Determinants of Poor Glycemic Control Among People Living With Diabetes in Two Hospitals of the Western Region of Cameroon: A Cross-Sectional Study

Background Diabetes mellitus (DM) is a non-communicable disease, and its morbidity and mortality are increasing in Cameroon. This study aimed to identify the factors that contribute to poor glycemic control among people living with DM at the Bafoussam Regional Hospital (BRH) and the Dschang Regional Hospital Annex (DRHA). Methods This was an observational study with two parts: a cross-sectional descriptive part and a case-control analytical part. It was conducted between March and May 2023 in both hospitals, focusing on people with type 2 diabetes mellitus (T2DM) who were recruited based on specific selection criteria. Poor glycemic control was defined as having a glycated hemoglobin (HbA1c) level ≥ 7%. The study’s cases were people with uncontrolled DM, while the controls were those with controlled DM, matched for sex and age. Data was collected through face-to-face questionnaires and a review of patient records. Multivariate analyses were conducted to identify factors associated with significant differences, with a p-value of less than 0.05 considered statistically significant. Results A total of 241 (102 men) people living with T2DM were included in this study. The median age was 61.03 years [IQR 53–71]. The median duration of DM was 7 years [IQR 3.5–11.5]. The rate of poor glycemic control was 71%. A DM duration between 5 and 10 years (aOR = 3.11 [95% CI 1.11–8.66]; p = 0.03) and nonadherence to treatment (aOR = 3.09 [95% CI 1.34–7.11]; p = 0.008) significantly increased the risk of poor glycemic control. Adherence to diet (aOR = 0.21 [95% CI0.09-0.51]; p < 0.001) significantly reduced the risk of poor glycemic control. Conclusion This study revealed a high rate of poor glycemic control at BRH and DRHA. Intermediate DM duration and poor treatment adherence were associated with poor glycemic control. These factors should be considered in developing interventions to improve diabetes control in Cameroon.