Type 2 diabetes control and complications in specialised diabetes care centres of six sub-Saharan African countries: the Diabcare Africa study

Abstract

Aim: The Diabcare Africa project was carried out across six sub-Saharan African countries to collect standardised and comparable information for the evaluation of diabetes control, management and late complications in diabetic populations at specialist clinics.

Methods: A cross-sectional, descriptive study of 2352 type-2 diabetes patients who were treated at specialist clinics for at least 12 months prior to the study.

Results: The mean age of patients was 53.0±16.0 years and had 8.0±6.0 years known duration of diabetes. 47% had their HbA1c assessed in the past year (mean 8.2±2.4%) with 29% achieving a level <6.5%. 21% had BP within 130/80 mmHg and 65% were treated for hypertension. Fasting lipids were assessed in 45% of the patients with mean cholesterol level of 4.9±1.2 mmol/L, HDL-cholesterol of 1.3±0.7 mmol/L and triglycerides of 1.2±0.7 mmol/L. 13% of the patients were treated for hyperlipidaemia, mostly with statins. Background retinopathy (18%) and cataract (14%) were the most common eye complications. Macrovascular disease was rare, and 48% had neuropathy.

Conclusions: Half of the patients benefitted from standard care, and a third had appropriate glycaemic control - attributed to access to, rather than quality of care. This study provided evidence to support appropriate interventions to diabetic populations of sub-Saharan origin.