GLYCEMIC CONTROL AND ITS DETERMINANTS IN DIABETIC-PATIENTS IN ETHIOPIA

A cross-sectional study was undertaken in which concentrations of glyc ated haemoglobins were measured in 102 diabetics seen at the outpatien t clinic in Gondar, Ethiopia, between 26 January and 7 March, 1995. Me an HbA(1) levels (standard deviations) were 5.35% (1.1) in non-diabeti c controls, 12.0% (1.5) in 59 insulin-dependent diabetics, and 11.0% ( 2.0) in 43 non-insulin dependent outpatients. The majority of insulin- dependent mellitus (IDDM) (78%) and non-insulin-dependent mellitus (NI DDM) patients (77%) were poorly controlled (HbA(1) > 10.8% in IDDM, an d > 9.7% in NIDDM, respectively). Multiple linear regression analyses revealed that HbA, levels were significantly positively associated wit h lower body mass index, duration of diabetes, a recent history of pol ydipsia, hypertension, and low income in NIDDM individuals. Whereas in IDDM patients lower age (or alternatively lower age at onset) was the only significant predictor. Whilst 49% of the model variance was expl ained by the predictors in NIDDM diabetics, only 9% were so in IDDM pa tients. Current fasting blood glucose level was marginally significant in NIDDM patients (r = 0.29; P = 0.058), but insignificant in IDDM in dividuals. This points towards the fluctuations in blood glucose level s experienced by IDDM patients in a setting where insulin supply is un reliable. It also confirms the doubts about the usefulness of fasting blood glucose values as a tool for assessing metabolic control. (C) 19 97 Elsevier Science Ireland Ltd.