Suboptimal glycemic control and prevalence of diabetes-related complications in Kenyan population with diabetes: cohort analysis of the seventh wave of the International Diabetes Management Practices Study (IDMPS)

ABSTRACT Aim To identify real-life medical practices in the management of diabetes mellitus (DM) in the Kenyan population. Methods Kenyan subjects with DM were recruited as part of the 7th wave of the International Diabetes Management and Practices Study in between September and October 2016. Data on demographics; medical history; glycemic control; concomitant anti-diabetic therapy; and hypoglycemic episodes were analyzed using descriptive statistics. Results Analysis of subjects with type 2 DM (T2DM), representing 96.7% (n/N: 187/194) of evaluable subjects, is presented. Target HbA1c achievement rate and average HbA1c at last measurement were 36.6% (n/N: 68/187) and 8.2% (66 mmol/mol), respectively. Microvascular complications were prevalent in 35.3% (n=65) of subjects, most frequently as neuropathy (n=41, 21.5%) and microalbuminuria (n=27, 14.1%). Most common comorbidities were dyslipidemia (n=125, 73.5%) and hypertension (n=123, 65.8%). Oral antidiabetic drugs, either alone (n=120, 64.2%) or in combination with insulin (n=48, 25.7%), were the preferred treatment. Inability in reaching glycemic targets in insulinized subjects were mostly attributed to lack of appropriate dose titration and lack of experience in management of dose. Conclusion The achievement of glycemic target in Kenyan subjects with T2DM is suboptimal. Further investigations are required to formulate effective health policies to improve rates of glycemic target attainment in Kenya.