Determinants of Poor Glycemic Control among Type 2 Diabetes in Dire Dawa, Eastern Ethiopia: a multi-centered case-control study

Abstract

Abstract Poor glycemic control is a public health problem that cause a serious health issues among chronic follow up clinic in diabetes patients. In Ethiopia, scarcity of evidence exist using HbA1c testing to monitor and control blood glucose levels. Therefore, this study is aimed to identify determinants of poor glycemic control by using HbAc1 among diabetes patients in Ethiopia. A case-control study was conducted among type 2 diabetes patients in follow-up clinic at private and public hospitals in Dire Dawa town. We selected a total of 190 participants (95 cases and 95 controls) by using systematic random sampling technique. Structured questionnaire interviews and data extraction check list were used to collect the data. The collected data was entered into EpiData and exported to STATA version 16.1 for analysis. Bivariate and multivariable logistic regression was applied to determine predictors of glycemic control using an adjusted odd ratio (AOR) and a 95% confidence interval (CI). Finally, p-value <0.05 was considered the cut-off point for declaring a significant association. The study show that being a female (AOR= 2.73; 95% CI=1.10-6.79), smokers (AOR= 14.85;95% CI=5.25-42.88), blood glucose monitoring three or less 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), ten years or above the treatment (AOR= 3.56; 95% CI: 1.17-10.82), and patients who have coronary artery disease (AOR=2.47; 95% CI: 1.01, 6.03) were independent predictors of poor glycemic control. On the other hand, adherence to diabetic medication five or more days per week was negatively independent predictor of poor glycemic control (AOR= 0.24; 95% CI: 0.10-0.63). Being a female, smoking, overweight or obese, medication adherence, poor blood glucose monitoring, coronary artery diseases were found the predictors of poor glycemic control. As a result, emphasis on modifiable factors intervention that targets to improving glycemic control is required.