ArticleJournal of diabetes and metabolic disorders2019
Appropriateness of insulin commencement and adequacy of glycemic control among ambulatory patients with type 2 diabetes in Ethiopia.
Article in Journal of diabetes and metabolic disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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3 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Prevalence of Glycemic Control and Factors Associated With Poor Glycemic Control: A Systematic Review and Meta-analysis.Inquiry : a journal of medical care organization, provision and financingPooled it
- Physical activity can improve diabetes patients' glucose control; A systematic review and meta-analysis.Heliyon · 2022Review
- Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis.Diabetology & metabolic syndrome · 2022Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKnowing when to start insulin is central to optimal management of Type 2 diabetes mellitus (T2DM) but a real clinical challenge. Poor glycemic control is critical for development of the deadly diabetic complications.
objectiveThe aim of the study was to assess the appropriateness of insulin commencement, adequacy of glycemic control and associated factors among patients with T2DM. SETTINGS: The study was conducted at three public hospitals in Southwest Ethiopia.
methodsCross sectional study was conducted using structured questionnaire and data abstraction format. All patients with T2DM who were available during the data collection period and fulfilling study criteria were included.
main outcome measureMultivariable binary logistic regression analysis was done for identifying factors associated with poor glycemic control by taking statistical significance at
resultsOne hundred sixty nine patient data was considered for analysis. Insulin was initiated in 28 patients, but only 10(35.7%) insulin commencements were appropriate. More than two third (70.4%) of the studied population had poor glycemic control. Addition of second antidiabetic medication (Adjusted Odds Ratio (AOR) = 2.5, 95% CI = 1.3-6.2) and living in urban areas (AOR = 2.5, 95% CI = 1.1-5.7) were associated with poor glycemic control while having regular diabetic care follow up of every >1 month (AOR = 0.4, 95% CI = 0.2-0.9) was negatively associated with poor glycemic control.
conclusionsAbout two third of insulin commencements were inappropriate and majority of patients could not stay on optimal glycemic control. Addition of second antidiabetic medication and living in urban areas were found to be associated with poor glycemic control. IMPACT OF FINDINGS ON PRACTICE STATEMENTS: • Initiation of insulin before optimization of oral agents increase cost of care.• Proper titration of the first oral agent is important prior to adding other antidiabetic agents.• Emphasis should be given to improve glycemic control, and hence halt subsequent complications.
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