Glycaemic control among patients with type 2 diabetes followed in a rural African primary care setting - A reality check in the Democratic Republic of Congo

Aims: The aim of this study was to assess diabetes control in adult patients with type II diabetes and to evaluate its association with socio-economic characteristics in rural the Democratic Republic Congo (DRC). Methods: We recruited patients >= 18 years in care for type II diabetes in a hospital in rural DRC. Socio-economic status, medical history and diabetes control were assessed through a structured questionnaire, a physical examination and laboratory tests, such as fasting glucose, HbA1c, serum creatinine and urine analysis. Uni- and multivariate logistic regression was used to assess for patient factors associated with diabetes control. Results: 319 diabetic patients (212 men, 107 women) were enrolled. The target threshold of HbA1c level at 7.0% or below was met by 17.8% (19/107) of female and 12.3% (26/212) of male patients. The fasting plasma glucose level was <7.0 mmol/l in 28.9% (31/107) and 36.3% (77/212) of women and men, respectively. Among participants with a fasting glucose <7.0 mmol/l only 32.4% (35/108) had an HbA1c at 7.0% or below. None of the assessed socioeconomic or lifestyle factors were predictive of diabetes control. Conclusions: In this study among diabetic patients in care at a rural hospital in DRC, less than one out of five had an HbA1c <7.0%. Fasting plasma glucose at study visit had poor correlation with HbA1c, only a third of patients with a fasting glucose level <7 mmol/l had an HbA1c <7.0%. (C) 2019 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.