Glycaemic control and its related factors among people with type 2 diabetes in low- and middle-income countries: a systematic review and meta-analysis
Bibliographic record
Abstract
Objective To estimate the prevalence of inadequate glycaemic control and identify factors associated with it among people with type 2 diabetes mellitus (T2DM) living in low- and middle-income countries (LMICs). Methods A systematic literature search was conducted in the Medline, Embase, CINAHL, PsychINFO, and Global Health databases for articles published between 1 January 2001 and 15 April 2025. Information was descriptively summarised following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The quality of the articles was assessed using the Newcastle-Ottawa Scale. Random effects model was used to obtain the pooled proportion of inadequate glycaemic control. Heterogeneity (I 2 ) was tested, sensitivity analyses were performed, and publication bias was examined using Egger’s regression test. Results Among 12,985 records, 62 studies from 28 countries involving 176,349 participants were reviewed. The estimated pooled proportion of inadequate glycaemic control (glycosylated haemoglobin [HbA1c] ≥7%) was 69% (95% confidence interval [CI]: 66%–72%, p <0.001, I 2 = 99.10%), with no publication bias (Egger’s test, p = 0.489). A number of factors were associated with inadequate glycaemic control (overall p < 0.001), including education below secondary level (OR: 1.47, 95% CI: 0.98–1.97), rural residence (OR: 1.80, 95% CI: 1.33–2.28), obesity (OR: 1.17, 95% CI: 1.11–1.22), use of oral glucose-lowering drugs and/or insulin (OR: 4.06, 95% CI: 2.58–5.54 and OR: 2.44, 95% CI: 1.70–3.19, respectively), non-adherence to diet (OR: 2.13, 95% CI: 1.33–2.93) and treatment (OR: 2.08, 95% CI: 1.61–2.54), and physical inactivity (OR: 2.15, 95% CI: 1.35–2.95). Conclusion More than two-thirds of people with T2DM in LMICs have inadequate glycaemic control. Urgent interventions are needed, focusing on sociodemographic, lifestyle, and treatment-related factors. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO , identifier CRD: 42023390577.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.044 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.027 | 0.039 |
| Bibliometrics | 0.009 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".