Determinants of blood glucose control among people with Type 2 diabetes in a regional hospital in Ghana

Djonor, Sampson Kafui; Ako-Nnubeng, Ignatius Terence; Owusu, Ewurama Ampadu; Akuffo, Kwadwo Owusu; Nortey, Pricillia; Agyei-Manu, Eldad; Danso‐Appiah, Anthony

doi:10.1371/journal.pone.0261455

Cited by 11 publications

(26 citation statements)

References 29 publications

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“…In most of the studies the duration of diabetes was longer than ten years. [3,[15][16][17] Therefore, the diabetes duration in our study was lower compared to many studies. [3,[15][16][17] The correlation between educational status and poor glycaemic control has been evaluated in many studies in the literature.…”

Section: Discussioncontrasting

confidence: 56%

“…[3,[15][16][17] Therefore, the diabetes duration in our study was lower compared to many studies. [3,[15][16][17] The correlation between educational status and poor glycaemic control has been evaluated in many studies in the literature. [3,12,15,[17][18][19][20][21] In most of them it was determined that poor glycaemic control was significantly higher in patients with a low educational status.…”

Section: Discussioncontrasting

confidence: 56%

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The relationship between poor glycaemic control and risk factors in patients with type 2 diabetes mellitus

atcı¹

2022

EJMA

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D iabetes mellitus is a chronic metabolic disease characterized mainly by hyperglycaemia, glycosuria and dyslipidaemia. Regardless of the cause, diabetes mellitus is a group of disorders with a complete or partial deficiency of insulin (which may also be accompanied by insulin resistance), and it involves various pathogenic mechanisms in which hyperglycaemia plays a major role. Type 2 diabetes, which is the most common type of diabetes and is increasing in prevalence, is one of the major health problems to emerge in recent years as its complications can lead to serious morbidity and mortality. [1][2][3] Although the primary goal in all diabetic patients is to Objectives: To identify risk factors for poor glycaemic control in type 2 diabetes mellitus patients. Methods: We obtained data from type 2 diabetes mellitus patients including their sociodemographic characteristics, body mass index (BMI), duration of diabetes, family history of diabetes, hypertension status, and current antidiabetic medications. At their last follow-up visits, the haemoglobin A1c (HbA1c), fasting glucose level, and lipid profiles were also recorded. Patients with a HbA1C ≥ 7% or a fasting plasma glucose level≥ 140 mg/dl were considered to have poor glycaemic control. Results: Of the 500 patients included in this study, 51.2% (n=256) were female. The average HbA1c level was 7.7% of whom 67% had a HbA1c level ≥ 7%, and 48% had a fasting plasma glucose≥ 140 mg/dl. Better glycaemic control rates (HbA1c < 7% and/or fasting plasma glucose < 140 mg/dl) were noted in patients with a shorter diabetes duration, no family history of diabetes, higher educational status, a lower waist circumference, and no hypertension, who were married and currently working, had been prescribed only oral antidiabetic agents and whose triglyceride levels were < 150 mg/dl. Independent risk factors for poor glycaemic control were longer duration of diabetes, diagnosed with diabetes at an earlier age, lower education level, higher triglyceride levels, being single and receiving insulin therapy. Conclusion: It could be suggested that waist circumference and triglyceride levels may be important parameters than BMI and cholesterol levels for glycaemic control. However, these data should be confirmed by further prospective studies.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussioncontrasting

confidence: 56%

The relationship between poor glycaemic control and risk factors in patients with type 2 diabetes mellitus

atcı¹

2022

EJMA

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“…Also, in line with the objectives of the Ghana NCD policy, which aims to strengthen early detection and management of NCDs including co-morbid hypertension and T2DM, maintaining BP and blood glucose control will lead to a reduction in morbidity and mortality from NCDs [19,24]. Compared with some patients with diabetes in Ghana, the blood glucose levels in this study was higher [30][31][32]. Generally, in low-resourced settings like Ghana, and especially in public health facilities where this study was conducted, glycaemic control was assessed using the fasting blood sugar.…”

Section: Discussionmentioning

confidence: 59%

Determinants of blood pressure and blood glucose control in patients with co-morbid hypertension and type 2 diabetes mellitus in Ghana: A hospital-based cross-sectional study

