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Prevalence and risk factors of poor glycemic control and diabetic nephropathy among patients with type 2 diabetes mellitus in Dhamar, Yemen

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Abstract

Background

Glycemic control is a significant step in reducing diabetic complications. The purpose of this study was to determine the prevalence and risk factors for poor glycemic control and diabetic nephropathy in patients with type 2 diabetes mellitus (T2DM) in Dhamar, Yemen.

Methods

A study was carried out in which 200 patients with type 2 diabetes were recruited from the outpatient departments of Dhamar General Hospital. Information on their sociodemographic and clinical factors were collected. Blood and urine samples were taken following an overnight fast. Automated instruments were utilized to evaluate HbA1c, microalbuminuria, creatinine, and fasting blood sugar (FBS) using standardized procedures.

Results

This study revealed that 58% of people with diabetes have poor glycemic control, while 14% have fair glycemic control. Multivariate logistic analysis showed that combined antihyperglycaemic drugs (oral tablet + insulin) [adjusted odds ratio (AOR) = 3.77; %CI = 1.36- 10.44], poor diet adherence (AOR = 1.97; %CI = 1.03–3.77) and lack of education (2.34; %CI = 0.93–5.90) were potential risk factors for poor glycemic control. The prevalence of diabetic nephropathy was 32%. It was found that age over 50 years (AOR = 2.37; %CI = 1.15–4.90), hypertension (AOR = 3.22; %CI = 1.39–7.47), uncontrolled blood glucose (AOR = 2.67; %CI = 1.16–6.16), the duration of diabetes of 5 years or more (AOR = 1.78; %CI = 1.05–3.00), and a lack of education (AOR = 1.90; %CI = 1.16–3.11) were risk factors for diabetic nephropathy.

Conclusion

The prevalence of uncontrolled glycemic status and diabetic nephropathy is significantly high among Yemeni T2DM patients in Dhamar, which may contribute to an increasing prevalence of complications and thus pose extra challenges to the poor health care services in Yemen.

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References

  1. International Diabetes Federation. IDF Diabetes Atlas, 10th edn. Brussels, Belgium: 2021. Available at: https://www.diabetesatlas.org.

  2. Shrivastava SR, Shrivastava PS, Ramasamy J. Role of self-care in management of diabetes mellitus. J Diabetes Metab Disord. 2013;12(1):14. https://doi.org/10.1186/2251-6581-12-14.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cavallari I, Bhatt DL, Steg PG, Leiter LA, McGuire DK, Mosenzon O, et al. Causes and Risk Factors for Death in Diabetes: A Competing-Risk Analysis From the SAVOR-TIMI 53 Trial. J Am Coll Cardiol. 2021;77(14):1837–40. https://doi.org/10.1016/j.jacc.2021.02.030.

    Article  PubMed  Google Scholar 

  4. Roy A, Maiti A, Sinha A, Baidya A, Basu AK, Sarkar D, et al. kidney disease in Type 2 Diabetes Mellitus and Benefits of Sodium-Glucose Cotransporter 2 Inhibitors: A Consensus Statement. Diabetes Ther. 2020;11(12):2791–827. https://doi.org/10.1007/s13300-020-00921-y.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Glycemic targets: Standards of Medical Care in Diabetes— 2020. American Diabetes Association. Diabetes Care. 2020;43(Suppl. 1):S66–76.

    Google Scholar 

  6. Standards of medical care in diabetes--2014. American Diabetes Association. Diabetes Care. 2014;37(Suppl 1):S14-80. https://doi.org/10.2337/dc14-S014. PMID: 24357209.

    Article  Google Scholar 

  7. Eckel RH, Kahn SE, Ferrannini E, Goldfine AB, Nathan DM, Schwartz MW, et al. Obesity and type 2 diabetes: what can be unified and what needs to be individualized? J Clin Endocrinol Metab. 2011;96(6):1654–63. https://doi.org/10.1210/jc.2011-0585.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Harrabi I, Harbi F, Ghamdi S. Predictors of Glycemic Control among Patients with Type 2 Diabetes in Najran Armed Forces Hospital: A Pilot Study. Journal of Diabetes Mellitus. 2014;4(2):141–7. https://doi.org/10.4236/jdm.2014.42021.

    Article  CAS  Google Scholar 

  9. Alsulaiman TA, Al-Ajmi HA, Al-Qahtani SM, Fadlallah IM, Nawar NE, Shukerallah RE, et al. Control of type 2 diabetes in King Abdulaziz Housing City (Iskan) population. Saudi Arabia J Family Community Med. 2016;23(1):1–5. https://doi.org/10.4103/2230-8229.172221.

    Article  PubMed  Google Scholar 

  10. Blonde L, Aschner P, Bailey C, Ji L, Leiter LA, Matthaei S. Global Partnership for Effective Diabetes Management. Gaps and barriers in the control of blood glucose in people with type 2 diabetes. Diab Vasc Dis Res. 2017;14(3):172–83. https://doi.org/10.1177/1479164116679775.

