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Table 3 Lifestyle factors and glycaemic control in sub-Saharan Africa

From: Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

First author name

Year

Study design

Study setting

Study population

Sample size

Measurement of glycemic control

Definition of glycaemic control

Generic factor

Specific factors

Measure of association

Point estimate

Lower bound

Upper bound

Association with glycemic control

Abera [88]

2022

Cross-sectional

Ethiopia

Type 2 diabetes

325

HbA1c

Good control (HbA1c < 7%); poor control (HbA1c ≥ 7%)

Dietary adherence

Poor dietary adherence

Odds Ratio

1.97

1.28

3.52

Poor dietary adherence was significantly associated with poor glycaemic control

Achila [17]

2020

Cross-sectional

Eritrea

Type 2 diabetes; 20–88 years

309

HbA1c

Poor control (HbA1c ≥ 7%)

Good dietary adherence

Odds Ratio

2.4

0.84

6.86

Following diet as prescribed is not significabtly associated with glycaemic control

Biru [29]

2017

Cross-sectional

Ethiopia

Type 2 diabetes;  ≥ 18 years

322

FBG

Good control (FBG ≤ 110 mg/dL)

Odds Ratio

3.27

1.23

8.67

Good dietary adherence was found significantly associated with good glycaemic control

Eticha [36]

2016

Cross-sectional

Ethiopia

Type 2 diabetes;  ≥ 18 years

384

HbA1c

Good control (HbA1c < 7%); poor control (HbA1c ≥ 7%)

Odds Ratio

0.3

0.1

0.5

Following recommended diet was significabtly associated with good glycaemic control

Fseha [40]

2017

Cross-sectional

Ethiopia

Type 2 diabetes; 22–60 years

200

FBS

Good (FBS 70–130 mg/dl), Poor (FBS > 130 mg/dl)

Odds Ratio

2.529

1.267

5.046

Taking meal appropriately was significantly associated with good glycaemic control

Mohammed [60]

2020

Cross-sectional

Ethiopia

Type 2 diabetes

307

FBG

Good control (average of last three FBG results between 70 mg/dL and 130 mg/dL)

Odds Ratio

3.56

1.75

8.23

Dietary adherence was found significantly associated with good glycemic control

Shimels [75]

2018

Cross-sectional

Ethiopia

Type 2 diabetes; ≥ 18 years

361

FPG

glycemic control (FPG:

100–130 mg/dl)

Odds Ratio

1.63

0.96

2.75

Good dietary adherence was found not significantly associated with glycaemic control

Demoz [34]

2019

Cross-sectional

Ethiopia

Type 2 diabetes;  ≥ 18 years

357

HbA1c and FBG

Adequate control (average fasting blood glucose 70–130 mg/dL or HbA1c < 7%); Poor control (average fasting blood glucose > 130 or < 70 mg/dL or HbA1c > 7%)

Poor dietary adherence

Odds Ratio

3.44

0.71

1.55

Poor adherence to dietary plan was not significantly associated with glycaemic control

Doglikuu [35]

2021

Cross-sectional

Ghana

Type 2 diabetes; ≥ 18 years

530

HbA1C

Low, moderate, and high

Low adherence to diabetics’ feeding recommendation

Odds Ratio

2.56

1.44

4.56

Low adherence to diabetics’ feeding recommendation was associated significantly with poor glycaemic control

Low adherence to fruit and vegetables

2.71

1.48

4.99

Low adherence to fruit and vegetables was associated significantly with poor glycaemic control

Low adherence to whole grain, beans, starchyfruits and plantain

3.29

1.81

6.02

Low adherence to whole grain, beans, starchyfruits and plantain was associated significantly with poor glycaemic control

Low adherence to foods prepared with walnut, canola, sunflower, cotton seed and fish oils

2.62

1.49

4.58

Low adherence to foods prepared with walnut, canola, sunflower, cotton seed and fish oils was associated significantly with poor glycaemic control

Fekadu [39]

2019

Cross-sectional

Ethiopia

Type 2 diabetes; 18–86 years

228

FBG

Good control (FBG: 70–130 mg/dL); poor control (< 70 mg/dL and > 130 mg/dL)

