Glycemic Control and Associated Factors among Outpatients with Type 2 Diabetes at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
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Date
2021-10
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Addis Abeba University
Abstract
Background: The goals of glycemic management for patients with diabetes are to prevent or delaycomplications and optimize the quality of life. However, in clinical practice, the recommendedglycemic control target is very difficult to achieve. It is important, therefore, to identify factorsthat influence the outcomes of glycemia to improve the quality of diabetic management.
Objectives: This study aimed to assess the level of glycemic control & identify the underlyingfactors associated with inadequate & poor glycemic control among type 2 diabetic outpatients atTikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Methods: Hospital-based prospective, cross-sectional study was conducted among systematicallselected 325 patients with type 2 diabetes who were attending diabetic clinics at Tikur AnbessaSpecialized Hospital. Pretested, structured, interviewer-administered questionnaires were used tocollect sociodemographic & diabetes-related information on participants between March and May2021. HbA1c was used to assess glycemic control according to the HbA1c target of <7% (‘good’control) as recommended by the American Diabetes Association for non-pregnant adults. TheHbA1c level in the range of 7-8% was defined as an ‘inadequate’ control & as ‘poor’ at levels >8%.Data entry and analysis were performed using SPSS v26. Multivariate logistic regression analysiswas used to identify determinants of glycemic control.
Result: The median level of HbA1c of the participants was 8.4% (IQR 6.8-10.1) andapproximately three-quarters (73.8%) of the patients had inadequate & poor glycemic control(HbA1c ≥7%). Older age (AOR: 2.46, 95% CI: 1.28-6.01), DM duration of >10 years (AOR: 3.15,95% CI: 2.22-6.54), insulin therapy (AOR: 3.07, 95% CI: 2.10-6.12), poor diet compliance (AOR:1.97, 95% CI: 1.28-3.52) and failure to set targets for glycemic control (AOR: 3.42, 95% CI: 2.175.97)werefactors associated withinadequate&poorglycemic control.
Conclusion: The study revealed that a considerable number of diabetic patients had inadequateand poor glycemic control levels. And this had been found to be associated with older age, longerduration of DM, insulin therapy, poor diet compliance, and failure to set control targets.
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Keywords
Glucose control, diabetes mellitus, HbA1c, glycosylated hemoglobin, TASH