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Predictors of poor glycemic control in type 2 diabetic patients attending public hospitals in Dar es Salaam.

Kamuhabwa AR, Charles E - Drug Healthc Patient Saf (2014)

Bottom Line: Tanzania has recently experienced a significant rise in the burden of diabetes, and it is estimated that more than 400,000 people are living with diabetes.Blood pressure, weight, and height were measured during the day of the interview.Females aged between 40 years and 59 years had significantly higher poor glycemic control (76.1%) as compared with their male counterparts.

View Article: PubMed Central - PubMed

Affiliation: Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

ABSTRACT

Background: Tanzania has recently experienced a significant rise in the burden of diabetes, and it is estimated that more than 400,000 people are living with diabetes. A major concern in the management of diabetes is the occurrence of diabetic complications that occur as a result of poor glycemic control. Identification of the factors associated with poor glycemic control is important in order to institute appropriate interventions for the purpose of improving glycemic control and prevention of chronic complications.

Aim: The aim of this study was to determine the level of glycemic control and explore the factors associated with poor glycemic control among patients with type 2 diabetes mellitus (T2DM).

Methodology: A cross-sectional study was carried out at the diabetic clinics for T2DM patients at the national and municipal hospitals in Dar es Salaam. A total of 469 patients were enrolled over a period of 8 weeks from March 2013 to May 2013. Patients' information such as sociodemographic characteristics, self-care management behaviors, and medication adherence were obtained through interviews. Blood pressure, weight, and height were measured during the day of the interview. All available last readings for fasting blood glucose (FBG) measurements, lipid profile, and other clinical characteristics were obtained from patients' records.

Results: The mean age of patients was 54.93 years. The majority (63.5%) of patients were females and only eight patients had records of lipid profile measurements. Out of 469 patients, 69.7% had FBG of ≥7.2 mmol/L, indicating poor glycemic control. Females aged between 40 years and 59 years had significantly higher poor glycemic control (76.1%) as compared with their male counterparts. Thirty-eight percent of patients had poor medication adherence, which was associated with poor glycemic control. The proportion of poor glycemic control increased with age. A significantly high proportion of poor glycemic control was observed in patients who had had the disease for more than 20 years since diagnosis. Factors associated with poor glycemic control included lack of health insurance, using more than one oral hypoglycemic agent, normal body mass index, obesity, and nonadherence to diabetic medications.

Conclusion: Patients in this study had generally poor glycemic control. From these findings it is recommended that diabetic patients should be routinely screened for lipid profile to determine levels of cholesterol, triglycerides, and low-density lipoproteins, which are risk factors for cardiovascular events. An education program should be developed to educate patients on the importance of medication adherence and weight management for better glycemic control.

No MeSH data available.


Related in: MedlinePlus

Levels of adherence to antidiabetic medications among type 2 diabetes mellitus patients (n=469).
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f1-dhps-6-155: Levels of adherence to antidiabetic medications among type 2 diabetes mellitus patients (n=469).

Mentions: Assessment of patients’ responses to the eight-item modified Morisky adherence predictor scale showed that 17.5% of patients were highly adherent to the prescribed medications, 218 (44.6%) patients were moderately adherent, while 38% of the patients were judged to have low adherence to the prescribed antidiabetic medications (Figure 1). The scale showed that most (57.1%) patients did miss taking their medications due to different reasons. The reported reasons for nonadherence were the cost of the medications (39.5%), omission (18%), unavailability of medications in the health facilities (16.9%), travel (16.9%), side effects (9.4%), sense of feeling better (4.1%), and use of alternative medicines (2.6%). One hundred and sixty-two (34.5%) patients reported that when symptoms were under control they stopped taking their medications.


Predictors of poor glycemic control in type 2 diabetic patients attending public hospitals in Dar es Salaam.

Kamuhabwa AR, Charles E - Drug Healthc Patient Saf (2014)

Levels of adherence to antidiabetic medications among type 2 diabetes mellitus patients (n=469).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4216043&req=5

f1-dhps-6-155: Levels of adherence to antidiabetic medications among type 2 diabetes mellitus patients (n=469).
Mentions: Assessment of patients’ responses to the eight-item modified Morisky adherence predictor scale showed that 17.5% of patients were highly adherent to the prescribed medications, 218 (44.6%) patients were moderately adherent, while 38% of the patients were judged to have low adherence to the prescribed antidiabetic medications (Figure 1). The scale showed that most (57.1%) patients did miss taking their medications due to different reasons. The reported reasons for nonadherence were the cost of the medications (39.5%), omission (18%), unavailability of medications in the health facilities (16.9%), travel (16.9%), side effects (9.4%), sense of feeling better (4.1%), and use of alternative medicines (2.6%). One hundred and sixty-two (34.5%) patients reported that when symptoms were under control they stopped taking their medications.

Bottom Line: Tanzania has recently experienced a significant rise in the burden of diabetes, and it is estimated that more than 400,000 people are living with diabetes.Blood pressure, weight, and height were measured during the day of the interview.Females aged between 40 years and 59 years had significantly higher poor glycemic control (76.1%) as compared with their male counterparts.

View Article: PubMed Central - PubMed

Affiliation: Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

ABSTRACT

Background: Tanzania has recently experienced a significant rise in the burden of diabetes, and it is estimated that more than 400,000 people are living with diabetes. A major concern in the management of diabetes is the occurrence of diabetic complications that occur as a result of poor glycemic control. Identification of the factors associated with poor glycemic control is important in order to institute appropriate interventions for the purpose of improving glycemic control and prevention of chronic complications.

Aim: The aim of this study was to determine the level of glycemic control and explore the factors associated with poor glycemic control among patients with type 2 diabetes mellitus (T2DM).

Methodology: A cross-sectional study was carried out at the diabetic clinics for T2DM patients at the national and municipal hospitals in Dar es Salaam. A total of 469 patients were enrolled over a period of 8 weeks from March 2013 to May 2013. Patients' information such as sociodemographic characteristics, self-care management behaviors, and medication adherence were obtained through interviews. Blood pressure, weight, and height were measured during the day of the interview. All available last readings for fasting blood glucose (FBG) measurements, lipid profile, and other clinical characteristics were obtained from patients' records.

Results: The mean age of patients was 54.93 years. The majority (63.5%) of patients were females and only eight patients had records of lipid profile measurements. Out of 469 patients, 69.7% had FBG of ≥7.2 mmol/L, indicating poor glycemic control. Females aged between 40 years and 59 years had significantly higher poor glycemic control (76.1%) as compared with their male counterparts. Thirty-eight percent of patients had poor medication adherence, which was associated with poor glycemic control. The proportion of poor glycemic control increased with age. A significantly high proportion of poor glycemic control was observed in patients who had had the disease for more than 20 years since diagnosis. Factors associated with poor glycemic control included lack of health insurance, using more than one oral hypoglycemic agent, normal body mass index, obesity, and nonadherence to diabetic medications.

Conclusion: Patients in this study had generally poor glycemic control. From these findings it is recommended that diabetic patients should be routinely screened for lipid profile to determine levels of cholesterol, triglycerides, and low-density lipoproteins, which are risk factors for cardiovascular events. An education program should be developed to educate patients on the importance of medication adherence and weight management for better glycemic control.

No MeSH data available.


Related in: MedlinePlus