Inadequate dietary adherence

Odds Ratio

1.82

0.31

2.15

Following an healthful eating plan for 0–3 days is not significantly associated with glycaemic control

Kefale [49]

2019

Cross-sectional

Ethiopia

Type 2 diabetes; ≥ 18 years

169

FBS

Glycemic control (FBS ≤ 130 mg/dl)

No adherence to diet

Odds Ratio

0.8

1.267

5.046

No adherence to diet was found not significantly associated with glycaemic control

Mphwanthe [62]

2020

Cross- sectional

Malawi

Type 2 diabetes

428

HbA1c

Poor control (HbA1c ≥ 8%)

Number of meals

Odds Ratio

2.680

1.145

4.970

Number of meals was significantly associated with good glycaemic control

Carbohydrates (CHO) percentage per day

1.167

1.107

1.231

CHO % of energy/day was found significantly associated with good glycaemic control

Preventive diet score

1.015

0.730

1.412

Preventive diet score was not associated with glycaemic control

Fat pourcentage of energy per day

1.063

0.968

1.168

Fat % of energy/day was not associated with glycaemic control

Polyunsaturated fat (PUFA) (g/day)

1.113

0.828

1.496

PUFA (g/day) was not associated with glycaemic control

Amount of fruit and vegetables (g/day)

0.432

0.165

1.132

Amount of fruit and vegetables (g/day) was not associated with glycaemic control

Followed diet recommendation

0.996

0.532

1.865

Followed diet recommendation was found not significantly associated with glycaemic control

Omar [67]

2018

Cross-sectional

Sudan

Type 2 diabetes; ≥ 18 years

339

HbA1c

Good control (HbA1c < 7%); Poor control (HbA1c ≥ 7%)

Adding sugar to food

Odds Ratio

1.73

1.07

2.80

Adding sugar to food was found significantly associated with poor glycemic control

Abera [88]

2022

Cross-sectional

Ethiopia

Type 2 diabetes

325

HbA1c

Good control (HbA1c < 7%); Poor control (HbA1c ≥ 7%)

diet adherence of 0–3 days per week

Odds Ratio

1.97

1.28

3.52

Diet adherence of 0–3 days per week is associated with poor glycaemic control

Adeniyi [18]

2016

Cross-sectional

South Africa

Type 2 diabetes;  ≥ 30 years at diagnostic of diabetes

327

HbA1c

Good control (HbA1c ≤ 7%); poor control (HbA1c > 7%); moderately poor (HbA1c = 7–8.9%); critically poor (HbA1c ≥ 9%)

Physical activity

Sedentary habits

Odds Ratio

21

7.2

61.3

Sedentary habits was found significantly associated with poor glycaemic control

Biru [29]

2017

Cross-sectional

Ethiopia

Type 2 diabetes;  ≥ 18 years

322

FBG

Good control (FBG ≤ 110 mg/dL)

Practice of exercise

Odds Ratio

3.37

1.39

8.20

Adherence to exercice was associated with good glycaemic control

Demoz [34]

2019

Cross-sectional

Ethiopia

Type 2 diabetes;  ≥ 18 years

357

HbA1c and FBG

Adequate control ( average fasting blood glucose 70–130 mg/dL or HbA1c < 7%); Poor control (average fasting blood glucose > 130 or < 70 mg/dL or HbA1c > 7%)

Odds Ratio

2.92

0.78

1.10

Exercising was found not significantly associated with glycaemic control

Eticha [36]

2016

Cross-sectional

Ethiopia

Type 2 diabetes;  ≥ 18 years

384

HbA1c

Good control (HbA1c < 7%); poor control (HbA1c ≥ 7%)

Odds Ratio

0.1

0.1

0.2

Participating in physical exercise was found to be significantly associated with good glycaemic control

Shimels [75]

2018

Cross-sectional

Ethiopia

Type 2 diabetes;  ≥ 18 years

361

FPG

Glycemic control (FPG: 100–130 mg/dl)

