According to WHO, 24 million adults live with diabetes in Africa and this figure is expected to rise by 129% to 55 million by 2045. The age-standardized mortality rate for diabetes is 48 per 100.000 inhabitants. This is more than double the global rate of 23 per 100.000. The first cause of death of the diabetic subject is represented cardiovascular diseases [1] .

Our work aimed to assess the level of control of diabetes and associated cardiovascular risk factors.

This was an observational cross-sectional study, conducted from April 13^th, 2021 to July 07^th, 2021 at the Diabetes and Cardio-Metabolic Diseases Management Centre (DIABCARMET). The patients are managed by specialist doctors, diabetologists and cardiologists.

Of a total of 404 patients surveyed, 326 met the inclusion criteria of our study. The number of patients not included was 78 (19.3%). The reasons for exclusion were represented by incomplete patient records (93.59%), a follow-up time of less than three months (5.13%), type 1 diabetes (1.28%). No patient refused to participate in the investigation.

The average age of patients in our work was 58 ± 11 years. This age of diabetic patients is close to that found by Yameogo et al. in Dakar which was 58.2 ± 9.2 years [9] . Diop et al. and Ndour et al. in African studies found slightly younger patients with an average age of 53.2 ± 9.2 years and 52.2 ± 12.4 years respectively [10] [11] . In contrast, Mcfarlane et al. in the United States found an average age of 64.5 ± 0.33 years [12] and Charpentier et al. in France 62 ± 11 years [13] . Diabetic patients were younger in African studies than in Western studies. This difference could be explained by the higher life expectancy in the West.

In our work, we noted a female predominance with a sex-ratio of 0.35 as found by Yameogo et al. with a sex-ratio of 0.3 [9] and Belhadj in Algeria [11] . On the other hand, a meta-analysis of European studies found a male predominance [14] . This female predominance in our study could be explained by the fact that women are the majority of patients attending hospital structures in our context. This hypothesis had already been defended by Yameogo et al. in a similar study [9] .

The prevalence of obesity in our study was 21.16%. Yameogo et al. found a lower prevalence of 9.11% of obese patients while Charpentier et al. in France found a higher prevalence of 39% [9] [13] .

The prevalence of abdominal obesity was 47.48% with a very significant female predominance (p = 0.001) in our work. This state of affairs could find its explanation at the socio-cultural level, given that African black societies seem to generally encourage overweight among women, being seen as an aesthetic criterion or sign of social comfort. Abdominal obesity is associated with increased metabolic and cardiovascular morbidity and mortality; it leads to a greater sensitivity of perivisceral fat to the lipolytic action of catecholamines, sympathetic nervous system and cortisol, causing an increase in the release of free fatty acids leading to insulin resistance and therefore predisposition to diabetes.

Just under a quarter of patients in our work remained sedentary (24.23%); without any significant difference between the two sexes. In his series, Yameogo et al. found that four out of five patients were sedentary [9] . Mbaye et al. also found a prevalence of 79.7% of physical inactivity among diabetics in their series [11] .

The relatively low sedentary level in our study contrasts with levels obtained in other studies across the country. This could be explained by the fact that our study, being carried out in a center dedicated to cardio-metabolic diseases, the management of patients is much more specialized.

However, the still high rate of inactivity could be explained by the advanced age of the patients, the prevalence of obesity and overweight as well as the female predominance. Indeed, these conditions are often factors limiting the practice of physical activity.

Regular physical activity was identified in the INTERHEART study as one of three factors that reduce the risk of myocardial infarction (the other two being: regular fruit and vegetable consumption and moderate alcohol consumption) [15] . The cardiovascular benefit of regular physical activity, especially in type 2 diabetics, would come from a significant decrease in peripheral insulin resistance, resulting in a decrease in fasting blood sugar. It also remains beneficial in lowering blood pressure by lowering peripheral vascular resistance.

In our series, tobacco consumption was found in 2 patients (0.6%). This rate was lower than that of 6% found by Yameogo [9] . Charpentier and Belhadj reported prevalence close to 11% and 10% of smokers in their populations, respectively [13] [16] . In McFarlane et al., 17% of men and 7% of women were smokers [12] . The INTERHEART study found that smoking was the second risk factor for myocardial infarction after dyslipidemia [15] . Therefore, its management suggests special attention and patients will have to be accompanied as necessary by supportive psychotherapy for the termination.

A duration of evolution of more than 10 years is found in more than one third of our patients of our work (39.26%) as by several other authors [9] [13] reflecting the chronic nature of this condition.

One-third of our study population (30.37%) had good adherence and just over half had minimal adherence problems (56.44%). Only 13.19% had poor adherence. The reasons for this poor adherence were dominated by poor understanding of treatment followed by fear of addiction or addiction. Low monthly income was a significant cause of poor adherence. The compliance level of our study population was higher than that found by Yameogo et al. [9] . Tieno and Abobo et al. had found optimal adherence in Burkina in 46.8% and 45% of patients respectively [17] [18] .

In the light of these data on anti-diabetic treatment, it is clear that therapeutic education efforts remain to be made to improve patient compliance.

If we consider a glycated hemoglobin target < 7%, 213 patients (65.34%) were controlled. This control rate was higher than the 28.8% found by Yaméogo et al. [9] and the 26.7% found by McFarlane [12] . Belhadj et al. in Algeria found control rates even lower at 18.7% [16] . The relatively low sedentary rate of our population may have contributed to this. Moreover, the rate of prescription of insulin therapy (42.6%) in line with the duration of diabetes in our series contrasts with the therapeutic inertia often observed in studies of sub-countries developed in relation to the low availability and accessibility of insulin associated with a fear of hypoglycemia [1] .

The prevalence of hypertension was 51.53% in T2D in our study with a control rate of 8.33%. A control rate of hypertension slightly higher than that of 5.4% found by Yaméogo et al. and lower than the rates of 22% found by Sayad et al. [19] 26.5% found by McFarlane in the USA [12] . It appears that blood pressure control is still very insufficient in hypertensive diabetic patients. In diabetics, dual therapy or triple therapy is recommended.

With respect to cholesterol control, 109 patients (33.44%) had achieved LDL-c targets. This rate was close to 35.5% found by Mcfarlane et al. [12] and was higher than the 4% reported by Yameogo et al. [9] .

Type 2 diabetes was frequently associated with other cardiovascular risk factors. Control of diabetes and these factors was insufficient. Therapeutic education of type 2 diabetics patients adapted to our socio-cultural realities needed to be improved. It would also be relevant to carry out longitudinal follow-up of these patients.

The authors declare no conflicts of interest regarding the publication of this paper.

Affangla, D.A., Doupa, F., Dione, J.-M.A., Akanni, S.C., Ngwa, H.E.E., Ba, D.M. and Leye, M.C.B.O. (2023) Assessment of Diabetes Control Level and Associated Cardiovascular Risk Factors. World Journal of Cardiovascular Diseases, 13, 879-889. https://doi.org/10.4236/wjcd.2023.1312076