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)

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.