Background Self-care practice plays a significant role in the reduction of life-threatening conditions. The study assessed the magnitude of poor self-care practices and associated factors among type 2 adult diabetic patients in Adama town in Ethiopia. Methods Institution-based cross-sectional study was conducted among 404 patients. Self-care practice was assessed by the summary of diabetes self-care activities questionnaires. Binary logistic regression was used to identify factors associated with poor self-care practices. Adjusted odds ratio with a 95% confidence interval was used to assess the strength of associations. The statistical significance was declared for a p-value < 0.05. Results The magnitude of poor self-care practices was 54% [95%CI: 49.1, 58.6]. Being divorced (AOR = 3.5; 95% CI: 1.0, 12.2), lower level of knowledge (AOR = 1.70; 95% CI: 1.0, 2.8), being on insulin (AOR = 6.3; 95% CI: 1.9, 20.6), taking oral medication (AOR = 8.6; 95% CI: 3.0, 24.5), unaware of fasting blood sugar (AOR = 2.9; 95% CI: 1.6, 5.2), not a member of diabetic association (AOR = 3.6; 95%CI: 1.7, 7.5), lack frequent social support (AOR = 2.9; 95% CI: 1.7, 4.9), and poor perceived benefit of self-care practices (AOR = 1.84; 95% CI: 1.0, 3.2) were associated with poor self-care practices. Conclusion The magnitude of poor self-care practices was higher than the national finding. Marital status, knowledge of diabetes and the level of fasting blood sugar, social support, types of medications, perceived benefit of self-care practices, and membership in the diabetic associations were independent determinants of poor self-care practices.
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