Factors Associated with Poor Glycaemic Control Among Patients With Type 2 Diabetes Mellitus at Gatundu Level 5 Hospital, Kiambu County, Kenya

Abstract

Background: Diabetes Mellitus poses a significant global public health concern, marked by a surge in morbidity and mortality rates. Its  incidence and prevalence have witnessed a consistent rise over recent decades, with a projected rise. Occurrence of complications is  primarily attributed to poor glycemic control, which leads to diabetes-related complications, among them retinopathy, atherosclerosis,  renal complications, limb amputations, as well as life threatening emergencies; Diabetes Ketoacidosis (DKA) and Hyperosmolar  Hyperglycaemic State (HHS).

Objectives: To determine the prevalence of and factors linked to poor glycemic control among Type 2  Diabetes Mellitus patients at Gatundu Level 5 in Kiambu County, Kenya.

Methodology: This was a cross-sectional study conducted  between May and June 2022. Patients were selected via systematic sampling, intervieweradministered semi-structured questionnaires  were completed and files reviewed for recorded random blood sugar. Data analysis was done using SPSS V25. Chi-square test and t-test  were employed to identify factors associated with poor glycemic control, while logistic regression estimated the odds ratio (UOR), while  ethical considerations were diligently observed.

Results: One hundred and ninety seven participants were selected. The study found that a third of the participants (36%), (95% CI: 0.295 -0.4295), exhibited poor glycemic control, while the mean random blood sugar was  10.8mmol/l. The age of the participants was significantly associated with poor glycemic control (p = 0.012), revealing a 3% decrease in the  risk of PGC with each year noting increase in age. Duration of disease (p = 0.007), and medication non adherence, (missing medication  due to reasons other than forgetting (p = 0.03) and stopping medication without telling the healthcare provider (p = 0.049), (p = 0.03),  were also significantly linked to poor glycemic control.

Implications: The study not only addresses the critical issue of poor glycaemic  control but also contributes to bridging existing knowledge gaps in identifying factors hindering euglycemia.

Conclusion/ Recommendations: Findings underscore the need for targeted interventions, particularly among the younger age group, and emphasize the importance of increasing awareness regarding factors influencing PGC, which also impact medication adherence.