Etiological Profiles of Glycemic Imbalance in Diabetic Inpatients in a University Hospital Libreville
Profils Etiologiques du Déséquilibre Glycémique des Patients Diabétiques Hospitalisés à Dans un Hôpital Universitaire de Libreville
DOI:
https://doi.org/10.67260/hra.v4i7.7872Keywords:
CHUL, imbalance diabetics, causes, hospitalized patients, profileAbstract
Introduction. Glycemic imbalance is a common cause of hospitalization and a major contributor to morbidity in sub-Saharan Africa. This study aimed to analyze the etiological profiles of glycemic imbalance among diabetic patients hospitalized at the Libreville University Hospital (CHUL). Patients and Methods. This was a cross-sectional analytical study conducted in 2025. Sociodemographic, clinical, laboratory, therapeutic, and follow-up data were collected from medical records. Results. Four hundred seventeen patients were included. The mean age was 52.8 ± 15.1 years, with a predominance of females (53%). Type 2 diabetics accounted for 88.0% of cases. The mean blood glucose level was 3.00 ± 1.21 g/L and the mean HbA1c was 11.2 ± 2.9%. Hypertension was present in 47.7% of patients. Infections were the main factor contributing to glycemic imbalance (66.7%). A positive CRP result (OR = 2.89; 95% CI: 1.15–7.20) and age over 50 years (OR = 8.73; 95% CI: 2.66–28.60) were significantly associated with identifying the cause of the imbalance. The outcome was favorable in 96.2% of patients. Conclusion. Glycemic imbalance is primarily associated with infectious factors. Strengthening infection screening and therapeutic education is essential.
References
1. IDF_Atlas_11th_Edition_2025-1.pdf [Internet]. [cité 23 nov 2025]. Disponible sur: https://diabetesatlas.org/media/uploads/sites/3/2025/04/IDF_Atlas_11th_Edition_2025-1.pdf
2. Diabetes Atlas [Internet]. [cité 15 janv 2026]. Home. Disponible sur: https://diabetesatlas.org/
3. Comino EJ, Harris MF, Islam MDF, Tran DT, Jalaludin B, Jorm L, et al. Impact of diabetes on hospital admission and length of stay among a general population aged 45 year or more: a record linkage study. BMC Health Serv Res 2015 ; 15: 12.
4. Berbudi A, Rahmadika N, Tjahjadi AI, Ruslami R. Type 2 Diabetes and its Impact on the Immune System. Curr Diabetes Rev. 2020 ; 16(5): 442‑9.
5. AbuHammad GAR, Naser AY, Hassouneh LKM. Diabetes mellitus-related hospital admissions and prescriptions of antidiabetic agents in England and Wales: an ecological study. BMC Endocr Disord. 2023 ; 23(1):102.
6. Umpierrez GE, Davis GM, ElSayed NA, Fadini GP, Galindo RJ, Hirsch IB, et al. Hyperglycemic Crises in Adults With Diabetes: A Consensus Report. Diabetes Care. 2024 ; 47(8): 1257‑75.
7. Brown JB, Ramaiya K, Besançon S, Rheeder P, Tassou CM, Mbanya JC, et al. Use of Medical Services and Medicines Attributable to Diabetes in Sub-Saharan Africa. PLOS ONE. 2014 ; 9(9): e106716.
8. Hardy YO, Libhaber E, Ofori E, Amenuke DAY, Kontoh SA, Dankwah JA, et al. Clinical and laboratory profile and outcomes of hospitalized COVID‐19 patients with type 2 diabetes mellitus in Ghana – A single‐center study. Endocrinol Diabetes Metab. 2022 ; 6(1): e391.
9. Risasi Etutu junior R, Lukusa Mbaya A, Amisi CM. Profil épidémiologique, clinique et facteurs de risque de diabète sucré. Cas de l’Hôpital Provincial Général de Référence de Kinshasa. Congo Res Pap. 2021 ; Congo Research Papers1(7): 98‑115.
10. Diallo M, Diallo A, Balde N, Camara A, Bah A, Bah A, et al. P339 Profil épidémiologique, clinique et thérapeutique de 100 diabétiques suivis en ambulatoire au CHU de Conakry, en Guinée. Diabetes Metab. 2014 ; 40 :A108.
11. Maammar F, Regagba D, Attar S, Snoussaoui Y, Benamar C, Belbachir F, et al. P127 Profil épidémiologique d’une population des diabétiques à Tlemcen ; Algérie. Diabetes Metab. 1 mars 2014 ; 40: A59.
12. Organisation mondiale de la santé, éditeur. World health statistics 2016: monitoring health for the SDGs sustainable development goals. Genève: World health organization; 2016.
