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 delay complications and optimize the quality of life. However, in clinical practice, the recommended glycemic control target is very difficult to achieve. It is important, therefore, to identify factors that 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 underlying factors associated with inadequate & poor glycemic control among type 2 diabetic outpatients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: Hospital-based prospective, cross-sectional study was conducted among systematically selected 325 patients with type 2 diabetes who were attending diabetic clinics at Tikur Anbessa Specialized Hospital. Pretested, structured, interviewer-administered questionnaires were used to collect sociodemographic & diabetes-related information on participants between March and May 2021. 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. The HbA1c 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 analysis was used to identify determinants of glycemic control. Result: The median level of HbA1c of the participants was 8.4% (IQR 6.8-10.1) and approximately 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) were factors associated with inadequate & poor glycemic control. Conclusion: The study revealed that a considerable number of diabetic patients had inadequate and poor glycemic control levels. And this had been found to be associated with older age, longer duration 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

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