The relationship between patient characteristics and glycemic control (HbA1c) in type 2 diabetes patients attending thika level five hospital, Kenya

Abstract

Type 2 Diabetes Mellitus is a metabolic disorder characterized by hyperglycemia due to relative insulin secretion deficiency and insulin resistance. It is a global public health concern with increasing prevalence each year. Social demographic, lifestyle and metabolic characteristic, play a crucial role in development and progression of Type 2 diabetes mellitus. Poor glycemic control worsens the condition, leading to complications that are very costly to treat. This calls for a need to explore the relationship between patient characteristics and glycemic control (HbA1c). One hundred and fifty three (153) participants with Type 2 diabetes mellitus aged 20-79 years and attending the Thika Level Five Hospital were enrolled in the study. Sociodemographic, clinical and lifestyle data were obtained using questionnaires. The nutrition status was determined by anthropometry. Lipid profile that included total cholesterol, (TC); high density lipoprotein-cholesterol, (HDL-c); low density lipoprotein cholesterol, (LDL-c) and triglyceride, (TG,) were determined by enzymatic method while glycated hemoglobin (HbA1c) and fasting blood sugar (FBS) were determined using high-performance liquid chromatography (HPLC) and glucose oxidase methods, respectively. Blood pressure of the patients was also determined. Overall sample size was 153 (40.5% men and 59.5% women). The overall mean age of patients was 56.07 years, and the mean age of patients with poor glycemic control (HbA1c>7%) was 56.79 years. The prevalence of the poor glycemic control (HbA1c>7%) was 77.8%. Participants with HbA1c > 7% showed statistically significant higher means for FBG, TC, and LDL-c than their counterparts with good glycemic control [11.71±3.11mmol/l vs. 8.54±3.19; 5.11±1.21mmol/l vs. 4.48±1.16 and 2.66±1.07 mmol/l vs. 2.22±1.04, respectively, (P<0.005; 0.000, 0.008 and 0.034, respectively]. The study showed a significant strong positive correlation between HbA1c and FBG (r=0.679, p<0.01); family history of diabetes, (FHD) (r=0.165, p<0.05); systolic blood pressure, (SBP) moderated with FHD (r=0.168, p<0.05); and diastolic blood pressure (DBP) moderated with FHD(r=0.181, p<0.05). In conclusion, poor glycemic control is associated with high/ blood pressure, high blood glucose and dyslipidemia, which are risk factors for macrovascular, microvascular and cardiovascular complications.