Glycemic Control and Self-Monitoring of Blood Glucose in Type 2 Diabetic Patients on Insulin and Prevalence of Candidiasis in these Patients at Dschang District Hospital, Cameroon: A Cross-Sectional Study

Abstract

Background: The number of deaths attributed to diabetes was estimated at nearly                                1.5 million worldwide in 2012, making this disease one of the 15 most deadly                                pathologies in the world. Self-monitoring of blood glucose is not widely used in type 2 diabetics on insulin. Objective: To evaluate the level of glycemic control and identified some factors that may influence it as well as determining the prevalence of candidiasis in these patients. Methodology: A descriptive cross-sectional study was conducted on a population of type 2 diabetic patients on insulin followed at Dschang District Hospital with an average age of 58 years treated with insulin for at least 2 months and the predictors of poor glycemic control were measured (HbA1c higher than 7%) and the search for three species of Candida carried out in 3 different types of samples (urine, blood and oral cavity). Furthermore, a questionnaire was used to collect information on self-monitoring of blood glucose. Results: This study included 66 diabetic patients with a mean age of 58 years and a male predominance (51.5%). The majority of patients had been diabetic for at least 6 years with a mean duration of insulin therapy of 6 months. 90.1% of the participants reported having a glucometer and 54.5% reported performing self-monitoring of blood glucose twice a day as recommended by the physician. This study found that 78.8% of these patients had inadequate glycemic control. Factors such as Body mass index, duration of diabetes and coexistence with hypertension influenced this glycemic control. Similarly, a prevalence of 15.2%, 12.1% and 00% were recorded for urinary, oral and systemic candidiasis respectively with Candida albicans being the species most involved in these infections. Conclusion: Poor glycemic control is common among type 2 diabetic patients on insulin at Dschang District Hospital and is due to poor use and lack of training of patients on the practice of self-monitoring of blood glucose. This poor glycemic control favours the development of candida infections, especially urinary and oral.