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Identification of predictors of glucose control in a cohort of adult patients with diabetes mellitus at Kalafong Hospital

Dissertation (MSc)--University of Pretoria, 2011.

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Other Authors: Rheeder, Paul
Format: Thesis
Published: University of Pretoria 2013
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access_status_str Open Access
author2 Rheeder, Paul
author_browse Rheeder, Paul
author_facet Rheeder, Paul
collection Thesis
dc_rights_str_mv © 2011, University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria.
description Dissertation (MSc)--University of Pretoria, 2011.
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institution University of Pretoria (South Africa)
last_indexed 2026-06-10T12:37:16.787Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository
publishDate 2013
publishDateRange 2013
publishDateSort 2013
publisher University of Pretoria
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spelling oai:repository.up.ac.za:2263/26125 Identification of predictors of glucose control in a cohort of adult patients with diabetes mellitus at Kalafong Hospital Rheeder, Paul tessy.dr@gmail.com Mutembe, Tessy Karimba Diabetes mellitus Diabetic patients Pretoria Kalafong hospital Blood glocose control UCTD Dissertation (MSc)--University of Pretoria, 2011. Background and objectives of the study: Although it is known that good glycaemic control improves microvascular outcomes in diabetic patients, no local study has yet been undertaken to investigate the potential factors that influence poor or good blood glucose control. This research focused on the evaluation of blood glucose control as assessed by glycosylated haemoglobin (HbA1c) levels in diabetic patients. In addition, certain determinants which contributed toward poor control at Kalafong Hospital were studied in a cohort of adults with diabetes mellitus for the year 2008. The aim of studying these determinants was to identify patients with a high risk of disease morbidity and barriers that prevent these patients from meeting their goals of improved health outcomes. The specific objectives were to estimate HbA1c control of patients seen at the diabetic clinic at Kalafong Hospital Pretoria in 2008 and to assess any existing association between patient demographic characteristics and diabetes characteristics with HbA1c. Methods: The study was a retrospective cohort study. All diabetic patients aged 18 years and above, who had been registered in the 2008 dataset and who had come for at least one visit to the diabetic clinic and had at least one HbA1C measurement, were included in the study. Patients who did not meet the above criteria were excluded from the study. A total of 942 patients seen in 2008 were selected, 801 patients met these inclusion criteria. The outcome variable HbA1c was obtained by computing the mean of the two HbA1c values collected for each participant for the year 2008, and used as a continuous dependent variable in multivariate linear regression. For descriptive purposes, HbA1c values were categorised into good control (<7%), poor control (> or = 7&< or =10%) and very poor control (>10%). Data analysis was performed using Stata version 10. Statistical significance was established at a threshold of 95% (p < 0.05). Results: More than half of participants in the study were females (60.8%/39.2%). The mean age of participants in the study was 56 years (sd 14.1). With regard to race, the proportion of blacks was more than three quarters of the sample (93.1%/2.4%/2.4%). Our results showed that HbA1c level decreased with increasing age, (p = 0.016). These results also showed that for every 1 mmol/l increase in total cholesterol, there was a 0.178% increase in HbA1c, (p = 0.019; 95% confidence interval (CI): 0.030 - 0.327), suggesting that higher cholesterol was associated with poorer HbA1c control. In addition, for every 1 mmol/l increase in capillary glucose, the HbA1c increased by 0.276%, (p = 0.000; CI: 0.230 - 0.322) while for every one unit increase in BMI, the HbA1c reduced by 0.032%, (p = 0.017; CI: -0.057 to -0.006). Conclusion: These results suggest that patients with higher total cholesterol and patients with higher capillary glucose level are more likely to exhibit poorer HbA1c control, whereas, older patients and patients with a higher BMI are more likely to have better HbA1c control. Clinical Epidemiology unrestricted 2013-09-07T02:40:43Z 2011-07-14 2013-09-07T02:40:43Z 2011-04-08 2011-07-14 2011-07-08 Dissertation Mutembe, TK 2011, Identification of predictors of glucose control in a cohort of adult patients with diabetes mellitus at Kalafong Hospital, MSc dissertation, University of Pretoria, Pretoria, viewed yymmdd < http://hdl.handle.net/2263/26125 > E11/306/gm http://hdl.handle.net/2263/26125 http://upetd.up.ac.za/thesis/available/etd-07082011-112042/ © 2011, University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria
spellingShingle Diabetes mellitus
Diabetic patients
Pretoria
Kalafong hospital
Blood glocose control
UCTD
Identification of predictors of glucose control in a cohort of adult patients with diabetes mellitus at Kalafong Hospital
title Identification of predictors of glucose control in a cohort of adult patients with diabetes mellitus at Kalafong Hospital
title_full Identification of predictors of glucose control in a cohort of adult patients with diabetes mellitus at Kalafong Hospital
title_fullStr Identification of predictors of glucose control in a cohort of adult patients with diabetes mellitus at Kalafong Hospital
title_full_unstemmed Identification of predictors of glucose control in a cohort of adult patients with diabetes mellitus at Kalafong Hospital
title_short Identification of predictors of glucose control in a cohort of adult patients with diabetes mellitus at Kalafong Hospital
title_sort identification of predictors of glucose control in a cohort of adult patients with diabetes mellitus at kalafong hospital
topic Diabetes mellitus
Diabetic patients
Pretoria
Kalafong hospital
Blood glocose control
UCTD
url http://hdl.handle.net/2263/26125
http://upetd.up.ac.za/thesis/available/etd-07082011-112042/