Determinants of glycemic control among persons living with type 2 diabetes mellitus attending a district hospital in Ghana

Abstract

Background Diabetes mellitus is a growing public health emergency with prevalence in sub-Sahara Africa expected to experience the highest increase by 2045. The cornerstone of diabetes management is glycemic control, a complex process with different contributing factors. This study determines the level of glycemic control and the associated individual factors among type 2 diabetes mellitus (T2DM) patients. Methods A cross-sectional descriptive study was conducted at the Shai-Osudoku District Hospital from October to December 2022. A structured questionnaire was used to collect data on socio-demographic characteristics, lifestyle modifications, co-morbidities, adherence to medication and diet regimens and duration of diabetes. Anthropometric and glycated hemoglobin (HbA1c) measurements were taken. Chi-squared and multivariate logistic regression analyses were carried out to determine factors associated with glycemic control at 95% confidence levels. Results A total of 227 patients participated in this study. The majority of the participants were females (77.97%) and the mean (+SD) age was 60.76 + 12.12 years. Good glycemic control (HbA1c < 7%) among the participants was 38.77% (n=88) and the median HbA1c was 7.5% (IQR: 6.5% to 9.4%). Significant factors associated with good glycemic control were eating healthy meals (AOR: 4.78, 95% CI: 1.65, 13.88: p=0.004), oral hypoglycemic agents alone (AOR: 15.71, 95% CI: 1.90, 129.44: p=0.010) and those with previously good glycemic control (AOR: 4.27, 95% CI: 2.16, 8.43: <0.001). Conclusion This study showed low levels of good glycemic control among T2DM patients at the primary care level in Ghana. Healthy eating, oral hypoglycemic agents and those with previously normal HbA1c were associated with glycemic control.