Abstract
Objective: The practice of self-care behaviors by patients with diabetes mellitus plays a vital role in achieving optimal glycaemic control. Previous Nigerian studies discussed how the knowledge of self-care behaviors among people with diabetes influences glycaemic control rather than the impact of these behaviors on glycaemic control. This study assesses the relationship between the practice of diabetes self-care behaviors and glycaemic control. Research Design and Methods : A cross-sectional study was conducted among people with type 2 diabetes at the medical outpatient clinic of the hospital. Three hundred and sixteen participants were recruited over four months, however, due to incomplete data only 313 of these participants were analyzed. Data on respondents’ characteristics and level of self-care behaviors were obtained using a pretested questionnaire and Summary of Diabetic Self-Care Activities (SDSCA). A1C was used as an indicator of glycaemic control. Results : The proportion of the participants with “good” glycaemic control and “good” practice of self-care behaviors were 40.6% and 26.8% respectively. Female gender (P=0.002, OR=4.23), using only oral hypoglycaemic agents (P=0.029, OR=4.83), the absence of truncal obesity (P<0.001, OR=15.33), and “good” practice of self-care behavior (P<0.001, OR=5.86) were predictors of “good” glycaemic control. Conclusions : The proportion of patients with “good” glycaemic control and “good” practice of self-care behaviors were low. The predictors of glycaemic control in this study, which included medical and non-medical components of diabetes care, underscores the importance of a multi-pronged approach involving prescriptive practices by physicians and improved self-care behavioral practices by patients.
Highlights
Diabetes mellitus is a global health problem that has reached a pandemic proportion
The presence of hypertension in 45% of type 2 diabetes (T2D) participants studied further reinforced the high prevalence of hypertension among patients with diabetes reported in previous studies [20, 21]
The predictors of glycaemic control in this study included medical and non-medical components of diabetes management. This underscores the importance of a multi-pronged approach that focuses on the collaborative partnership between healthcare professionals and patients, better medical and non-medical prescriptive approaches by T2D multidisciplinary teams, and improved self-care behaviors by patients
Summary
The number of people with diabetes in 2017 was estimated to be 425 million with a prevalence of 8.8%. Nigeria has the largest number of people living with diabetes in Africa due to its size [1]. The International Diabetes Federation (IDF) estimated that about 1,240-3,876 million cases of diabetes occurred in Nigeria in 2017 with a current overall prevalence of 4.6% [1]. This represents more than a two-fold increase in prevalence from the previously reported national prevalence rate of 2.2% [3]. Reports from subsequent studies have indicated an alarming increase in the prevalence of diabetes among all ethnic groups, with a higher prevalence rate in urban populations when compared to rural populations [4, 5]
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