Determinants of Poor Glycemic Control among People with Type 2 Diabetes in Selected Hospitals, in DireDawa City Administration, Eastern Ethiopia: Unmatched Case-Control Study

Abstract

Background: Poor glycemic control often leads to diabetes-related morbidity and mortality. In Ethiopia, the magnitude of people with poorly controlled type 2 diabetes was 60.5%. However, there is little evidence on the factors
contributing to poor glycemic control using the HbAc1 test. This study aimed to identify the determinants of poor
glycemic control among people with type 2 diabetes in selected hospitals in Dire Dawa City Administration, Eastern
Ethiopia.
Methods: A facility-based unmatched case-control study was conducted among people with diabetes in follow-up
clinics of private and public hospitals in Dire Dawa City Administration. Cases were people with HbA1c > 7%, while
people with HbA1c ≤ 7% were assigned as controls. A total of 190 patients (95 cases and 95 controls) were recruited
in chronic follow-up diabetic clinics in the hospitals. The data was collected using structured questionnaire interviews
and extracted from medical charts. The collected data were entered into EpiData and exported to Stata version 16.1
for analysis. A binary logistic regression model was fitted to identify the determinants of poor glycemic control.
Results: In the study, females were predominant, accounting for 72% of participants. The mean age of the participants
was 56.11 ±13.75 years in cases and 53.74 ± 12.23 years in controls. The study showed that being females (AOR=2.73;
95% CI:1.10,6.79), smokers (AOR=14.85;95% CI:5.25,42.88), blood glucose monitoring ≤ 3 times per week (AOR=
4.87; 95% CI:1.42,16.71), overweight (AOR= 4.96;95% CI:1.82,13.52) and obese (AOR=5.19; 95% CI:1.76,15.56),
more than 10 years or above on treatment (AOR= 3.56; 95% CI:1.17-10.82), and having coronary artery disease
(AOR=2.47; 95% CI:1.01, 6.03), adherence to diabetic medication (AOR, 0.24; 95% CI: 0.10,0.63) were found predictors of poor glycemic control.
Conclusion: Smoking, being overweight or obese, poor medication adherence, low monitoring of blood glucose level,
and having coronary artery disease were found to be predictors of poor glycemic control. Health promotion on the
benefits of quitting smoking, maintaining a healthy weight, adhering to medication, and monitoring blood glucose
levels.