension.

scholarly journals Analysis of Reasons For Readmission of Diabetic Patients: 2015-2019

2022 ◽  
Author(s):  
Junmei Wang ◽  
Jiayao Xiong ◽  
Chao Yang ◽  
Xianshu Jiang ◽  
Min Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glycemic Control ◽  
Influencing Factors ◽  
Diabetic Foot ◽  
Readmission Rate ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Spearman Correlation ◽  
Diabetic Foot Infection ◽  
Duration Of Diabetes

Abstract Background: Among patients with diabetes who had been hospitalized, 30% had twice or more hospitalisations rate, accounting for more than 50% of total hospitalizations and hospitalization expense. The purpose of our study was to to find available strategies to reduce the readmission rate of diabetics in rural areas.Methods: This retrospective single-center study used the data from Yongchuan Hospital of Chongqing Medical University. The t-test and the chi-square test or Fisher's exact test were used to compare continuous and categorical variables, respectively. We used the Spearman correlation coefficient to examine the relationship between variables. Multiple linear regression was performed to analyze the influencing factors of hospitalisation time, and dummy variables were set for categorical independent variables. Results: There were a total of 1721 readmissions during a five-year period; among them, 829 were females and 892 males. The readmission rate of diabetic patients in the endocrinology department was 32.40%. The age, times of hospitalisation, and duration of all subjects were 64.67 ± 13.82, 2.69 ± 1.41 and 10.60 ± 6.78, respectively. Among all the diabetic patients, type 2 diabetes accounted for 98.55% (n = 1696). Most of the patients were readmitted due to poor glycemic control, infection, edema, dizziness, and weakness, accounting for approximately 56%. During the 5-year period, the majority of readmitted diabetic patients were hospitalized twice. Times of hospitalisation was weakly positively correlated with age (Rho = 0.206, P≤0.001), diabetic duration (Rho = 0.248, P ≤ 0.001) and hospitalisation expenses (Rho = 0.008, P = 0.035) by Spearman correlation analysis. Age, duration of diabetes, systolic blood pressure (SBP), diastolic blood pressure (DBP) and alanine aminotransferase (ALT) were the main factors affecting times of hospitalisation in diabetes patients (all P < 0.05). Compared with current smokers, non-smokers and cessation smokers had high hospitalisations rate (all P for trend < 0.05). When taking diabetic foot infection as a reference, edema was more accountable than diabetic foot infection for hospitalisation times, which was statistically significant (P for trend = 0.048).Conclusion: Age, duration of diabetes and hospitalisation costs were positively correlated with times of hospitalisation. Age, duration of diabetes, blood pressure, ALT, smoking status and edema are the influencing factors of hospitalisation times. The most common causes of hospitalisation for diabetics are poor glycemic control, infection, edema, dizziness, and weakness. Controlling these factors may be key to developing rational health strategies for rural diabetics.

scholarly journals Achievements of Diabetes Goals and Their Determinants in Type 2 Diabetic Patients Attending Outpatient Diabetic Clinic in Northern Ethiopia

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Ezra Belay ◽  
Abel Abera ◽  
Aman Mehari ◽  
Gidey Gebremeskel ◽  
Asrat Endrias ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glycemic Control ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Duration Of Diabetes ◽  
Type 2 Diabetic

Background. The aim of this study was to assess target diabetic goal achievements and to explore variables associated with them. Methods. A cross-sectional study was conducted between December 2015 and April 2016 on 188 type 2 diabetic patients attending Ayder Referral Hospital’s outpatient diabetic clinic. Glycemic control was assessed using fasting plasma glucose values and total cholesterol and triglyceride were used to evaluate lipid profiles. Bivariate and multivariate logistic regression analyses were done to identify factors associated with poor glycemic control, hypertension, and dyslipidemia. Result. Mean duration of diabetes was 6.5 years. Combined glycemic, lipid, and blood pressure targets were achieved only in 8.5% of the participants. More males achieved combined targets than females. Separately, while above two-thirds of the patients had poor glycemic control (67%), more than half of the participants have had poor lipid (58.5%) and blood pressure (52.1%) control. A significant portion of the patients (68.1%) had also comorbidities other than hyperglycemia. In bivariate and multivariate analyses, longer duration of diabetes disease (AOR: 3.4; P=0.013) and marked month to month fasting plasma glucose (FPG) variability as measured by large standard deviation (AOR: 2.5; P=0.023) were significantly associated with overall poor mean FPG results. Female sex was also significantly associated with dyslipidemia (AOR: 1.9; P=0.049). Conclusion. The study showed that achievements of combined diabetic goals are generally poor.

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