Glycemic Control and its Associated Factors among Elderly Diabetic Patients in a Tertiary Hospital in Lagos, Nigeria

Abstract

Background: Glycaemic control in the elderly diabetic patient is highly individualized and achieving desired targets in the presence of comorbid conditions could be very challenging. This study was conducted to assess the glycemic control of elderly diabetics and identify associated factors at the Lagos University Teaching Hospital (LUTH). Methods: A hospital-based, cross-sectional descriptive study involving 199 randomly selected elderly diabetic patients receiving care at LUTH. A pretested, interviewer-administered questionnaire was used in data collection, which include sociodemographic characteristics, clinical history, and glycaemic control. Glycemic control was assessed using glycated haemoglobin (HBA1C). HBA1C<7.0% was tight; 7-8% targeted and >8% poor glycaemic control. Associations between glycemic control and independent variables was assessed using the chi-square test and its predictors identified by logistic regression analysis. Level of significance was set at p<0.05. Results: The mean age of the participants was 68.6 years ± 6.7 years. Tight and poor glycemic control was seen in 35.1% and 34.2% respectively. Significant associations existed between glycemic control, age (ꭓ2 =9.310; p – 0.010), and marital status (ꭓ2 = 9.934; p – 0.007). Independent predictors include >2 antidiabetic medication (aOR – 2.55; p – 0.048) Conclusion: Poor glycaemic control was high among the elderly and there was a negative correlation between age and glycaemic control among the participants. Statistically significant association was also found between glycaemic control and marital status of the participants as well as the number of diabetic medications, the presence of co-morbid conditions and adherence to medications. The need for individualized care among elderly diabetics cannot be overemphasized in order to reduce the risk of hypoglycaemia, improve clinical outcome, while considering other factors which could have an impact on glycaemic control among the elderly.