Ekpor Emmanuel, Wilson Dorothy, Osei Eric Peprah, Mensah Bernard Abeiku, Akyirem Samuel
School of Psychology, Deakin University, Geelong, Victoria, Australia.
School of Nursing and Midwifery, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
PLoS One. 2025 Jul 18;20(7):e0327610. doi: 10.1371/journal.pone.0327610. eCollection 2025.
Effective glycemic control is a cornerstone of diabetes management, essential for reducing the risk of complications and mortality. However, in Ghana, persistent limitations in diabetes management capacity present significant challenges to meeting recommended glycemic targets. This systematic review synthesizes the available evidence on the prevalence and sociodemographic determinants of suboptimal glycemic control among individuals with diabetes in Ghana. Relevant observational studies were obtained through a systematic search conducted on PubMed, Medline, Embase, Global health, Scopus, and Web of Science, from their inception to November 29, 2024. A random-effects meta-analysis was used to estimate the pooled prevalence of suboptimal glycemic control, accounting for heterogeneity across studies. Subgroup analyses were performed to explore potential sources of variability. We assessed publication bias statistically using Egger's regression and Begg's rank correlation test. Out of 1390 articles screened, 28 meet the inclusion criteria, comprising a total of 11,242 participants. The pooled prevalence of suboptimal glycemic control was 67.6% (95% CI: 64.2-70.8). When stratified by glycemic control measures, the prevalence was 69.2% (95% CI: 62.5-75.2) for fasting blood glucose levels ≥7.0 mmol/L and 66.9% (95% CI: 62.5-70.9) for hemoglobin A1c levels ≥7.0%. Sociodemographic factors such as age, income, gender, and ethnicity were found to be associated with suboptimal glycemic control. These findings underscore the substantial burden of suboptimal glycemic control among individuals with diabetes in Ghana, with over two-thirds not meeting recommended targets. There is an urgent need for targeted, context-specific interventions to address both clinical and systemic barriers to effective diabetes management in Ghana.
有效的血糖控制是糖尿病管理的基石，对于降低并发症风险和死亡率至关重要。然而，在加纳，糖尿病管理能力的持续限制给实现推荐的血糖目标带来了重大挑战。本系统评价综合了加纳糖尿病患者血糖控制不佳的患病率及社会人口学决定因素的现有证据。通过对PubMed、Medline、Embase、Global health、Scopus和Web of Science进行系统检索，从其创刊至2024年11月29日获取相关观察性研究。采用随机效应荟萃分析来估计血糖控制不佳的合并患病率，并考虑研究间的异质性。进行亚组分析以探索潜在的变异来源。我们使用Egger回归和Begg秩相关检验对发表偏倚进行统计学评估。在筛选的1390篇文章中，28篇符合纳入标准，共包括11242名参与者。血糖控制不佳的合并患病率为67.6%（95%CI：64.2 - 70.8）。按血糖控制指标分层时，空腹血糖水平≥7.0 mmol/L的患病率为69.2%（95%CI：62.5 - 75.2），糖化血红蛋白水平≥7.0%的患病率为66.9%（95%CI：62.5 - 70.9）。年龄、收入、性别和种族等社会人口学因素被发现与血糖控制不佳有关。这些发现强调了加纳糖尿病患者血糖控制不佳的沉重负担，超过三分之二的患者未达到推荐目标。迫切需要有针对性的、因地制宜的干预措施，以解决加纳有效糖尿病管理的临床和系统性障碍。
