Profiling of cardio-metabolic risk factors and medication utilisation among Type II diabetes patients in Ghana: a prospective cohort study

Eric Adua; Peter Roberts; Samuel Asamoah Sakyi; Francis Agyemang Yeboah; Albert Dompreh; Kwasi Frimpong; Enoch Odame Anto; Wei Wang

doi:10.1186/s40169-017-0162-5

Profiling of cardio-metabolic risk factors and medication utilisation among Type II diabetes patients in Ghana: a prospective cohort study

Clin Transl Med. 2017 Sep 7;6(1):32. doi: 10.1186/s40169-017-0162-5.

Authors

Eric Adua¹, Peter Roberts¹, Samuel Asamoah Sakyi², Francis Agyemang Yeboah², Albert Dompreh³, Kwasi Frimpong¹, Enoch Odame Anto¹, Wei Wang⁴

Affiliations

¹ School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, 6027, WA, Australia.
² Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
³ Department of Serology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
⁴ School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, 6027, WA, Australia. wei.wang@ecu.edu.au.

Abstract

Background: Type II diabetes mellitus (T2DM) is complicated by multiple cardio-metabolic risk factors. Controlling these factors requires lifestyle modifications alongside utilisation of anti-diabetic medications. Different glucose lowering [(biguanides (BIGs), sulfonylureas (SUAs), thiazolidinediones (TNZ)], lipid lowering (statins), and anti-hypertensive medicines [angiotensin converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), angiotensin II receptor blockers (ARBs) and central acting drugs (CADs)] have been approved for controlling hyperglycaemia, dyslipidaemia and hypertension respectively. Here, we examined factors that characterise T2DM and explored the response to medication therapy among T2DM patients.

Methods: This prospective cohort study recruited 241 T2DM patients reporting at a clinic in Ghana, from January through to August, 2016. Each patient's demographic, medications and anthropometric data was obtained while information on medication adherence was captured using Morisky adherence scale-8 (MMAS-8). Fasting blood samples were collected for biochemical analysis.

Results: The mean age of participants was 57.82 years for baseline and six-month follow-up. Physical activity differed at baseline and follow up (p < 0.05) but not body mass index (BMI). BIG alone, or in combination with SUA and TNZ did not improve glycaemic status at follow up (p > 0.05). Many participants using either ACEI or ARB were able to control their blood pressures. Among dyslipidaemia patients under statin treatment, there was an improved lipid profile at follow-up.

Conclusions: Statin medications are effective for reducing dyslipidaemia in T2DM patients. However, control of modifiable risk factors, particularly blood glucose and to a lesser degree blood pressure is suboptimal. Addressing these will require concomitant interventions including education on medication adherence and correct dietary plans, lifestyle modifications and physical activity.

Keywords: Anti-diabetic medications; Ghana; Hypertension; Risk factors; Type II diabetes mellitus.