The OPTIMAL Project
Establishing optimal methods of monitoring diabetes
Student: Anxious Niwaha
Financial constraints mean that the monitoring of diabetes, and decisions to intensify treatment, are predominantly based on the measurement of a single glucose value rather HbA1c and home-based glucose monitoring in Uganda and much of Sub-Saharan Africa.
Current clinical practice varies with fasting glucose used by many clinicians, but others routinely using non fasting ‘random’ measurements. For rural patients, fasting glucose will often be measured after a prolonged fast and/or very long walk to clinic. The impact of this is not known. HbA1c may be used for monitoring where financial resources are sufficient, but may be unreliable in this population due to a high prevalence of comorbidities which can alter the results of this test.
In the Optimal study, we will assess accuracy of these commonly used tests (fasting, non-fasting glucose and HbA1c) as measures of glycaemic burden in patients with Type 2 diabetes in Uganda in comparison with glucose values measured using continuous glucose monitoring (CGM), as a gold standard of glucose burden. We will also investigate the impact of prolonged walking (through controlled exercise activity) on fasting glucose measurements.