Non-Dietary Factors Associated with Glycemic Status among Adults Diagnosed with Type 2 Diabetes Mellitus in Malawi.

We assessed glycemic status and associations with socio-demographic, biomedical, anthropometric, and physical activity (PA) levels among adults with type 2 diabetes mellitus (T2DM) (n = 428; urban n = 288; semi-urban n = 140) using a cross-sectional study. Multivariate linear regression was used to determine factors associated with glycosylated hemoglobin (A1C) . A1C was clinically elevated ≥8% for 60.3% of the participants. Overall, age and PA levels showed a negative association with A1C, and positively with underweight status, duration of diabetes, and participants' view of fluctuating/unstable blood glucose and blood glucose not improved compared to first diagnosed. A significant negative association with A1C was shown with PA levels and additional blood glucose monitoring (BGM) beyond that received at the public clinic in the urban area. Whilst, in the semi-urban area, there was a significant positive association with A1C with regards to duration of diabetes and insulin regimen. Determinants of A1C in this target group are multifactorial, therefore, interventions aiming to improve diabetes clinical outcomes are needed to reduce the likelihood of serious ramifications. Additionally, a team approach from healthcare professionals is needed in conjunction with active patient engagement as well as the development of more comprehensive diabetes care guidelines and policies.