Endocrine Abstracts

JOINT3907

Introduction: Diabetes is a major public health problem, responsible for life-threatening complications. Maintaining therapeutic control in diabetics is a challenge for all primary care physicians. We aimed to study the clinico-biological profile of diabetics followed up in primary care centers, to identify factors predictive of metabolic control and to evaluate the quality of management of these patients in these centers.

Methods: It was observational, descriptive, cross-sectional and retrospective study, conducted in three primary care facilities: Mhamdia, Megrine and Megrine Chaker. Recruitment took place from February 1 to July 31, 2023. We collected the clinical and biological data of the included patients from the medical files and by interrogation carried out by the investigator.

Results: We collected 221 type 2 diabetics with a mean age of 64.67 ± 11.04 years, predominantly female (sex ratio=0.38). The mean duration of diabetes was 11.8 ± 8.79 years. Glycemic, blood pressure and lipid control were attained in respectively 38.7%, 27.2% and 12.4% of patients. The multivariate study showed poor glycemic control in diabetics who were elderly (P = 0.05); on insulin therapy (P = 0.001); had a frequent consumption of sweets (P = 0.009) and consumed bread excessively (P = 0.010). Better blood pressure control was found among those on antihypertensive treatment (P<0.0001) and non-smokers (P = 0.037). Better lipid balance was noted in patients at low to moderate cardiovascular risk (P<0.0001). Hypoglycemia was observed in 37.1% of patients. Risk factors independently associated with the occurrence of hypoglycemia were overweight (P = 0.004), insulin therapy (P = 0.006) and the presence of macroangiopathy (P = 0.038). At least one microangiopathic and macroangiopathic complication was noted in 37.1% and 19% of diabetics respectively. Protective factors against the onset of microangiopathy were dietary reminders at each consultation (P = 0.006), metformin intake (P = 0.027) and target blood pressure (P = 0.037). The development of macroangiopathy was significantly associated with insulin therapy (P = 0.008). Glycated hemoglobin was tested as recommended in 63.8% of patients.

Conclusion: The present study showed a discrepancy between the recommendations and our results. The management of diabetics needs to be improved in primary-care center.