Glycaemic control and associated factors among patients living with type 2 diabetes in Kinshasa, Democratic Republic of the Congo: a Cross-sectional study

ObjectivesTo assess the prevalence and factors associated with glycaemic control to inform potential interventions to improve glycaemic control in Kinshasa, Democratic Republic of the Congo. DesignThis was a cross-sectional study conducted between November 2011-September 2022. We conducted the selection of the participants through a two-stage sampling process. Participants were asked to complete a structured questionnaire and to provide two millilitres of blood for Hb1AC assay. We performed univariate and multivariable logistic regressions to identify factors associated with poor glycaemic control. SettingA total of 20 randomly selected primary care facilities in Kinshasa, Democratic Republic of the Congo. ParticipantsThe sample included 620 patients living with type 2 diabetes with a median age of 60 (IQR=53.5-69) years. ResultsMost of the study participants were female (66.1%), unemployed (67.8%), having income below the poverty line (76.4%), and without health insurance (92.1%). Two-thirds of the participants (420; 67.6%) had poor glycaemic control. Those participants having taken only insulin (AOR=1.64, 95%CI 1.10 to 2.45) and those on a treatment duration [≥]7 years (AOR=1.45, 95%CI 1.01 to 2.08) were associated with increased odds of poor glycaemic control, while being overweight (AOR= 0.47, 95%CI 0.26 to 0.85) and those with uncontrolled blood pressure (AOR=0.65, 95% CI 0.48 to 0.90) were protective for poor glycaemic control. ConclusionsThis study confirms that poor glycaemic control is common among patients living with type 2 diabetes in Kinshasa, DRC. There is a need for targeted interventions to improve glycaemic control, including metabolic and clinical comorbidity control, lifestyle modifications, and health system factors. SIGNIFICANCE OF THE STUDYO_ST_ABSWhat is already known on this topicC_ST_ABSO_LIGlycaemic control is poor in most of the SSA settings, with glycaemic control ranging from 10-60%. C_LIO_LIFactors associated with glycaemic control are context specific; in the Democratic Republic of the Congo, few studies have investigated poor glycaemic control. C_LI What this study addsO_LIThe extent of poor glycaemic control among patients living with type 2 diabetes is determined in Kinshasa, Democratic Republic of the Congo. C_LIO_LIIdentification of factors associated with poor glycaemic control in Kinshasa: taking only insulin and having a treatment duration [≥]7 years increased the likelihood of poor glycaemic control, while being overweight and having uncontrolled blood pressure were protective. C_LI How this study might affect research, practice or policyO_LIThe study findings will inform potential interventions to improve glycaemic control in Kinshasa, DRC or similar settings elsewhere. C_LI