Glycemic Control and Lifestyle-Related Factors Among Adults With Type 2 Diabetes Attending Primary Health Care Centers in Wad Madani Grand Locality, Sudan

Background: Glycemic control is frequently suboptimal among adults with type 2 diabetes mellitus (T2DM).Objective: To describe HbA1c-defined glycemic control as the primary outcome; assess lifestyle-related knowledge, attitudes, practices, and reported barriers as secondary descriptive outcomes; and explore associated factors among adults with T2DM attending primary health care centers in Wad Madani Grand Locality, Gezira State, Sudan.Methods: This analytical cross-sectional baseline study included 260 adults attending Al-Daraja and Abu Sunun centers from May 4 to August 1, 2026.Questionnaire responses and recorded HbA1c and blood glucose (fasting status unverified) were analyzed.Control categories were derived from HbA1c.Exploratory analyses included chi-square tests with Monte Carlo p-values for sparse tables, Kruskal-Wallis tests, correlations, and multivariable regressions using 256 complete cases.Conclusions were restricted to descriptive findings because of model and measurement limitations.Results: Mean HbA1c was 10.5±2.5%.Poor control (HbA1c >9%) occurred in 178 (68.5%) participants, moderate control (7-9%) in 55 (21.2%), and good control (<7%) in 27 (10.4%).Recorded knowledge and attitude responses were generally favorable.Weight-management behaviors and daily fruit and vegetable intake were less consistently reported than medication use and follow-up.Cultural dietary habits, 218 (85.8%), and financial constraints, 212 (83.5%), were the most frequent barriers among 254 respondents.Practice-score interpretation was limited by differences between printed response options and stored coding.The logistic model failed calibration assessment (Hosmer-Lemeshow p=0.008); its odds ratios were not used for independent-predictor or clinical inference.The small diet-only group (n=9), low explained variance, and other limitations also restricted interpretation of the exploratory linear model.Conclusion: Poor glycemic control was common in these two centers.Reported cultural and financial barriers and less consistently reported dietary and weight-management behaviors warrant further assessment in primary care.The cross-sectional design and measurement and model limitations prevent causal or treatment-effect conclusions.