Alhassan

Kwakye

Dwomoh

et al. 2022

PLOS Glob Public Health

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Hypertension and diabetes are major risk factors for cardiovascular diseases and optimal control of blood pressure (BP) and blood glucose are associated with reduced cardiovascular disease events. This study, therefore, sought to estimate the prevalence and associated factors of controlled BP and blood glucose levels among patients diagnosed with both hypertension and Type 2- diabetes mellitus (T2DM). A quantitative cross-sectional study was conducted in a primary health setting in Ghana among patients 18 years and older diagnosed with both hypertension and T2DM. Pearson’s chi-square was used to assess the association between BP and blood glucose levels and the independent variables. The multivariable binary logistic regression model was used to assess the adjusted odds of controlled BP and blood glucose levels. Among the 329 participants diagnosed with both hypertension and T2DM, 41.3% (95% CI: 36.1–46.8%) had controlled BP, 57.1% (95% CI: 51.7–62.4%) had controlled blood glucose whilst 21.8% (95% CI: 17.7–26.7%) had both controlled BP and blood glucose levels. Increased age, non-formal education, non-married, employed, single-dose anti-hypertensives or anti-diabetic medications, and hyperlipidaemia or stroke co-morbidities were positively associated with controlled BP levels. Being female, married, taking 2 or more anti-hypertensive medications, and moderate to high medication-related burden were positively associated with controlled blood glucose levels. In terms of both controlled BP and blood glucose levels, being employed, reduced income level, being registered with national health insurance, single anti-diabetes or anti-hypertensive medications, hyperlipidaemia or stroke co-morbidities, and moderate to high medication-related burden were positively associated with having both controlled BP and blood glucose levels. One in five patients with hypertension and T2DM had both BP and blood glucose levels under control. The benefits and risks of blood pressure and blood glucose targets should thus be factored into the management of patients with hypertension and T2DM.

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“…The diabetic participants had been diagnosed based on their glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG) test results [ 1 ]. These patients had consistently displayed high plasma glucose levels, and had shown HbA1c assay results that classified their diabetes status as: HbA1c of 6.0–8.0% as good diabetes, 8.1–10.0% as fair diabetes, and >10.0 as poor diabetes [ 35 , 36 , 37 ]. The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) recommend a HbA1c cut-off point of 7.0% (53.0 mmol/mol) as optimal [ 35 , 36 , 37 ].…”

Section: Methodsmentioning

confidence: 99%

“…In Ghana, however, most HbA1c assay results from reputable laboratories such as Synlab Ghana Limited, MDS Lancet Laboratories Limited and Greater Accra Regional Hospital laboratory, which work closely with health facilities and clinicians, come with a glycaemic control guideline (reference range) as described [ 37 ]. In this study, individuals with transient elevated plasma glucose levels were not enrolled, as well those on antibiotics.…”

Section: Methodsmentioning

confidence: 99%

Similarities in Bacterial Uropathogens and Their Antimicrobial Susceptibility Profile in Diabetics and Their Non-Diabetic Caregivers at a National Diabetes Management and Research Centre, Accra-Ghana

2022

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Background: Diabetes mellitus has some damaging effects on the genitourinary system and has been found to have adverse effects on the host immune system, resulting in higher risk of infections including urinary tract infections (UTI). Incidences of UTI caused by bacteria have been increasingly reported globally and the abuse of antibiotics leading to evolving resistant strains of antibiotics is a public health challenge for the management of this condition. Information on the difference in types of bacterial agents causing UTI in diabetic patients and non-diabetic individuals, and their susceptibility profiles, will facilitate effective management among these groups of patients. Therefore, this study aimed at determining the difference in prevalence of UTI, the causative bacteria, and their antimicrobial susceptibility profiles in diabetic patients and non-diabetic individuals at a diabetes management center. Methods: This was a prospective cross-sectional study conducted amongst 100 diagnosed diabetic patients and 100 non-diabetic individuals. Urine sample was collected aseptically and analyzed microbiologically for the presence of urinary tract bacterial pathogens. Drug susceptibility testing was conducted on the isolates by the Kirby Bauer method to ascertain the antibiotic susceptibility patterns. Results: Among the diabetic and non-diabetic individuals, urinary tract bacterial pathogens were observed in 28.0% and 26.0% of samples, respectively. The organisms were in the following proportions for diabetic and non-diabetic individuals, respectively: E. coli (14/28, 50% and 8/26, 30.7%), S. aureus (2/28, 7.1% and 4/26, 15.4%), K. pneumoniae (4/28, 14.3% and 8/26, 30.7%), K. ozoenae (2/28, 7.14% and 0/26, 0%), K. oxytoca (0/28, 0% and 4/26, 15.4%) and C. urealyticum (6/28, 21.4% and 2/26, 7.69%). The difference between the proportions of bacteria isolated was, however, not statistically significant (p-value = 0.894). Bacteria isolated from both diabetic and non-diabetic individuals were highly susceptible to most of the antibiotics tested, especially nitrofurantoin, cefuroxime, ceftriaxone, and cefotaxime. Conclusion: This study has shown that similarities exist in prevalence of UTI, the causative bacteria, and their antimicrobial susceptibility patterns amongst diabetic patients and non-diabetic individuals at a diabetes management center. These data will help in the management of UTI among these individuals.

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Determinants of blood glucose control among people with Type 2 diabetes in a regional hospital in Ghana

Cited by 11 publications

References 29 publications

The relationship between poor glycaemic control and risk factors in patients with type 2 diabetes mellitus

The relationship between poor glycaemic control and risk factors in patients with type 2 diabetes mellitus

Determinants of blood pressure and blood glucose control in patients with co-morbid hypertension and type 2 diabetes mellitus in Ghana: A hospital-based cross-sectional study

Similarities in Bacterial Uropathogens and Their Antimicrobial Susceptibility Profile in Diabetics and Their Non-Diabetic Caregivers at a National Diabetes Management and Research Centre, Accra-Ghana

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