Department of Adult Health and Emergency Nursing

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    DETERMINANTS OF POOR GLYCEMIC CONTROL AMONG ADULT PATIENS WITH TYPE 2 DIABETES MELLITUS ON FOLLOW UP AT THE DIABETIC CLINIC OF REFERRAL HOSPITALS OF TIGRAY, ETHIOPIA, 2025
    (Mekelle University, 2025-05-28) GIRMAY TEKLE
    Background: Poor glycemic control remains a major public health concern among individuals with type 2 diabetes mellitus. In Ethiopia, the prevalence of uncontrolled blood glucose has been reported to range from 45.2% to 73.5%, including findings from studies in the Tigray region. Despite this substantial burden, there is limited research on the specific determinants of poor glycemic control, particularly in the Tigray region. Moreover, most existing studies in Ethiopia have utilized cross-sectional designs, which are limited in establishing temporal relationships between risk factors and glycemic control. A case-control study design offers a more robust approach for identifying these determinants. Therefore, investigating the factors associated with poor glycemic outcomes through a case-control design is essential to guide targeted interventions and strengthen diabetes management strategies. Objectives: The aim of this study was to identify the Determinants of poor glycemic control among adult patients with type 2 diabetes mellitus on follow up at the diabetic clinic of referral hospitals of Tigray, Ethiopia 2025. Methods: An institution-based unmatched case-control study design was conducted between January 15, and February 15, 2025. A total of 250 participants were included, consisting of 84 cases and 166 controls with case-to-control ratio of 1:2. Systematic random sampling was used to recruit cases and controls. Data were collected using an interviewer-administered structured questionnaire via KoBo Toolbox. In bivariable analysis those variables having a P-value of 0.25 were subsequently included in the multivariable. In multivariable analysis at a P-value of 0.05 with 95% confidence interval were considered statistically significant. Descriptive statistics were performed first, with the results summarized using tables, text, and figures. Ethical clearance was secured from the Institutional Review Board of the College of Health Sciences at Mekelle University. Result: This study revealed that inadequate dietary adherence (AOR = 2.59; 95% CI (1.187-5.684)), poor medication adherence (AOR = 2.96 95% CI (1.417–6.207)), presence of comorbidities (AOR = 2.72, 95% CI (1.30–5.69)), and having polypharmacy (AOR = 2.25, 95% CI (1.088- 4.691)) were significantly associated with poor blood sugar control. Conclusion and recommendation: Inadequate dietary adherence, poor medication adherence, co morbidity and having polypharmacy were determinant factors of poor glycemic control. Therefore, we recommend that patients should regularly follow their diet and medication.
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    DEPARTMENT OF ADULT HEALTH NURSING DETERMINANTS OF HYPERTENSION AMONG DIABETES MELLITUS PATIENTS IN PUBLIC HOSPITALS OF CENTRAL ZONE TIGRAY, ETHIOPIA 2024 (CASE-CONTROL STUDY)
    (Mekelle University, 2025-02) GEBREZGABHER HAGOS
    Background: Hypertension is defined as a persistent elevation of blood pressure with systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg. Poor diabetes management is a major significant of macrovascular and microvascular complications, as well as death. The gaps were inconsistent in study design and impact of war on health care. Objective: The objective of this study was to identify the determinants of hypertension among diabetes mellitus patients attending in public hospitals of the Central Zone of Tigray, Ethiopia 2024. Methods and materials: An institution-based unmatched case-control design was conducted, among a total sample size of 379 on clients from August 10, October 2024. Systematic random sampling was employed. Data were entered into Epidata version 4.6 and exported to SPSS version 22.0 for analysis. Variables with a p-value < 0.2 in bivariable logistic regression were included in the multivariable logistic regression. A p-value < 0.05 and a 95% confidence interval for the adjusted odds ratio were considered statistically significant determinants of hypertension. Ethical clearance was acquired from Mekelle University College of Health Science's ethical review committee. Results: A total of 379 participants with 1:3, case to controls ratio (95 cases and 284 controls) were included in the study achieving a 100% response rate. The significant factors for the development of hypertension among diabetic were age ≥ 50 years (AOR =6.266, CI 1.777-22.093), long duration of DM (greater than 10 years) (AOR=2.924, CI 1.100-7.771), family history of hypertension (AOR=3.819, CI 1.918-7.605), poor glycemic control (AOR=2.522, CI 1.212- 5.245), high waist to hip ratio (AOR=2.960, CI 1.408-6.220), physicaly inactive (AOR=2.121, CI 1.069-4.211) and poor knowledge about DM (AOR=4.5561, CI 2.308-8.990). Conclusion and Recommendations: Age ≥ 50 years, long duration of DM (above 10 years), Family history of hypertension, Higher waist-to-hip ratio, Poor glycemic control, physicaly inactive and poor knowledge of diabetic mellitus were determinants of hypertension among diabetes mellitus patients. We recommend to health professionals to give health education (about the relationship between obesity, physical inactivity, hypertension, and diabetes).We recommend to the participants to promote physical activity. We also recommended to Tigray Health Bureau to raise awareness among health professionals about the need to monitor patients with diabetes.