Glycaemic control and its determinants in diabetic patients in Ethiopia

• Published in: Diabetes research and clinical practice Vol. 35; no. 2; pp. 129 - 134
• Main Authors: Gebre-Yohannes, Asfawesen, Rahlenbeck, Sibylle I.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.03.1997; Elsevier Science
• Subjects: Adult; Africa; Aged; Biological and medical sciences; Cross-Sectional Studies; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - physiopathology; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Ethiopia; Female; Glycated Hemoglobin A - analysis; Glycated Hemoglobin A - classification; HbA 1; Humans; Insulin-dependent mellitus; Linear Models; Male; Management. Various non-drug treatments. Langerhans islet grafts; Medical sciences; Metabolic control; Middle Aged; Non-insulin-dependent mellitus; Prospective Studies; Surveys and Questionnaires; Ethiopia; Africa; Insulin-dependent mellitus; HbA 1; Metabolic control; Non-insulin-dependent mellitus; Africa; Endocrinopathy; Assay; Human; Immunopathology; Surveillance; Check; Insulin dependent diabetes; Autoimmune disease; Concentration; Hemoglobin A1; Non insulin dependent diabetes; Glycemia
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/S0168-8227(96)01367-8

A cross-sectional study was undertaken in which concentrations of glycated haemoglobins were measured in 102 diabetics seen at the outpatient clinic in Gondar, Ethiopia, between 26 January and 7 March, 1995. Mean HbA 1 levels (standard deviations) were 5.35% (1.1) in non-diabetic controls, 12.0% (1.5) in 59 insulin-dependent diabetics, and 11.0% (2.0) in 43 non-insulin dependent outpatients. The majority of insulin-dependent mellitus (IDDM) (78%) and non-insulin-dependent mellitus (NIDDM) patients (77%) were poorly controlled (HbA 1 > 10.8% in IDDM, and > 9.7% in NIDDM, respectively). Multiple linear regression analyses revealed that HbA 1 levels were significantly positively associated with lower body mass index, duration of diabetes, a recent history of polydipsia, hypertension, and low income in NIDDM individuals. Whereas in IDDM patients lower age (or alternatively lower age at onset) was the only significant predictor. Whilst 49% of the model variance was explained by the predictors in NIDDM diabetics, only 9% were so in IDDM patients. Current fasting blood glucose level was marginally significant in NIDDM patients ( r = 0.29; P = 0.058), but insignificant in IDDM individuals. This points towards the fluctuations in blood glucose levels experienced by IDDM patients in a setting where insulin supply is unreliable. It also confirms the doubts about the usefulness of fasting blood glucose values as a tool for assessing metabolic control.