Poor Glycemic Control and Its Predictors Among Type 2 Diabetes Patients: Insights From a Single-Centre Retrospective Study in Ghana

Abstract

Background and Aims

The primary objective of glycemic control in individuals with diabetes mellitus is to avert or postpone complications, which ultimately leads to an improved quality of life. Nonetheless, achieving the recommended targets for glycemic control in clinical settings often proves challenging. Consequently, it is crucial to ascertain factors that affect glycemic outcomes to enhance the management of diabetes mellitus. This study sought to evaluate the levels of glycemic control and the associated factors among patients with type 2 diabetes receiving care at the Methodist Hospital, Wenchi, Ghana.

Methods

A retrospective study was conducted using an existing database. Glycemic control was evaluated by HbA1c measurements with a target of < 7% indicating good control, as per the guidelines established by the American Diabetes Association for nonpregnant adults. HbA1c levels ≥ 7% were classified as poor control. Data analysis was conducted using SPSS version 25 and multivariate logistic regression analysis was employed to determine the factors affecting glycemic control.

Results

The median HbA1c level among the participants was 7.9% (IQR: 5.8–9.9). Majority (59.3%) demonstrated poor glycemic control with HbA1c ≥ 7%. Factors associated with poor glycemic control included advanced age (AOR: 4.32, 95% CI: 0.61–11.21, p = 0.012), duration of diabetes mellitus > 10 years (AOR: 3.60, 95% CI: 1.05–9.82, p = 0.019), insulin therapy (AOR: 3.13, 95% CI: 0.55–11.01, p = 0.009) and hypertension diagnosis (AOR: 2.88, 95% CI: 0.75–5.45, p = 0.030).

Conclusions

The study indicated that a considerable proportion of individuals with diabetes exhibited inadequate glycemic control. Older age, longer duration of diabetes mellitus, insulin therapy and comorbid hypertension were significantly associated with poor glycemic control among the study population. Multidisciplinary interventions as well as customized management strategies are required to ensure effective glycemic control to prevent long-term complications of diabetes mellitus.