DOI: 10.4103/ijhas.ijhas_15_25 ISSN: 2278-4292

Poor glycemic control among type II diabetes adult patients in Ethiopia: A systematic review

Endawoke Amsalu Alemayue, Dagim Jirata, Sitotaw Aklil Mekonnen
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BACKGROUND:

The growing burden of diabetes mellitus (DM), specifically among type II patients, is rising globally, regionally, and locally in many African countries, including Ethiopia. Hence, it is crucial to figure out the level of glycemic control, understand the contributing factors, and develop a framework to existing guidelines and systems in Ethiopia. This systematic review aimed to determine the prevalence and factors associated with glycemic control in Ethiopia.

METHODS:

PubMed, Google Scholar, Semantic Scholar, and Science Direct databases were used. All observational studies with eligibility criteria; 1) Only type II DM patients only (2) in adult patients, (3) reported the prevalence of glycemic control. (4) Studies conducted in Ethiopia from 2018 to 2023, and (4) only cross-sectional studies. Narrative review, studies conducted in type I patients and children, qualitative systematic reviews, and outside Ethiopia were excluded. Critical appraisal tool used to assess the quality of studies. Egger’s test and I 2 statistical analysis were used to check publication bias and heterogeneity of studies, respectively. Subgroup analysis across regions and sensitivity test were also conducted. All analysis was done using STATA v-17 software. International Prospective Register of Systematic Reviews (PROSPERO) registered this study with registration number CRD42023472999.

RESULTS:

A total of 26 studies, involving 9927 participants, were included. The pooled prevalence of poor glycemic control was 38% (95% confidence interval: 33%–44%). The prevalence ranged from 34% to 51% in Ethiopia. The glycemic level using glycated hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) was 38% and 39%, respectively. There is a significant change in glycemic control rate by year in the meta-regression. Factors associated with glycemic control were sociodemographic factors (age, sex, and residence), lifestyle factors (smoking, dietary practice, and physical activity), treatment-related factors, and clinical factors (presence of comorbidity/complications, diet adherence, duration of the disease, and physical activity).

CONCLUSION:

Poor glycemic control is prevalent among adult diabetes patients with type II in Ethiopia and poses a significant public health challenge. The existing healthcare system needs change in Ethiopia, warranting effective financing, design, and implementation of effective glycemic control strategies and enables the identification of effective interventions by considering associated factors.

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