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

ABSTRACT Objectives To assess the prevalence and factors associated with glycaemic control to inform potential interventions to improve glycaemic control in Kinshasa, Democratic Republic of the Congo. Design This 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. Setting A total of 20 randomly selected primary care facilities in Kinshasa, Democratic Republic of the Congo. Participants The sample included 620 patients living with type 2 diabetes with a median age of 60 (IQR=53.5-69) years. Results Most 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. Conclusions This 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 STUDY What is already known on this topic Glycaemic control is poor in most of the SSA settings, with glycaemic control ranging from 10–60%. Factors associated with glycaemic control are context specific; in the Democratic Republic of the Congo, few studies have investigated poor glycaemic control. What this study adds The extent of poor glycaemic control among patients living with type 2 diabetes is determined in Kinshasa, Democratic Republic of the Congo. Identification 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. How this study might affect research, practice or policy The study findings will inform potential interventions to improve glycaemic control in Kinshasa, DRC or similar settings elsewhere.