Odds Ratio

1.00

0.47

2.13

Being active was found not significantly associated with glycaemic control

Kefale [49]

2019

Cross-sectional

Ethiopia

Type 2 diabetes; ≥ 18 years

169

FBS

Glycemic control (FBS ≤ 130 mg/dl in all these most three recent measurements)

Odds Ratio

1.2

0.5

2.6

Exercising regularly was not significantly associated with glycaemic control

Fekadu [39]

2019

Cross-sectional

Ethiopia

Type 2 diabetes; 18–86 years

228

FBG

Good control (FBG: 70–130 mg/dL); poor control (< 70 mg/dL and > 130 mg/dL)

Inadequate physical activity

Odds Ratio

3.19

1.05

19.84

Doing exercise planned 0–3 days was significantly associated with poor glycaemic control (p:0.019)

Mamo [53]

2019

Case–control

Ethiopia

Type 2 diabetes with poor glycemic control (cases) and without good glycemic control (controls); > 18 years

410

FBG

Good control (average fasting blood glucose of 80–130 mg/dL); poor control (average fasting blood glucose of > 130 mg/dL)

Odds Ratio

4.79

1.70

13.53

Inadequate physical activity was significantly associated with poor glycaemic control

Fseha [40]

2017

Cross-sectional

Ethiopia

Type 2 diabetes; 22–60 years

200

FBS

Good (FBS 70–130 mg/dl), Poor (FBS > 130 mg/dl)

Moderate physical activity

Odds Ratio

2.927

1.335

6.420

Moderate physical exercise was found to be significantly associated with good glycaemic control

Mphwanthe [62]

2020

Cross- sectional

Malawi

Type 2 diabetes;  ≥ 25 years

428

HbA1c

Poor control (HbA1c ≥ 8%)

Physical activity level

ß coefficient

− 0.143

− 0.186

− 0.100

Physical activity level was significantly correlated with good glycaemic control (p:0.001)

BeLue [128]

2016

Cross-sectional

Senegal

Type 2 diabetes

106

HbA1c

Glycemic control (HbA1c < 7%)

Smoking

Not smoking

ß coefficient

− 0.25

-1.25

0.75

Being a no smoker was not found significantly associated with glycaemic control

Fekadu [39]

2019

Cross-sectional

Ethiopia

Type 2 diabetes; 18–86 years

228

FBG

Good control (FBG: 70–130 mg/dL); poor control (< 70 mg/dL and > 130 mg/dL)

Smoking

Odds Ratio

4.51

0.00

0.50

Smoking was found significantly associated with poor glycaemic control (p:0.022)

Woldu [83]

2014

Cross-sectional

Ethiopia

Type 2 diabetes

102

FBG

Poor control (FBG level of > 126 mg/dl)

Odds Ratio

2.7

0.264

27.102

Smoking was not significantly associated with glycaemic control

Fekadu [39]

2019

Cross-sectional

Ethiopia

Type 2 diabetes; 18–86 years

228

FBG

Good control (FBG: 70–130 mg/dL); poor control (< 70 mg/dL and > 130 mg/dL)

Alcohol consumption

Acohol consumption

Odds Ratio

1.44

1.24

19.02

Alcohol consumption was not significantly associated with glycaemic control (p:0.177)

Biru [29]

2017

Cross-sectional

Ethiopia

Type 2 diabetes;

 ≥ 18 years

322

FBG

Good control (FBG ≤ 110 mg/dL)

History of alcohol consumption

Odds Ratio

0.15

0.03

0.65

The fact to ever had drunk alcohol was found significantly associated with poor glycaemic control

Kefale [49]

2019

Cross-sectional

Ethiopia

Type 2 diabetes; ≥ 18 years

169

FBS

Glycemic control (FBS ≤ 130 mg/dl)

Use of illicit substance

Use of illicit substance

Odds Ratio

0.5

0.2

1.2

Previous use of substance was not significantly associated with glycaemic control

  1. HbA1c Haemoglobin A1c, FBG Fasting blood glucose, FBS Fasting blood sugar, FPG Fasting plasma glucose