CHALLENGES AND BARRIERS OF GLYCEMIC CONTROL AMONG ADULTS WITH DIABETES IN AYDER COMPREHENSIVE SPECIALIZED HOSPITAL

Abstract

Diabetes mellitus is a public health concern in developed and developing countries. Currently, attaining the intended glycemic control in adult patients with diabetes is challenging more in lower income countries. This study aimed to evaluate the challenges and barriers of controlling glycated hemoglobin among adult patients with diabetes in diabetes clinic, Ayder Comprehensive Specialized Hospital, Mekelle University. The study also aimed to evaluate associated factors of knowledge, medication adherence, and self-care practice of the same patients. A cross-sectional study was conducted in diabetes clinic, Ayder comprehensive specialized hospital Mekelle University from May to June 2024. Structured tools were used to collect data about socio-demographics, knowledge, medication adherence, and self-care practices. The data was analyzed using the software Statistical Package for Social Science (SPSS) version 27.0. Binary logistic regression was performed to determine associated factors with poor glycemic control and poor self-care practice whereas ordinal logistic regression was applied to determine factors associated with knowledge and medication adherence. Statistical consideration was given for bivariate binary logistic regression at p-value<0.25 and a p-value <0.05 was considered statistically significant for mult-variate and ordinal logistic regression. Out of 338 study participants nearly three-fourth (73.4%) had poor glycemic control. Secondary educational level (AOR = 5.1, P<0.02), diabetes duration [(AOR = 3.1, p<0.002), AOR = 3, p<0.01), AOR = 5.1, p<0.02)], moderate adherence (AOR = 0.28, p<0.001), high knowledge levels (AOR = 3.3, p<0.007), and good self-care practice (0.26, p< 0.001) were found associated with poor glycemic control. Single (AOR = 3.3, p<0.018) and married (AOR = 2.4, p<0.03) marital status, levels of knowledge [(low, AOR = 0.3, p<0.001), (average, AOR = 0.4, p<0.03)] and presence of comorbidities (AOR = 0.56, p<0.03) and high knowledge level (AOR = 2.1, p<0.01) were associated with counterparts of knowledge, adherence, and self-care practice. Glycemic status was observed uncontrolled in participants with secondary educational level, long diabetes duration, poor adherence and self-care practice. Thus, the study recommends patients to overcome the problems discussed through strictly following the advice offered by physicians and stick to their prescribed medication.