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Management of adult patients with type 1 diabetes mellitus in Africa: A post-hoc cohort analysis of 12 African countries participating in the International Diabetes Management Practices Study (Wave 7)
There is a paucity of information on real world management of African adult patients with type 1 diabetes mellitus (T1DM). We aimed to describe a cohort of African adults with T1DM. The International Diabetes Management Practices Study is an observational survey conducted from 2005 to 2017. Data wer...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310899/ https://www.ncbi.nlm.nih.gov/pubmed/32569176 http://dx.doi.org/10.1097/MD.0000000000020553 |
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author | Mbanya, Jean Claude Naidoo, Poobalan Kolawole, Babatope Ayodeji Tsymbal, Ellina McMaster, Alicia Karamchand, Sumanth Kaplan, Hilton Rambiritch, Virendra Cotton, Mark Malek, Rachid Allen Distiller, Lawrence Leisegang, Rory Forseth |
author_facet | Mbanya, Jean Claude Naidoo, Poobalan Kolawole, Babatope Ayodeji Tsymbal, Ellina McMaster, Alicia Karamchand, Sumanth Kaplan, Hilton Rambiritch, Virendra Cotton, Mark Malek, Rachid Allen Distiller, Lawrence Leisegang, Rory Forseth |
author_sort | Mbanya, Jean Claude |
collection | PubMed |
description | There is a paucity of information on real world management of African adult patients with type 1 diabetes mellitus (T1DM). We aimed to describe a cohort of African adults with T1DM. The International Diabetes Management Practices Study is an observational survey conducted from 2005 to 2017. Data were collected in seven individual waves from countries in Asia, Africa, East Europe, and Latin America. Wave 7 was conducted from 2016 to 2017 and the African cohort included 12 countries. Questionnaires were administered to clinicians and patients. Analyses were mainly descriptive. Logistic regressions were performed to identify predictive factors for glycaemic control. A total of 788 patients were enrolled in the study. HbA1c values were available for 712 patients; only 16.6% had HbA1c values <7%. A total of 196 (24.9%) reported being hospitalized in the preceding year, with the most common reasons being diabetic ketoacidosis (58.1%, 93/160) and hypoglycaemia (31.1%; 52/167). Over half of the patients (55.4%) stated that the cost of test strips limited regular glycemic monitoring; a minority of patients (15%, 120/788) received structured diabetes education. Predictors of HbA1c <7% included patients receiving diabetes education (odds ratio [OR] [95% confidence interval, CI] = 2.707 [1.157–6.335] P = .022), following a healthy diet and exercise plan (OR [95% CI] = 2.253 [1.206–4.209], P < .001) and self-managing (monitoring glucose levels and adjusting insulin accordingly) (OR [95% CI] 2.508 [1.500–4.191] P < .001). African adults with T1DM have suboptimal glycemic control with almost one-quarter reporting hospitalization within the preceding year. Most patients felt comfortable with self-adjustment of insulin dose but said that the cost of test strips was the main factor that limited regular monitoring. Reducing direct costs of testing strips and insulin, and improving education will address major challenges within these settings. |
format | Online Article Text |
id | pubmed-7310899 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-73108992020-07-08 Management of adult patients with type 1 diabetes mellitus in Africa: A post-hoc cohort analysis of 12 African countries participating in the International Diabetes Management Practices Study (Wave 7) Mbanya, Jean Claude Naidoo, Poobalan Kolawole, Babatope Ayodeji Tsymbal, Ellina McMaster, Alicia Karamchand, Sumanth Kaplan, Hilton Rambiritch, Virendra Cotton, Mark Malek, Rachid Allen Distiller, Lawrence Leisegang, Rory Forseth Medicine (Baltimore) 4300 There is a paucity of information on real world management of African adult patients with type 1 diabetes mellitus (T1DM). We aimed to describe a cohort of African adults with T1DM. The International Diabetes Management Practices Study is an observational survey conducted from 2005 to 2017. Data were collected in seven individual waves from countries in Asia, Africa, East Europe, and Latin America. Wave 7 was conducted from 2016 to 2017 and the African cohort included 12 countries. Questionnaires were administered to clinicians and patients. Analyses were mainly descriptive. Logistic regressions were performed to identify predictive factors for glycaemic control. A total of 788 patients were enrolled in the study. HbA1c values were available for 712 patients; only 16.6% had HbA1c values <7%. A total of 196 (24.9%) reported being hospitalized in the preceding year, with the most common reasons being diabetic ketoacidosis (58.1%, 93/160) and hypoglycaemia (31.1%; 52/167). Over half of the patients (55.4%) stated that the cost of test strips limited regular glycemic monitoring; a minority of patients (15%, 120/788) received structured diabetes education. Predictors of HbA1c <7% included patients receiving diabetes education (odds ratio [OR] [95% confidence interval, CI] = 2.707 [1.157–6.335] P = .022), following a healthy diet and exercise plan (OR [95% CI] = 2.253 [1.206–4.209], P < .001) and self-managing (monitoring glucose levels and adjusting insulin accordingly) (OR [95% CI] 2.508 [1.500–4.191] P < .001). African adults with T1DM have suboptimal glycemic control with almost one-quarter reporting hospitalization within the preceding year. Most patients felt comfortable with self-adjustment of insulin dose but said that the cost of test strips was the main factor that limited regular monitoring. Reducing direct costs of testing strips and insulin, and improving education will address major challenges within these settings. Wolters Kluwer Health 2020-06-19 /pmc/articles/PMC7310899/ /pubmed/32569176 http://dx.doi.org/10.1097/MD.0000000000020553 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | 4300 Mbanya, Jean Claude Naidoo, Poobalan Kolawole, Babatope Ayodeji Tsymbal, Ellina McMaster, Alicia Karamchand, Sumanth Kaplan, Hilton Rambiritch, Virendra Cotton, Mark Malek, Rachid Allen Distiller, Lawrence Leisegang, Rory Forseth Management of adult patients with type 1 diabetes mellitus in Africa: A post-hoc cohort analysis of 12 African countries participating in the International Diabetes Management Practices Study (Wave 7) |
title | Management of adult patients with type 1 diabetes mellitus in Africa: A post-hoc cohort analysis of 12 African countries participating in the International Diabetes Management Practices Study (Wave 7) |
title_full | Management of adult patients with type 1 diabetes mellitus in Africa: A post-hoc cohort analysis of 12 African countries participating in the International Diabetes Management Practices Study (Wave 7) |
title_fullStr | Management of adult patients with type 1 diabetes mellitus in Africa: A post-hoc cohort analysis of 12 African countries participating in the International Diabetes Management Practices Study (Wave 7) |
title_full_unstemmed | Management of adult patients with type 1 diabetes mellitus in Africa: A post-hoc cohort analysis of 12 African countries participating in the International Diabetes Management Practices Study (Wave 7) |
title_short | Management of adult patients with type 1 diabetes mellitus in Africa: A post-hoc cohort analysis of 12 African countries participating in the International Diabetes Management Practices Study (Wave 7) |
title_sort | management of adult patients with type 1 diabetes mellitus in africa: a post-hoc cohort analysis of 12 african countries participating in the international diabetes management practices study (wave 7) |
topic | 4300 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310899/ https://www.ncbi.nlm.nih.gov/pubmed/32569176 http://dx.doi.org/10.1097/MD.0000000000020553 |
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