Abere Woretaw Azagew, Chilot Kassa Mekonnen, Mark Lambie, Thomas Shepherd, Opeyemi O Babatunde
{"title":"Poor glycemic control and its predictors among people living with diabetes in low- and middle-income countries: a systematic review and meta-analysis.","authors":"Abere Woretaw Azagew, Chilot Kassa Mekonnen, Mark Lambie, Thomas Shepherd, Opeyemi O Babatunde","doi":"10.1186/s12889-025-21828-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Variability in blood glucose remains a challenge in diabetic management. Therefore, this review aimed to estimate the overall poor glycemic control and identify its predictors among people living with diabetes in low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>The authors searched articles in PubMed, Embase, OVID, CINAHL Plus, Cochrane Library, PsychInfo, Google, and Google Scholar. The search results were exported to the Rayyan software to check their eligibility. The Newcastle-Ottawa scale was used to assess the study quality. Stata version 17 was used for analysis. A random effect model was computed. Heterogeneity was assessed by the Cochrane Q test and I-squared (I<sup>2</sup>). The funnel plot asymmetry test and/or Egger's regression test (p < 0.05) were used to detect the publication bias. Then it was treated by the trim and fill analysis. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the reference number CRD42023430175.</p><p><strong>Results: </strong>In total, forty-nine articles were used. Of which forty-five articles with 15,981 participants were used for pooled prevalence estimation. The pooled prevalence of poor glycemic control among people living with diabetes in LMICs was found to be 69.06% (95% CI: 65.66-72.46), I<sup>2</sup> = 96.1%, p < 0.001). Alcohol intake (AOR = 2.07: 95% CI: 1.27-3.36), poor adherence to dietary recommendations (AOR = 3.16, 95% CI: 1.13-8.85), poor adherence to anti-diabetic medication (AOR = 2.85, 95% CI: 1.04 -7.85), diabetic complications (AOR = 1.37, 95% CI: 1.00-1.88), and co-morbid conditions (AOR = 1.98, 95% CI: 1.28-30.07) were found to be predictors of poor glycemic control.</p><p><strong>Conclusions: </strong>The pooled prevalence of poor glycemic control was significantly high in LMICs. Drinking alcohol, poor adherence to dietary recommendations, poor adherence to anti-diabetic medication, diabetes complications, and co-morbid conditions were found to be the determinants of poor glycemic control among people living with diabetes. Tight glycemic control strategies have been implemented to achieve optimal blood glucose. Further research on the regional and contextual factors influencing glycemic control would be recommended.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"714"},"PeriodicalIF":3.5000,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Public Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12889-025-21828-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Variability in blood glucose remains a challenge in diabetic management. Therefore, this review aimed to estimate the overall poor glycemic control and identify its predictors among people living with diabetes in low- and middle-income countries (LMICs).
Methods: The authors searched articles in PubMed, Embase, OVID, CINAHL Plus, Cochrane Library, PsychInfo, Google, and Google Scholar. The search results were exported to the Rayyan software to check their eligibility. The Newcastle-Ottawa scale was used to assess the study quality. Stata version 17 was used for analysis. A random effect model was computed. Heterogeneity was assessed by the Cochrane Q test and I-squared (I2). The funnel plot asymmetry test and/or Egger's regression test (p < 0.05) were used to detect the publication bias. Then it was treated by the trim and fill analysis. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the reference number CRD42023430175.
Results: In total, forty-nine articles were used. Of which forty-five articles with 15,981 participants were used for pooled prevalence estimation. The pooled prevalence of poor glycemic control among people living with diabetes in LMICs was found to be 69.06% (95% CI: 65.66-72.46), I2 = 96.1%, p < 0.001). Alcohol intake (AOR = 2.07: 95% CI: 1.27-3.36), poor adherence to dietary recommendations (AOR = 3.16, 95% CI: 1.13-8.85), poor adherence to anti-diabetic medication (AOR = 2.85, 95% CI: 1.04 -7.85), diabetic complications (AOR = 1.37, 95% CI: 1.00-1.88), and co-morbid conditions (AOR = 1.98, 95% CI: 1.28-30.07) were found to be predictors of poor glycemic control.
Conclusions: The pooled prevalence of poor glycemic control was significantly high in LMICs. Drinking alcohol, poor adherence to dietary recommendations, poor adherence to anti-diabetic medication, diabetes complications, and co-morbid conditions were found to be the determinants of poor glycemic control among people living with diabetes. Tight glycemic control strategies have been implemented to achieve optimal blood glucose. Further research on the regional and contextual factors influencing glycemic control would be recommended.
期刊介绍：
BMC Public Health is an open access, peer-reviewed journal that considers articles on the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
