Frequency and predictors of suboptimal glycemic control in an African diabetic population

Figures & data

Table 1 Sociodemographic, clinical, and laboratory characteristics of the study participants

Variable	N (%)
Age in years, median (IQR)	53 (43.5–62)
Gender, n (%)
Male	140 (33.02)
Female	284 (66.98)
Education level, n (%)
None	38 (8.96)
Primary	165 (38.92)
Secondary	141 (33.25)
Tertiary	79 (18.63)
Occupation, n (%)
Employed	212 (50)
Unemployed	212 (50)
Marital status, n (%)
Married	259 (61.08)
Cohabiting	10 (2.36)
Single	47 (11.08)
Divorced	41 (9.67)
Widow/widowed	67 (15.80)
Place of residence
Rural	136 (32.08)
Urban	288 (67.92)
Study site
Government	199 (46.82)
Private	226 (53.18)
Smoking
Yes	10 (2.35)
No	415 (97.65)
Known HT
Yes	292 (68.87)
No	132 (31.13)
HIV coexistent
Yes	17 (4.00)
No	408 (96.00)
FH-DM
Yes	264 (62.26)
No	160 (37.74)
Type of DM
Type 1 DM	55 (13.13)
Type 2 DM	364 (86.87)
Drug history
Diet alone	3 (0.71)
Metformin alone	79 (18.59)
Met + SU	127 (29.88)
Met + SU + TZD	16 (3.76)
Met + Incretins	8 (1.88)
Insulin alone/+Met	188 (44.34)
Statins	89 (20.94)
Variable	Median (IQR), N=425
Age at diagnosis, years	47 (37–55)
Duration with DM, years	4.5 (2–10)
BMI, kg/m^2	27 (23–30.6)
HbA1c (%)	9 (6.8–12.4)
LDLC, mmol/L	2.9 (2.3–3.84)
HDLC, mmol/L	1.19 (0.9–1.42)
TC, mmol/L	4.82 (4.1–5.71)
TGL, mmol/L	1.6 (1.23–2.2)
SBP, mmHg	139 (124–155)
DBP, mmHg	80 (73–91)

Note: Copyright ©2017. Dove Medical Press. Reproduced from Lumu W, Kampiire L, Akabwai GP, Kiggundu DS, Kibirige D. Statin therapy reduces the likelihood of suboptimal blood pressure control among Ugandan adult diabetic patients. Ther Clin Risk Manag. In press 2017.¹⁹

Abbreviations: IQR, interquartile range; DM, diabetes mellitus; HT, hypertension; FH, family history; SU, sulfonylureas; Met, metformin; Pio, pioglitazone; BMI, body mass index; HbA_1c, glycated hemoglobin; LDLC, low-density lipoprotein cholesterol; HDLC, high-density lipoprotein cholesterol; TC, total cholesterol; TGL, triglycerides; SBP, systolic blood pressure; DBP, diastolic blood pressure; TZD, thiazolidinediones.

Table 2 Extent of glycemic, BP, and lipid control among the study participants (n=423)

HbAlc (%)	N (%)
<7	112 (26.48)
7–8	56 (13.24)
8.1–9.9	76 (17.97)
≥10	179 (42.32)
All L (LDLC, HDLC, TC, TGL collectively), BP, HbA1c normal	9 (2.1)
HbA1c-BP normal	59 (13.9)
HbA1c-L normal	15 (3.6)
L-BP normal	27 (6.4)

Abbreviations: L, lipid profile; HbA_1c, glycated hemoglobin; BP, blood pressure; LDLC, low-density lipoprotein cholesterol; HDLC, high-density lipoprotein cholesterol; TC, total cholesterol; TGL, triglycerides.

Table 3 Bivariate analysis of sociodemographic and clinical characteristics associated with suboptimal glycemic control

