Rate of glycemic control and associated factors among type two Diabetes mellitus patients attending at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia

Abstract

Abstract Background: Even though studies had well-established the negative impacts of poor glycemic control on the progression of diabetic complications, a small proportion of type 2 diabetic populations are able to achieve glycemic goal. Studies have pointed out many factors as contributing factors for not achieving treatment glycemic goals. However, the factors influencing poor glycemic control differ across countries and between different ethnic groups. Objective: To assess rate of glycemic control and associated factors among type 2 diabetes mellitus patients at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia. Methods: A cross-sectional study was conducted from 13 May to 16 August 2019. Participants included in the study were type 2 diabetic patients who had to follow up at Dilchora Referral Hospital during the study period. A systematic random sampling was used to recruit study participants. The primary outcome was rate of glycemic control defined as the average of fasting blood sugar level on the previous three continuous occasions of their visit to the hospital is greater than or equal to 154mg/dl. The data were entered into Epi info 7 then exported and analyzed using Statistical Packages for Social Sciences (SPSS) version 20. Multivariable logistic regression analysis was used to identify factors associated with poor glycemic control. All statistical tests were performed using a level of significance of 0.05 and 95% confidence intervals. Result: A total of 422 patients were recruited to participate in this study. Of whom, 394 (93.36%) participants responded to the interview. The study participants had a mean age of 40.76 years (SD=+12.79). Nearly fifty percent of respondents (51.8%) were female. From all the respondents, 184(46.7%) belong in the age group of 40-59 years. Mean fasting blood sugar was 154.57mg/dl (SD=+36.33). The overall prevalence of poor glycemic control was 45.2% (95%CI: 40.6-50.0). In multivariable logistic regression analysis, T2DM patients who were on oral antidiabetic drug plus insulin had nearly two times greater chance of having poor glycemic control than those who were on oral anti-diabetic drug alone: 2.177(95%CI:1.104-4.294; p=0.025). The odds of poor glycemic control in study participants who did not understand the pharmacist’s advice regarding their drug was approximately two times higher: 1.86(95%CI: 1.10-3.13; p=0.020). Patients who had a poor level of practice were found to be nearly 1.5 times more likely to have poor glycemic control: 1.69(95% CI: 1.126- 2.545; p=0.011) Conclusion: This study found that the overall prevalence of poor glycemic control was high. Oral anti-diabetic drugs in combination with insulin, lack of understood pharmacist’s advice regarding their drugs, and poor practice of diabetic patients were significant factors of poor glycemic control. Pharmacy personnel, physician and nurses who are dealing with T2DM patients should consider significant factors associated with poor glycemic control for more patient-centered diabetes care.

Keywords: Dilchora Hospital, Glycemic control, Type 2 diabetes mellitus.