Department of Clinical Pharmacy, School of Pharmacy, Jimma University, Jimma, Oromia, Ethiopia.
Department of Pharmacology, School of Pharmacy, Jimma University, Jimma, Oromia, Ethiopia.
Sci Rep. 2023 Sep 24;13(1):15952. doi: 10.1038/s41598-023-42774-y.
Despite the development of new medications over the past decade to aid in the control of blood glucose, most diabetic patients often do not reach recommended glycemic targets of glycated hemoglobin (HbA1C) < 7% in daily clinical practice because of many contributing factors. This study was designed to assess the magnitude and predictors of poor glycemic control among adult diabetic patients on ambulatory chronic care follow-up at Jimma Medical Center. A cross sectional study was conducted on 307 adult diabetic patients between January 2 and April 30, 2022. Representative samples were selected using a systematic random sampling technique. Predictors of poor glycemic control were assessed using a binary and multi variable logistic regression. Data analysis was performed using Statistical Package for Social Science version 25 and R in the R studio environment. A total of 307 adult diabetic patients were included in the study making a response rate of 93%. Out of 307 adult diabetic patients, majority (62.5%) were males. Mean age of the patients was 48.91 ± 15.68 years. The majority, 221 (72%), of patients had poor glycemic control. Non-adherence of patients to medications (AOR = 3.36, 95% CI 1.16-9.72, p = 0.04), no formal education (AOR = 3.84, 95% CI (1.06-13.93, p = 0.04), therapeutic inertia (AOR = 3.16, 95% CI 1.61-6.20, p = 0.001) and poor diabetic knowledge (AOR = 4.79, 95% CI 1.56-14.68, p = 0.006) were found to be independent predictors of poor glycemic control. Nearly three fourth of diabetic patients in the present study had poor glycemic control and were at higher risk of developing diabetic complications or already developed it. These results highlight the need for appropriate management of patients focusing on adherence to medications, education, therapeutic inertia and diabetic knowledge to maintain good glycemic control and improve adverse outcomes of the disease in this study setting.
尽管在过去十年中开发了新的药物来帮助控制血糖,但由于许多因素的影响,大多数糖尿病患者在日常临床实践中通常无法达到糖化血红蛋白 (HbA1C) < 7%的建议血糖目标。本研究旨在评估在 Jimma 医疗中心接受门诊慢性护理随访的成年糖尿病患者中血糖控制不佳的程度和预测因素。 2022 年 1 月 2 日至 4 月 30 日,对 307 名成年糖尿病患者进行了横断面研究。使用系统随机抽样技术选择代表性样本。使用二元和多变量逻辑回归评估血糖控制不佳的预测因素。使用 Statistical Package for Social Science 版本 25 和 R 工作室环境中的 R 进行数据分析。共有 307 名成年糖尿病患者纳入研究,应答率为 93%。在 307 名成年糖尿病患者中,大多数(62.5%)是男性。患者的平均年龄为 48.91 ± 15.68 岁。大多数(221 名,72%)患者血糖控制不佳。患者对药物的不依从(AOR = 3.36,95%CI 1.16-9.72,p = 0.04)、无正规教育(AOR = 3.84,95%CI(1.06-13.93,p = 0.04)、治疗惰性(AOR = 3.16,95%CI 1.61-6.20,p = 0.001)和糖尿病知识差(AOR = 4.79,95%CI 1.56-14.68,p = 0.006)被发现是血糖控制不佳的独立预测因素。本研究中,近四分之三的糖尿病患者血糖控制不佳,患糖尿病并发症的风险较高或已经患有并发症。这些结果强调需要对患者进行适当的管理,重点关注药物依从性、教育、治疗惰性和糖尿病知识,以维持良好的血糖控制并改善该研究环境下疾病的不良结局。