Characteristic	HbAlc ≥7%, n (%)	HbAlc <7%, n (%)	OR (95% CI)	p-value
Age, years
≤40	30 (20.69)	82 (29.50)	0.62 (0.39–1.01)	0.052
>40	115 (79.31)	196 (73.52)
Gender
Male	41 (29.50)	98 (0.50)	0.79 (0.51–1.25)	0.325
Female	71 (25.00)	213 (75.00)
Type of hospital
Government	56 (28.14)	143 (71.86)	0.85 (0.55–1.31)	0.466
Private	56 (25)	168 (75)
Place of residence
Rural	28 (20.74)	107 (79.26)	1.57 (0.96–2.57)	0.067
Urban	84 (29.17)	204 (70.83)
Smoking
Smoker	3 (30.00)	7 (73.00)	0.84 (0.21–3.30)	0.799
Nonsmoker	109 (26. 39)	304 (73.61)
Coexisting HT
Yes	78 (26.71)	214 (73.29)	0.96 (0.60–1.54)	0.870
No	34 (25.95)	97 (74.05)
DM type
Type 1 DM	13 (23.64)	42 (76.36)	1.21 (0.62–2.35)	0.571
Type 2 DM	99 (27.27)	264 (72.73)
Family history of DM
Yes	70 (26.52)	194 (73.48)	0.99 (0.64–1.55)	0.982
No	42 (26.42)	117 (73.58)
HIV comorbidity
Yes	5 (29.41)	12 (70.59)	0.86 (0.30–2.50)	0.780
No	107 (26.35)	299 (73.65)
Median years with DM
≤10	89 (27.55)	234 (72.45)	1.27(0.75–2.16)	0.368
>10	23 (23.00)	77 (77.00)
BP, mmHg
≤140/90	55 (23.81)	176 (76.19)	0.74 (0.48–1.14)	0.173
>140/90	57 (29.69)	135 (70.31)
BMI, kg/m^2
≤25	44 (26.83)	120 (73.17)	1	1
25.1–29	23 (21.90)	82 (78.10)	1.31 (0.73–2.33)	0.363
≥30	42 (30.43)	96 (69.57)	0.84 (0.51–1.38)	0.489
Glucose-lowering therapy, n (%)
Metformin alone	41 (52.56)	37 (47.44)	0.23 (0.14–0.40)	<0.005
Met + SU	34 (26.77)	93 (73.23)	0.98 (0.61–1.57)	0.929
Incretins + Met	1 (12.50)	7 (87.50)	2.56 (0.31–21.10)	0.366
Met + SU + TZD	6 (37.50)	10 (62.50)	0.59 (0.21–1.66)	1.309
Insulin alone/+ Met	27 (14.36)	161 (85.64)	3.38 (2.04–5.59)	<0.005
On statin therapy, n (%)	26 (29.21)	63 (70.79)	0.84 (0.500–1.41)	0.511
LDLC, mmol/L
≤2.6	45 (29.22)	109 (70.78)	1.26 (0.80–1.97)	0.32
>2.6	64 (24.71)	195 (75.29)
HDLC, mmol/L
<1	33 (26.61)	76 (26.39)	1.01 (0.62–1.63)	0.962
≥1	76 (26. 39)	212 (73.61)
TC, mmol/L
≤5	64 (27.95)	165 (72.05)	1.19 (0.76–1.85)	0.443
>5	45 (24.59)	138 (75.41)
TGL, mmol/L
≤1.7	65 (27.78)	169 (72.22)	1.18 (0.76–1.84)	0.466
>1.7	44 (24.58)	135 (75.42)
Non-HDLC, mmol/L
<3.4	49 (29.52)	117 (70.48)	1.29 (0.83–2.02)	0.248
≥3.4	60 (24.39)	186 (75.61)
TC/HDLC ratio
<4.5	68 (29.06)	166 (70.94)	1.37(0.87–2.15)	0.170
≥4.5	41 (23.03)	137 (76.97)
SBP, mmHg
<140	45 (21.03)	169 (78.97)	0.56 (0.36–0.88)	0.01
≥140	67 (32.06)	142 (67.94)
DBP, mmHg
<90	72 (26.37)	201 (73.63)	0.99 (0.63–1.55)	0.948
≥90	40 (26.67)	110 (73.33)

Abbreviations: OR, odds ratio; CI, confidence interval; DM, diabetes mellitus; BP, blood pressure; HT, hypertension; FH, family history; SU, sulfonylureas; Met, metformin; BMI, body mass index; HbA_1c, glycated hemoglobin; LDLC, low-density lipoprotein cholesterol; HDLC, high-density lipoprotein cholesterol; TC, total cholesterol; TGL, triglycerides; SBP, systolic blood pressure; DBP, diastolic blood pressure; TZD, thiazolidinediones.

Table 4 Independent predictors of suboptimal glycemic control on multivariable analysis

Variable	Unadjusted		Adjusted analysis
	OR (95% CI)	p-Value	OR (95% CI)	p-Value
Place of residence	1.57 (0.96–2.57)	0.067	0.64 (0.38–1.07)	0.089
Metformin monotherapy	0.23 (0.14–0.40)	0.000	0.36 (0.21–0.63)	<0.005
Insulin therapya	3.38 (2.04–5.59)	0.000	2.41 (1.41–4.12)	0.001

Note:

a Either in monotherapy or in combination with metformin.

Abbreviations: OR, odds ratio; CI, confidence interval.

LumuWKampiireLAkabwaiGPKiggunduDSKibirigeDStatin therapy reduces the likelihood of suboptimal blood pressure control among Ugandan adult diabetic patientsTher Clin Risk ManagIn press2017

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