Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
Disease Prevention and Control Directorate, Gambella Regional Health Bureau, Gambella, Ethiopia.
PLoS One. 2023 Mar 23;18(3):e0282962. doi: 10.1371/journal.pone.0282962. eCollection 2023.
Diabetes is one of the biggest worldwide health emergencies of the 21st century. A major goal in the management of diabetes is to prevent diabetic complications that occur as a result of poor glycemic control. Identification of factors contributing to poor glycemic control is key to institute suitable interventions for glycemic control and prevention of chronic complications.
A hospital-based cross-sectional study was conducted among 305 adult type 2 diabetic patients at public hospitals in Hadiya zone from March 1-30, 2019. The study participants were selected by systematic sampling technique. Data were collected using a pretested structured questionnaire and patient chart review; anthropometric and blood pressure measurements were taken. Multivariable logistic regression analysis was used to identify factors associated with poor glycemic control. Adjusted odds ratios (AOR) with respective 95% Confidence Interval (CI) and p < 0.05 were used to set statistically significant variables.
Out of 305 diabetic patients, 222 (72.8%) were found to have poor glycemic control. Longer duration of diabetes (5-10 years) [AOR = 2.24, 95% CI: 1.17-4.27], lack of regular follow-up [AOR = 2.89, 95% CI: 1.08-7.71], low treatment adherence [AOR = 4.12, 95% CI: 1.20-8.70], use of other alternative treatments [AOR = 3.58, 95% CI: 1.24-10.36], unsatisfactory patient physician relationship [AOR = 2.27, 95% CI: 1.27-4.04], and insufficient physical activity [AOR = 4.14, 95% CI: 2.07-8.28] were found to be independent predictors of poor glycemic control. Diabetes Mellitus (DM) complications were slightly higher among participants with poor glycemic control (39.2%), duration of DM 10 and above years (41.9%), low medication adherence (48.5%), taking oral anti-diabetics (54.3%), and DM patients having unsatisfactory patient provider relationship (72.4%).
A significant proportion of diabetic patients had poor glycemic control and DM complications. Therefore, appropriate interventions are required to maintain optimal glycemic control and prevent the development of life-threatening complications among DM patients.
糖尿病是 21 世纪全球最大的健康危机之一。糖尿病管理的主要目标是预防因血糖控制不佳而导致的糖尿病并发症。确定导致血糖控制不佳的因素是实施适当的血糖控制干预措施和预防慢性并发症的关键。
2019 年 3 月 1 日至 30 日，在哈迪耶地区的公立医院进行了一项基于医院的横断面研究，纳入了 305 名成年 2 型糖尿病患者。研究参与者通过系统抽样技术选择。使用经过预测试的结构化问卷和病历回顾收集数据；进行了人体测量和血压测量。使用多变量逻辑回归分析来确定与血糖控制不佳相关的因素。使用调整后的优势比（AOR）及其相应的 95%置信区间（CI）和 p<0.05 来确定有统计学意义的变量。
在 305 名糖尿病患者中，有 222 名（72.8%）血糖控制不佳。糖尿病病程较长（5-10 年）[AOR=2.24，95%CI：1.17-4.27]、缺乏定期随访[AOR=2.89，95%CI：1.08-7.71]、治疗依从性低[AOR=4.12，95%CI：1.20-8.70]、使用其他替代疗法[AOR=3.58，95%CI：1.24-10.36]、医患关系不满意[AOR=2.27，95%CI：1.27-4.04]、体力活动不足[AOR=4.14，95%CI：2.07-8.28]，这些都是血糖控制不佳的独立预测因素。血糖控制不佳的参与者中，糖尿病并发症略高（39.2%），糖尿病病程 10 年及以上（41.9%）、药物依从性低（48.5%）、服用口服降糖药（54.3%）、医患关系不满意（72.4%）。
相当一部分糖尿病患者血糖控制不佳且伴有糖尿病并发症。因此，需要采取适当的干预措施，以维持糖尿病患者的最佳血糖控制，预防危及生命的并发症的发生。
