Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Science, Haramaya University, Harar, Ethiopia.
Department of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
PLoS One. 2021 May 11;16(5):e0251506. doi: 10.1371/journal.pone.0251506. eCollection 2021.
To assess the rate of glycemic control and associated factors among type 2 diabetes mellitus patients at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia.
A cross-sectional study was conducted from 13 May to 16 August 2019. Type 2 diabetic patients on follow up at Dilchora Referral Hospital who fulfilled the inclusion criteria of the study were included. Systematic random sampling was used to select study participants. Data was collected by a face-to-face interview and review of medical records. The primary outcome was the level of blood glucose during three consecutive visits. Poor glycemic control was defined as a blood sugar level of more than 154 mg/dL based on the average of measurements from three consecutive visits. Multivariate logistic regression analysis was used to identify determinants of glycemic control.
A total of 394 participants responded to the interview and were included in the final analysis. The overall prevalence of poor glycemic control was 45.2% (95%CI: 40.6%-50.0%). Patients who were on oral anti-diabetic drug plus insulin had more than two times greater chance of poor glycemic control than patients on oral anti-diabetic drug alone: 2.177(95%CI:1.10-4.29). The odds of poor glycemic control in patients who did not understand the pharmacist's instructions was two times higher than patients with good understanding of instructions 1.86(95%CI: 1.10-3.13). Patients who had poor level of practice were found to have poor glycemic control: 1.69(95% CI: 1.13-2.55).
The overall prevalence of poor glycemic control was high among type 2 diabetes patients. Oral anti-diabetic drugs in combination with insulin, lack of understanding of pharmacist's advice, and poor practice of diabetic patients were significant factors of poor glycemic control. Pharmacists should reassure the understanding of patients before discharge during counseling. Optimization of the dose of antidiabetic medications and combination of oral hypoglycemic agents should be considered.
评估埃塞俄比亚东部 Dire Dawa 的 Dilchora 转诊医院 2 型糖尿病患者的血糖控制率及相关因素。
这是一项横断面研究，于 2019 年 5 月 13 日至 8 月 16 日进行。符合研究纳入标准的在 Dilchora 转诊医院接受随访的 2 型糖尿病患者被纳入研究。采用系统随机抽样法选择研究对象。通过面对面访谈和病历回顾收集数据。主要结局为连续三次就诊时的血糖水平。根据三次连续就诊测量的平均值，血糖水平＞154mg/dL 定义为血糖控制不佳。采用多变量 logistic 回归分析确定血糖控制的决定因素。
共有 394 名患者接受了访谈并纳入最终分析。血糖控制不佳的总患病率为 45.2%（95%CI：40.6%-50.0%）。与仅服用口服降糖药的患者相比，服用口服降糖药加胰岛素的患者血糖控制不佳的可能性高出两倍以上：2.177（95%CI：1.10-4.29）。不理解药剂师指示的患者血糖控制不佳的可能性是理解良好的患者的两倍 1.86（95%CI：1.10-3.13）。发现实践水平差的患者血糖控制不佳：1.69（95%CI：1.13-2.55）。
2 型糖尿病患者血糖控制不佳的总体患病率较高。口服降糖药联合胰岛素、缺乏对药剂师建议的理解以及糖尿病患者的实践较差是血糖控制不佳的显著因素。药剂师在咨询期间应在出院前确保患者的理解。应考虑优化降糖药物的剂量和联合使用口服降糖药。