    Article  PubMed  Google Scholar 

  11. Bi Y, Zhu D, Cheng J, Zhu Y, Xu N, Cui S, et al. The status of glycemic control: a cross-sectional study of outpatients with type 2 diabetes mellitus across primary, secondary, and tertiary hospitals in the Jiangsu province of China. Clin Ther. 2010;32(5):973–83. https://doi.org/10.1016/j.clinthera.2010.05.002.

    Article  PubMed  Google Scholar 

  12. Alzaheb RA, Altemani AH. The prevalence and determinants of poor glycemic control among adults with type 2 diabetes mellitus in Saudi Arabia. Diabetes Metab Syndr Obes. 2018;11:15–21. https://doi.org/10.2147/DMSO.S156214.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Al Balushi KA, Al-Haddabi M, Al-Zakwani I, Al Za’abi M. Glycemic control among patients with type 2 diabetes at a primary health care center in Oman. Primary care diabetes. 2014;8(3):239–43. https://doi.org/10.1016/j.pcd.2014.01.003.

    Article  PubMed  Google Scholar 

  14. Al-Kaabi J, Al-Maskari F, Saadi H, Afandi B, Parkar H, Nagelkerke N. Assessment of dietary practice among diabetic patients in the United arab emirates. Rev Diabet Stud. 2008;5(2):110–5. https://doi.org/10.1900/RDS.2008.5.110.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Khattab M, Khader YS, Al-Khawaldeh A, Ajlouni K. Factors associated with poor glycemic control among patients with type 2 diabetes. J Diabetes Complications. 2010;24(2):84–9. https://doi.org/10.1016/j.jdiacomp.2008.12.008.

    Article  PubMed  Google Scholar 

  16. Chetoui A, Kaoutar K, Elmoussaoui S, Boutahar K, El Kardoudi A, Chigr F, Najimi M. Prevalence and determinants of poor glycemic control: a cross-sectional study among Moroccan type 2 diabetes patients. Int Health. 2022;14(4):390–7. https://doi.org/10.1093/inthealth/ihz107. PMID:31957782;PMCID:PMC9248056.

  17. Szőke D, Braga F, Valente C, Panteghini M. Measurement imprecision of common urinary biochemical analytes on the Roche Cobas 6000 system. Clin Chem Lab Med. 2013;51(8):e175-177. https://doi.org/10.1515/cclm-2012-0809.

    Article  CAS  PubMed  Google Scholar 

  18. Knapp ML, Hadid O. Investigations into negative interference by jaundiced plasma in kinetic Jaffé methods for plasma creatinine determination. Ann Clin Biochem. 1987;24(Pt 1):85–97. https://doi.org/10.1177/000456328702400114.

    Article  CAS  PubMed  Google Scholar 

  19. Purnell JQ. Definitions, Classification, and Epidemiology of Obesity. [Updated 2023 May 4]. In: Feingold KR, Anawalt B, Blackman MR, editors. Endotext. South Dartmouth (MA): MDText.com, Inc; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279167/.

    Google Scholar 

  20. Lin CC, Liu CS, Li TC, Chen CC, Li CI, Lin WY. Microalbuminuria and the metabolic syndrome and its components in the Chinese population. Eur J Clin Invest. 2007;37(10):783–90.

    Article  CAS  PubMed  Google Scholar 

  21. Flack JM, Adekola B. Blood pressure and the new ACC/AHA hypertension guidelines. Trends Cardiovasc Med. 2020;30(3):160–4.

    Article  PubMed  Google Scholar 

  22. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451–62. https://doi.org/10.1136/bjsports-2020-102955. PMID:33239350;PMCID:PMC7719906.

    Article  PubMed  Google Scholar 

  23. Afroz A, Ali L, Karim MN, Alramadan MJ, Alam K, Magliano DJ, et al. Glycemic Control for People with Type 2 Diabetes Mellitus in Bangladesh - An urgent need for optimization of management plan. Sci Rep. 2019;9(1):10248.

  24. Ho-Pham LT, Nguyen UDT, Tran TX, Nguyen TV. Discordance in the diagnosis of diabetes: Comparison between HbA1c and fasting plasma glucose. PLoS ONE. 2017;12(8):e0182192. https://doi.org/10.1371/journal.pone.0182192.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Ulf S, Ragnar H, Arne WP, Johnny L. Do high blood glucose peaks contribute to higher HbA1c? Results from repeated continuous glucose measurements in children. World J Pediatr. 2008;4(3):215–21.

