https://orcid.org/0000-0002-9593-4812
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ABSTRACT
Background
Poor glycaemic control is a multifactorial and complex problem with dire clinical and economic implications. In the Democratic Republic of the Congo, recent studies have shown alarming poor control rates. There is no policy framework to guide corrective actions.
Objectives
To build a consensus on interventions to improve glycaemic control among patients with type 2 diabetes in Kinshasa, Democratic Republic of the Congo.
Methods
This was a two-round electronic Delphi study involving 31 local and 5 international experts. The experts rated proposed interventions from previous studies on glycaemic control in sub-Saharan Africa and Kinshasa on a 4-Likert scale questionnaire. Additionally, the experts were asked to suggest other recommendations useful for the purpose. The mode, mean and standard deviation of each statement were calculated for each round.
Results
Participants reached consensus in five domains that included 39 statements on how to improve glycaemic control in Kinshasa: strengthening the health system, enhancing the awareness of diabetes, alleviating the financial burden of diabetes, enhancing the adoption of lifestyle modifications, and reducing the proportion of undiagnosed diabetes.
Conclusions
Improved glycaemic control needs to be considered within the broader framework of managing noncommunicable diseases in a more integrated, coordinated and better financed healthcare system. Further studies are needed to operationalise the interventions identified for successful implementation.
Responsible Editor Jennifer Stewart Williams
Responsible Editor Jennifer Stewart Williams
Acknowledgments
The authors would like to thank all the experts who gave their time to contribute to this reflection.
Author contributions
JP FL conceived the study, conducted the process, analysed the findings; JMF and OBO contributed to the conception of the study and the analyses of findings. All the authors agreed with the manuscript.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethics and consent
The study was conducted after the approval from the Ethics committee of the Protestant University of Congo (reference number: CEUPC 0067; Date: 05/02/2021) and Human Research Ethics Committee (Medical) of the University of the Witwatersrand (reference number: M210308; Date: 26/08/2021). An informed consent was sought from the participants.
Paper context
Achieving good glycaemic control is a global challenge. The challenge is particularly acute in sub-Saharan Africa due to multiple barriers. This study identified a number of interventions for improving glycaemic control in a particular context, but which may be relevant in similar settings.