Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana.
Central Laboratory, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana.
PLoS One. 2021 Dec 22;16(12):e0261455. doi: 10.1371/journal.pone.0261455. eCollection 2021.
To assess the determinants of glycaemic control among patients with Type 2 diabetes mellitus (T2DM) presenting at the Greater Accra Regional Hospital, Ghana.
The study employed semi-structured questionnaires and review of clinical records of patients 16 years and above with Type 2 Diabetes.
The mean age of participants was 56.6 ± 13.8 years, with majority (71.6%) being females. A total of 161 (59.4%) of patients had poor glycaemic control (HbA1c ≥8.1%; 95% CI: 53.6 to 65.3%). Poor glycaemic control was significantly associated with high body mass index of the patient (AOR 13.22; 95% CI: 1.95 to 89.80), having only elementary education (AOR 5.22, 95% CI 2.12-12.86, p<0.0001) and being on insulin therapy (AOR 2.88; 95% CI: 1.05 to 7.88). On the other hand, seldom coffee intake (AOR: 0.27; 95% CI: 0.11 to 0.64), high physical activity (AOR 1.57, 95% CI 1.06-2.35, p = 0.025) and having a cardiovascular disease (AOR: 0.15; 95% CI: 0.05 to 0.46) appeared to positively influence glycaemic control. Self-monitoring of blood glucose and diet interventions did not appear to influence glycaemic control.
The study results showing that a high proportion of patients attending the Diabetes Clinic with uncontrolled diabetes has serious implications for the management of T2DM diabetes as it suggests that current hospital-based treatment measures are less effective. Comprehensive management of T2DM targeting all the key factors identified in this study and incorporating a multispectral collaborative effort based on holistic approach, combined with non-pharmacological components are strongly warranted.
评估加纳大阿克拉地区医院就诊的 2 型糖尿病（T2DM）患者血糖控制的决定因素。
本研究采用半结构式问卷和患者 16 岁及以上 2 型糖尿病临床记录回顾。
参与者的平均年龄为 56.6±13.8 岁，其中大多数（71.6%）为女性。共有 161 名（59.4%）患者血糖控制不佳（HbA1c≥8.1%；95%CI：53.6 至 65.3%）。血糖控制不佳与患者较高的体重指数（AOR 13.22；95%CI：1.95 至 89.80）、仅接受过小学教育（AOR 5.22，95%CI 2.12-12.86，p<0.0001）和接受胰岛素治疗（AOR 2.88；95%CI：1.05 至 7.88）显著相关。另一方面，很少喝咖啡（AOR：0.27；95%CI：0.11 至 0.64）、高体力活动（AOR 1.57，95%CI 1.06-2.35，p=0.025）和患有心血管疾病（AOR：0.15；95%CI：0.05 至 0.46）似乎对血糖控制有积极影响。自我监测血糖和饮食干预似乎没有影响血糖控制。
研究结果表明，很大比例在糖尿病诊所就诊的糖尿病患者血糖控制不佳，这对 T2DM 糖尿病的管理有严重影响，因为这表明目前基于医院的治疗措施效果较差。针对本研究中确定的所有关键因素进行全面的 T2DM 管理，并结合基于整体方法的多光谱协作努力，结合非药物治疗成分，是非常有必要的。
