Factors Associated with Achievement of Glycemic Goal in Africa—Results from the International Diabetes Management Practices Study (IDMPS)
Authors: MBANYA JEAN CLAUDE , ASCHNER PABLO , GAGLIARDINO JUAN J. , ILKOVA HASAN M. , LAVALLE-GONZALEZ FERNANDO J. , RAMACHANDRAN AMBADY , KADDAHA GHAIDA , SHESTAKOVA MARINA V. , CHANTELOT JEAN-MARC , CHAN JULIANA C. 
Published: June 2018

The IDMPS is a global observational survey on the management and patterns of care of people with type 1 (T1D) and type 2 (T2D) diabetes in the developing world. Due to regional heterogeneity, a logistic regression model per region was performed entering factors significant at the 10% level from the univariate analysis. Odds ratios with 95% CI were estimated for each significant predictor. A backward selection procedure identified predictive factors that were significant at the 5% level. Here we report the cross-sectional results observed using data collected in 2015-16 from 12 African countries (Algeria, Cameroon, Côte d’Ivoire, Democratic Republic of the Congo, Egypt, Kenya, Madagascar, Morocco, Nigeria, Senegal, South Africa, Tunisia).
An unhealthy diet and lack of exercise increased the risk of not reaching glycemic target by 7 and 4.5 times in people with T1D (n=781) and T2D (n=2403), respectively (Figure). Lack of self-management (self-monitoring of blood glucose and self-adjustment of insulin) was also a significant predictor in both populations. A negative impact of poor diabetes education and longer duration was only observed for people with T1D. Hospitalizations in the past 12 months seem to be a significant marker of poor glycemic control.
All these predictors call for improved patient education regarding the management and use of insulin.

Disclosure
J. Mbanya: Advisory Panel; Self; GlaxoSmithKline plc.. Speaker's Bureau; Self; Novo Nordisk A/S, Sanofi, Servier. P. Aschner: Other Relationship; Self; Sanofi. J.J. Gagliardino: Other Relationship; Self; Sanofi. H.M. Ilkova: Advisory Panel; Self; Abbott, Eli Lilly and Company, Novartis AG, Novo Nordisk A/S, Boehringer Ingelheim GmbH, Servier, Merck Sharp & Dohme Corp.. Speaker's Bureau; Self; AstraZeneca. Advisory Panel; Self; Medtronic, Roche Diabetes Care Health and Digital Solutions, Bilim İlac. F.J. Lavalle-Gonzalez: Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Research Support; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; Novo Nordisk Inc.. Advisory Panel; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Research Support; Self; AstraZeneca. Advisory Panel; Self; Merck Sharp & Dohme Corp.. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Abbott. Speaker's Bureau; Self; Abbott. A. Ramachandran: None. G. Kaddaha: Other Relationship; Self; Sanofi. M.V. Shestakova: None. J. Chantelot: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. J.C. Chan: Consultant; Self; Bayer AG. Other Relationship; Self; Bayer AG. Consultant; Self; Sanofi. Other Relationship; Self; Sanofi, Eli Lilly and Company, Amgen Inc.. Consultant; Self; AstraZeneca, Merck & Co., Inc., Pfizer Inc.. Other Relationship; Self; Pfizer Inc.. Board Member; Self; Asia Diabetes Foundation. Stock/Shareholder; Self; GemVCare. Other Relationship; Self; Merck Sharp & Dohme Corp.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novartis AG, Eli Lilly and Company.