Poor Self-Care Practices and Being Urban Resident Strongly Predict Chronic Complications Among Patients with Type 2 Diabetes in Eastern Ethiopia: A Hospital-Based Cross-Sectional Study

Abstract

Background

Diabetes, together with its complications, has a considerable negative influence on people’s quality of life and healthcare delivery and raises diabetic mortality. However, there is limited information about the diabetes-associated chronic complications in the study setting. Therefore, this study aimed to determine the burden and factors related to the chronic complications among patients with type 2 diabetes (T2D) in Eastern Ethiopia.

Methods

A hospital-based cross-sectional study was conducted among 879 patients with T2D at two public hospitals in Harar. The data were collected through interviews using a structured questionnaire. Data related to the diagnosis of chronic complications and biochemical tests were extracted from medical records. The outcome variable was the number of chronic complications that happened to the patients. A generalized Poisson regression model with robust variance estimation was used to investigate the association of independent variables with chronic complications. An adjusted prevalence ratio with a 95% CI was reported to show an association using a p-value ≤0.05.

Results

One or more chronic complications were presented in 43% of T2D (95% CI: 39.65, 46.19). Macrovascular and microvascular complications were found in 27.6% and 23.5% of patients, respectively. Urban residence (APR = 2.64; 95% CI: 1.54, 4.54), low wealth status (APR = 1.80; 95% CI: 1.17, 2.76), diabetes duration ≥5 years (APR = 1.46; 95% CI: 1.05, 2.01), hypertriglyceridemia (APR = 1.48; 95% CI: 1.07, 2.09) and poor self-care practices (APR = 1.62; 95% CI: 1.18, 2.23) were factors significantly associated with the chronic complications.

Conclusion

The burden of chronic complications was high, with nearly half of T2D patients experiencing one or more chronic complications. Almost one in ten patients suffered from multiple chronic complications. The complications were mainly influenced by being urban resident, low wealth status, and poor self-care practices. Therefore, health care providers need to educate patients and promote self-care practices and healthy lifestyles to achieve treatment goals and lower the risk of chronic complications.

Keywords:

• chronic complications
• type 2 diabetes
• Harar
• Eastern Ethiopia

Ethical Approval

The study protocol was approved by the Institutional Health Research and Ethical Review Committee of the College of Health and Medical Sciences, Haramaya University with Ref. No: IRERC/217/2020). The study participants were recruited voluntarily after receiving sufficient information about the study. All those volunteer participants signed written informed consent. The interview and anthropometric measurements were taken in a separate room to maintain the participants’ privacy. Personal identifiers were never used, and all information was kept confidential. We also checked that this study complies with the Helsinki Declaration.⁷⁶

Acknowledgments

We thank the study participants, data collectors, supervisors, RHB, hospital administrators, and Haramaya University.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest.

Additional information

Funding

The research’s field activities were funded by Haramaya University. The grant code was HURG-2020-02-02-09. The funder had no role in the design, data collection, analysis, interpretation, writing, or publication of the manuscript.