Determinants of poor glycaemic control in type 2 diabetes in Dire Dawa City, Eastern Ethiopia: a case-control study.

Abstract

Background: In Ethiopia, there is little evidence on the factors contributing to poor glycaemic control. This study aimed to identify determinants of poor glycaemic control among type 2 diabetes in Dire Dawa City, Eastern Ethiopia.

Methods: A facility-based unmatched case-control study was conducted among type 2 diabetes mellitus patients in follow-up clinics. Cases were people with glycated haemoglobin (HbA1c) ≥7%, while those with HbA1c <7% were controls. A total of 190 patients were recruited in chronic follow-up diabetic clinics. The data were collected using structured questionnaire interviews and extracted from medical charts and entered into EpiData (EpiData Association, Odense, Denmark) and exported to Stata version 16.1 (StataCorp, College Station, TX, USA) for analysis. A binary logistic regression model was fitted to identify the determinants of poor glycaemic control.

Results: The study showed that being female (adjusted odds ratio [AOR] 2.73 [95% confidence interval {CI} 1.10 to 6.79]), a smoker (AOR 14.85 [95% CI 5.25 to 42.88]), blood glucose monitoring ≤3 times per week (AOR 4.87 [95% CI 1.42 to 16.71]), overweight (AOR 4.96 [95% CI 1.82 to 13.52]) or obese (AOR 5.19 [95% CI 1.76 to 15.56]), ≥10 y on treatment (AOR 3.56 [95% CI 1.17 to 10.82]), having coronary artery disease (AOR 2.47 [95% CI 1.01 to 6.03]) and poor adherence to diabetic medication (AOR 0.24 [95% CI 0.10 to 0.63]) were found to be predictors of poor glycaemic control.

Conclusions: Smoking, overweight or obese, poor medication adherence and blood glucose levels lead to poor glycaemic control. This study shows the benefits of quitting smoking, maintaining a healthy weight, adhering to medication and monitoring blood glucose levels.