Level of sustained glycemic control and associated factors among patients with diabetes mellitus in Ethiopia: a hospital-based cross-sectional study

Abstract

Background

The level of sustained glycemic control in patients with diabetes mellitus (DM) is a major determinant of the occurrence of both acute and chronic complications. However, information about the level of glycemic control among patients in the follow-up care at the University of Gondar Referral Hospital is scanty. The study assessed the degree of glycemic control and associated factors among diabetic patients in the study area.

Method

A hospital-based cross-sectional study was conducted at the University of Gondar Referral Hospital. All diabetic patients aged ≥18 years who visited the Diabetes Clinic in January and February 2013 for follow-up medical evaluation and medication participated in the study. Patients with glycosylated hemoglobin test (HbA_1c) of ≥7% were classified as having a poor level of glycemic control. Propensity score was used to estimate the treatment effect. Multivariable logistic regression analysis was applied to determine the associated factors.

Result

Two hundred and fifty three (64.7%) of the 391 diabetic patients included in the study had a poor level of glycemic control, as evidenced by HbA_1c ≥7%. Poor glycemic control was much higher among Type 1 patients (82.9%) compared with Type 2 patients (57.5%). Being on insulin treatment (AOR =2.51; 95% CI =1.25, 5.04) and reporting poor medication adherence (AOR =3.19; 95% CI =1.76, 5.80) were found to be associated with poor glycemic control among Type 2 DM patients. High waist circumference was inversely associated with a poor level of glycemic control in Type 1 DM patients (AOR =0.05; 95% CI =0.01, 0.85).

Conclusion

The proportion of diabetic patients with a poor level of glycemic control is high. We recommend a comprehensive intervention to improve the overall treatment adherence with special attention to DM patients receiving insulin.

Keywords:

• glycemic control
• HbA_1c
• waist circumference
• diabetes mellitus
• BMI

Acknowledgments

We express our deepest gratitude to all of the study participants. We are also very grateful to the University of Gondar (UoG), the World Health Organization (WHO), and Addis Continental Institute of Public Health for funding and supporting the project.

Disclosure

The funders had no role in the study design, data collection, analysis, decision to publish, or in the preparation of the manuscript. The authors report no conflicts of interest in this work.