    Article  PubMed  Google Scholar 

  26. Siddiqui FJ, Avan BI, Mahmud S, Nanan DJ, Jabbar A, Assam PN. Uncontrolled diabetes mellitus: prevalence and risk factors among people with type 2 diabetes mellitus in an Urban District of Karachi. Pakistan Diabetes Res Clin Pract. 2015;107(1):148–56.

    Article  PubMed  Google Scholar 

  27. Al-Sharafi BA, Gunaid AA. Effect of Habitual Khat Chewing on Glycemic Control, Body Mass Index, and Age at Diagnosis of Diabetes in Patients with Type 2 Diabetes Mellitus in Yemen. Clin Med Insights Endocrinol Diabetes. 2015;8:47–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Al-Salman RA, Al-Basri HA, Al-Sayyad AS, Hearnshaw HM. Prevalence and risk factors of albuminuria in Type 2 diabetes in Bahrain. J Endocrinol Invest. 2009;32(9):746–51. https://doi.org/10.1007/BF03346530.

    Article  CAS  PubMed  Google Scholar 

  29. Al-Adsani A. Risk factors associated with albuminuria in Kuwaiti adults with type 2 diabetes. Saudi J Kidney Dis Transpl. 2012;23(4):860–5.

    Article  PubMed  Google Scholar 

  30. Farahat TM, Elsaeed GK, Gazareen SS, Elsayed TI. Prevalence of proteinuria among type 2 diabetic patients in Menoufia governorate. Egypt Menoufia Med J. 2014;27:363–71.

    Article  Google Scholar 

  31. Afkhami-Ardekani M, Modarresi M, Amirchaghmaghi E. Prevalence of microalbuminuria and its risk factors in type 2 diabetic patients. Indian J Nephrol. 2008;18(3):112–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Wu AY, Kong NC, de Leon FA, Pan CY, Tai TY, Yeung VT, et al. An alarmingly high prevalence of diabetic nephropathy in Asian type 2 diabetic patients: the MicroAlbuminuria Prevalence (MAP) Study. Diabetologia. 2005;48(1):17–26.

    Article  CAS  PubMed  Google Scholar 

  33. Aldukhayel A. Prevalence of diabetic nephropathy among Type 2 diabetic patients in some of the Arab countries. Int J Health Sci (Qassim). 2017;11(1):1–4 PMID: 28293155; PMCID: PMC5327670.

    PubMed  Google Scholar 

  34. Mogensen CE, Neldam S, Tikkanen I, Oren S, Viskoper R, Watts RW, et al. Randomised controlled trial of dual blockade of renin-angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: the candesartan and lisinopril microalbuminuria (CALM) study. BMJ. 2000;321(7274):1440–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Levin SR, Coburn JW, Abraira C, Henderson WG, Colwell JA, Emanuele NV, et al. Effect of intensive glycemic control on microalbuminuria in type 2 diabetes. Veterans Affairs Cooperative Study on Glycemic Control and Complications in Type 2 Diabetes Feasibility Trial Investigators. Diabetes Care. 2000;23(10):1478–85.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

Our heartfelt gratitude goes to all study participants, physicians, nurses, and clinical laboratory scientists working at Dhamar General Hospital Commission. Our special thanks go to the Department of Medical Biochemistry, Faculty of Medicine, and Department of Biological Sciences at Thamar University. This work has received no funding from any funding organizations.

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Authors and Affiliations

  1. Department of Medical Biochemistry Faculty of Medicine, Thamar University, Dean of Faculty of Medical Sciences, Al-Saeeda University, Dhamar, Yemen

    Abdulqawi Ali Al-Shammakh

  2. Department of Biology, Faculty of Applied Sciences, Thamar University, Dhamar, Yemen

    Abdul Haleem Salem Al-Tamimi & Qaid Taher Qaid Robed

  3. Department of Medical Laboratory, Institute of Continuous Education, Albaydha University, Al Bayda, Yemen

    Faheem Qaid Al-Mojahid

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  1. Abdulqawi Ali Al-Shammakh
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Contributions

Abdulqawi A Al- Shammakh, Abdul Haleem S Al-Tamimi and Qaid T Qaid designed the study and planned the experiments. Abdulqawi A Al- Shammakh analysed the data, explained the results and wrote the manuscript. Abdul Haleem S Al-Tamimi contributed in the discussion of the results. Qaid T Qaid, Faheem Q Al-Mojahid performed the laboratory tests. All authors reviewed the results and approved the final version of the manuscript.

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Correspondence to Abdulqawi Ali Al-Shammakh.

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All eligible patients were given a written informed consent form to sign. The study was approved by the ethical committee of Thamar University.

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Al-Shammakh, A.A., Al-Tamimi, A.S., Robed, Q. et al. Prevalence and risk factors of poor glycemic control and diabetic nephropathy among patients with type 2 diabetes mellitus in Dhamar, Yemen. Int J Diabetes Dev Ctries (2024). https://doi.org/10.1007/s13410-024-01356-y

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