Prevalence and determinants of poor glycaemic control: a cross-sectional study among Moroccan type 2 diabetes patients

Abstract

Background Diabetes remains poorly controlled in a high proportion of diabetes patients. This study examines the prevalence of poor glycaemic control and associated factors in type 2 diabetes patients in the Beni-Mellal Khenifra region in Morocco. Methods A cross-sectional survey was conducted in 2017 among 1456 diabetes patients attending primary health centres. Demographic and clinical data were collected through face-to-face interviews using structured and pre-tested questionnaires. Anthropometric measurements, including body weight, height and waist circumference were taken using standardized techniques and calibrated equipment. Glycaemic control was assessed in terms of the glycated haemoglobin (HbA1c) level and poor glycaemic control was defined as HbA1c ≥7% and a level <7% reflects good glycaemic control. Results Of the total participants, 66.3% had poor glycaemic control. Bivariate analysis showed that sex (p=0.010), education level (p=0.013), body mass index (p=0.048), duration of diabetes (p<0.0001) and type of therapeutic regimen (p<0.0001) were significantly associated with HbA1c level. However, multiple logistic regression analyses revealed that only a longer duration of diabetes (OR 1.525 [95% confidence interval {CI} 1.183–1.967], p=0.001) and receiving insulin therapy alone (OR 1.589 [95% CI 1.157–2.183], p=0.004) or a combination of oral antidiabetics with insulin (OR 2.554 [95% CI 1.786–3.653], p<0.001) were significantly associated with inadequate glycaemic control. Conclusions Despite the particularities of the region, the findings about glycaemic control and its cross-sectionally associated factors are in line with findings from other regions of Morocco. In this subgroup, the longer duration of diabetes and insulin treatment could constitute a cause leading to poor glycaemic control. However, inverse causality cannot be excluded.

Association of Health Literacy and Nutritional Status Assessment with Glycemic Control in Adults with Type 2 Diabetes Mellitus

“…In Iraq, the prevalence of T2DM was about 15%, and the highest was recorded in Basrah City (19.7%) [2]. Among those with T2DM, poor glycemic control was highly prevalent, with about 86.2% of T2DM had an HbA1c of more than 7% [3], which is consistent with the other studies worldwide [4,5]. About 40-60% of patients worldwide still have poorly controlled diabetes [6,7], suggesting the critical needs to understand the factors influencing glycemic control.…”

“…The results were not consistent with previous studies [ 18 , 33 ]. The employment status did not predict glycemic control among Moroccans patients with T2DM [ 4 ]. Nevertheless, a study conducted among 325 adults with T2DM attending in Jimma University Teaching Hospital in Ethiopia showed that farmers with diabetes have inadequate glycemic control compared with unemployed patients.…”

The effect of comorbidities on glycemic control among Colombian adults with diabetes mellitus: a longitudinal approach with real-world data

“…Taking into account race and ethnicity, studies have demonstrated significant differences between ethnic groups in achieving glycemic target [ 10 , 11 ]. An additional determinant of inadequate glycemic control is a longer time since the diagnosis of DM [ 9 , 12 ].…”

Significant Association of Polymorphisms in the TCF7L2 Gene with a Higher Risk of Type 2 Diabetes in a Moroccan Population

“…International Diabetes Federation estimates that there were 415 million people with diabetes in 2017 and that the number will increase to 642 million by 2040 [ 3 ]. Currently around 2.5 million people are diabetic in the Moroccan population [ 4 ]. It is important to find changes in genes as well as other risk factors that make people more susceptible to T2DM.…”

“…Other studies in different populations have indicated the association of genetic variants of TCF7L2 genes with the risk of developing T2DM and its complications [ 7 ]. However, data on the Moroccan population are scarce; most of the published studies were focusing on the epidemiology, diagnosis and management of T2DM patients [ 4 ], except one which was carried out in the region of Fez and was published by El Achhab et al [ 10 ]. This study showed a positive relationship between TCF7L2 rs7903146 and susceptibility of developing diabetes (OR = 1.61, 95% CI = 1.32–1.96, p < 0.001).…”