13. Nigussie S, Birhan N, Amare F, Mengistu G, Adem F, Abegaz TM. Rate of glycemic control and associated factors among type two diabetes mellitus patients in Ethiopia: A cross sectional study. PLoS ONE. 2021 ; 16(5): e0251506.
14. Birhanu N, Mamo G, Shiferaw GS, Gizachew D, Belayneh F, Birhanu T. Factors affecting diabetes related hospitalization and in-hospital outcomes of adults with diabetes in south Ethiopia: A prospective observational study. PLOS One. 2025 ; 20(8): e0330735.
15. Kimando MW, Otieno FCF, Ogola EN, Mutai K. Adequacy of control of cardiovascular risk factors in ambulatory patients with type 2 diabetes attending diabetes out-patients clinic at a county hospital, Kenya. BMC Endocr Disord. 2017 ; 17:73.
16. Alourfi Z, Homsi H. Precipitating factors, outcomes, and recurrence of diabetic ketoacidosis at a university hospital in Damascus. Avicenna J Med. 2015 ; 5(1): 11‑5.
17. Al-Adsani AMS, Abdulla KA. Reasons for hospitalizations in adults with diabetes in Kuwait. Int J Diabetes Mellit. 2015 ; 3(1):65‑9.
18. Dunachie S, Chamnan P. The double burden of diabetes and global infection in low and middle-income countries. Trans R Soc Trop Med Hyg. 2019 ; 113(2): 56‑64.
19. Azagew AW, Mekonnen CK, Lambie M, Shepherd T, Babatunde OO. Poor glycemic control and its predictors among people living with diabetes in low- and middle-income countries: a systematic review and meta-analysis. BMC Public Health. 2025 ; 25: 714.
20. Tegegne KD, Gebeyehu NA, Yirdaw LT, Yitayew YA, Kassaw MW. Determinants of poor glycemic control among type 2 diabetes in Ethiopia: a systematic review and meta-analysis. Front Public Health. 2024 ; 12: 1256024.
21. Le da RCM, Sp G, Lg B, Jl C, Gh T, Bd S. Precipitating factors of diabetic ketoacidosis in type 1 diabetes patients at a tertiary hospital: a cross-sectional study with a two-time-period comparison. Arch Endocrinol Metab. 2022 ; 66(3).
22. Barasa Masaba B, Mmusi-Phetoe RM. Determinants of Non-Adherence to Treatment Among Patients with Type 2 Diabetes in Kenya: A Systematic Review. J Multidiscip Healthc. 2020 ; 13: 2069‑76.
23. DECODE Study Group, the European Diabetes Epidemiology Group. Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med. 12 févr 2001 ; 161(3): 397‑405.
24. Cost-Effectiveness of Intensified Versus Conventional Multifactorial Intervention in Type 2 Diabetes: Results and projections from the Steno-2 study - PMC [Internet]. [cité 12 févr 2026]. Disponible sur: https://pmc.ncbi.nlm.nih.gov/articles/PMC2494636/
25. Hamtzany O, Weiser G, Heiman E, Avnon-Ziv C, Auerbauch A, Levy-Khademi F. Leukocytosis and C-Reactive Protein Levels as Indicators of Infection in Children With Diabetic Ketoacidosis. Pediatr Emerg Care. 2023 ; 39(11): 828‑31.
26. Predictive Value of White Blood Cell Counts for Infection in Patients With Diabetic Ketoacidosis and Rational Use of Antibiotics: A Cross-Sectional Study - PubMed [Internet]. [cité 23 mars 2026]. Disponible sur: https://pubmed.ncbi.nlm.nih.gov/41716425/
27. Regassa LD, Tola A. Magnitude and predictors of hospital admission, readmission, and length of stay among patients with type 2 diabetes at public hospitals of Eastern Ethiopia: a retrospective cohort study. BMC Endocr Disord. 2021 ; 21: 74.
28. Sako A, Yasunaga H, Matsui H, Fushimi K, Hamasaki H, Katsuyama H, et al. Hospitalization for Hypoglycemia in Japanese Diabetic Patients. Medicine (Baltimore). 26 juin 2015 ; 94(25) : e1029.
29. Umoh VA, Otu AA, Enang OE, Okereke QO, Essien O, Ukpe I. The pattern of diabetic admissions in UCTH Calabar, South Eastern Nigeria: A five year review. Niger Health J. 2012 ; 12(1): 7‑11.
30. B U, I E, Na A, Ej P, Ju E. Indications for and outcome of diabetic admissions at the University of Uyo Teaching Hospital, Uyo. Ibom Med J. 2013 ; 6(1): 16‑22.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Tsoucka Ibounde Eudine Z., Daniela Nsame, Peggy F. Biloghe, Nesta Ziza, Treycia Pambo, Agathe Gorra, Davy Kombila
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License CC BY-NC-ND 4.0 that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
