Challenges and factors associated with poor glycemic control among type 2 diabetes mellitus patients at Nekemte referral hospital, western Ethiopia: cross-sectional study

Abstract

Background: Diabetes is increasing at an alarming rate throughout the world and about 80% of diabetics’ lives in developing countries. Similar to the rest of sub Saharan African countries, Ethiopia is experiencing significant burden of diabetes with increased prevalence, complications and mortality as well as life threatening disabilities. Reasons for poor glycemic control in type 2 diabetes are complex and multivariable. Hence, this study was aimed to identify challenges and factors associated with poor glycemic control among type 2 diabetes patients. Method: A hospital based cross sectional study was conducted on type 2 diabetic patients attending diabetic clinic of Nekemte Referral Hospital (NRH) from February 1 to April 30, 2018. Fasting blood glucose of last three clinic visits were obtained and the mean fasting blood glucose measurements was used to determine the level of glycemic control. Analysis included both descriptive and inferential statistics with SPSS version 20.0. Predictor variable with P< 0.05 was considered statistically significant. Result: Out of the total 228 included type 2 diabetes mellitus (DM) patients, 51.8% were males. The mean age of participants was 43±12.4 years and 154(67.5%) were found not following their general dietary program correctly. Nearly one third, 73(32%) of participants never attended diabetic education and 52(22.8%) of the patients had greater than 10 years’ duration on treatment. The majority, 148(64.9%) of patients had poor blood glucose control. Age range of 40-60 years (AOR=2.01, 95% CI 0.04-0.06, P=0.044), being illiterate (AOR = 3.12, 95 % CI 1.52-8.50, P=0.001), having informal education only (AOR=2.28, 95% CI 2.14-32.60, P=0.024), longer duration of diabetes treatment (>10 years) (AOR = 3.94, 95 % CI 1.51-27.83, P=0.012), inadequate physical exercise (AOR = 3.19, 95 % CI 1.05-19.84, P=0.019), smoking (AOR = 4.51, 95 % CI 0.00-0.50, p=0.022) were independent predictors of poor glycemic control up on a multivariable logistic regression analysis. Conclusion: Nearly two third of patients had poorly controlled diabetes. Age, exercise, level of education, duration of the treatment and smoking were significantly associated with poor glycemic control. Health facilities should provide continuous education as well as barriers of glycemic control should be explored with further research.

Glycemic control and its associated factors among adult diabetic patients in Southern Ethiopia: a cross-sectional study

“…This finding was in line with a previous studies conducted in Bangladesh (82%) 11 , India (76.6%) 13 , Asmara, Eritrea (76.7%) 16 , and Addis Ababa, Ethiopia (80%) 17 . Our finding was higher than studies conducted across Europe (37.4%) 24 , Tanzania (69.7%) 25 , Nekemte Referral Hospital (64.9%) 26 , and Gondar (60.5%) 27 . However, lower than study finding reported from India (91.8%) 28 and South Africa (86.5%) 29 .…”

The occurrence of urinary tract infection and determinant factors among diabetic patients at Dessie Referral Hospital, South Wollo, Northeast Ethiopia

“…Behavioral factors like smoking and alcohol drinking have a vital effect on poor glycemic control which indirectly affects the occurrence of UTIs among those diabetics. 17 Females were more likely to develop UTIs than males due to anatomic and physiologic factors 10 ; diabetic patients with high blood glucose levels, type II DM, and patients who cannot read and write have more prone to be infected. 18 A study conducted in New York showed that participants with diabetes receiving insulin therapy experience an even higher risk of infection than those not receiving insulin.…”