Magnitude and predictors of poor glycemic control in patients with diabetes at Jimma Medical Center, Ethiopia

Abstract

Despite the development of new medications over the past decade to aid in the control of blood glucose, most diabetic patients often do not reach recommended glycemic targets of glycated hemoglobin (HbA1C) < 7% in daily clinical practice because of many contributing factors. This study was designed to assess the magnitude and predictors of poor glycemic control among adult diabetic patients on ambulatory chronic care follow-up at Jimma Medical Center. A cross sectional study was conducted on 307 adult diabetic patients between January 2 and April 30, 2022. Representative samples were selected using a systematic random sampling technique. Predictors of poor glycemic control were assessed using a binary and multi variable logistic regression. Data analysis was performed using Statistical Package for Social Science version 25 and R in the R studio environment. A total of 307 adult diabetic patients were included in the study making a response rate of 93%. Out of 307 adult diabetic patients, majority (62.5%) were males. Mean age of the patients was 48.91 ± 15.68 years. The majority, 221 (72%), of patients had poor glycemic control. Non-adherence of patients to medications (AOR = 3.36, 95% CI 1.16–9.72, p = 0.04), no formal education (AOR = 3.84, 95% CI (1.06–13.93, p = 0.04), therapeutic inertia (AOR = 3.16, 95% CI 1.61–6.20, p = 0.001) and poor diabetic knowledge (AOR = 4.79, 95% CI 1.56–14.68, p = 0.006) were found to be independent predictors of poor glycemic control. Nearly three fourth of diabetic patients in the present study had poor glycemic control and were at higher risk of developing diabetic complications or already developed it. These results highlight the need for appropriate management of patients focusing on adherence to medications, education, therapeutic inertia and diabetic knowledge to maintain good glycemic control and improve adverse outcomes of the disease in this study setting.