scholarly journals Glycemic control and its association with sociodemographics, comorbid conditions, and medication adherence among patients with type 2 diabetes in southwestern Nigeria

2021 ◽  
Vol 49 (10) ◽  
pp. 030006052110440
Author(s):  
Azeez Oyemomi Ibrahim ◽  
Segun Mattew Agboola ◽  
Olayide Toyin Elegbede ◽  
Waheed Olalekan Ismail ◽  
Tosin Anthony Agbesanwa ◽  
...  

Objective We determined the prevalence of poor glycemic control and associations with sociodemographics, comorbid conditions, and medication adherence among patients with type 2 diabetes mellitus (T2DM) at a tertiary hospital in southwestern Nigeria. Methods We conducted a retrospective observational study among 300 patients with T2DM using systematic random sampling. We used a semi-structured questionnaire to collect information on respondents’ sociodemographic profile, lifestyle, comorbid conditions, and antidiabetic medications. Adherence was determined using the Morisky Medication Adherence Scale. Fasting blood samples were tested using a glycated hemoglobin marker. Multivariate logistic regression was used to identify factors associated with poor glycemic control. Results Respondents’ mean age was 61.9 ± 11.8 years. The prevalence of poor glycemic control was 40.0% (95% confidence interval [CI]: 34.4%–45.8%). The adjusted odds ratio (95% CI) for factors associated with poor glycemic control was 2.522 (1.402–4.647) for older age, 1.882 (1.021–3.467) for low income, 1.734 (1.013–3.401) for obesity, 2.014 (1.269–5.336) for non-initiation of insulin therapy, and 1.830 (1.045–3.206) for poor medication adherence. Conclusion Older age, lower income, obesity, non-initiation of insulin, and poor medication adherence were associated with poor glycemic control. These variables may help clinicians identify patients at high risk of poor glycemic control.

2017 ◽  
Vol 9 (1) ◽  
pp. 3-14 ◽  
Author(s):  
Mahmoud Radwan ◽  
Aymen Elsous ◽  
Hasnaa Al-Sharif ◽  
Ayman Abu Mustafa

Aim: In this study, we aimed to assess the level of good glycemic control, to determine association between adherence to antidiabetic medications and glycosylated hemoglobin (HbA1c) and to examine factors influencing good glycemic control. Materials and methods: A cross-sectional design was employed among 369 patients with type 2 diabetes mellitus (T2DM) from four Ministry of Health health centers in 2016. A sample of 3 ml blood was taken to measure the HbA1c, and patients were asked to fill out a pretested questionnaire. Univariate and multivariate logistic regressions, to identify independent factors associated with good glycemic control, were conducted using SPSS software version 22 (IBM Corp, Armonk, NY, USA). Results: Mean [±standard deviation (SD)] of HbA1c was 8.97 (2.02) and one fifth of patients had good glycemic control (HbA1c ⩽ 7%). Factors associated with good glycemic control were: older age [odds ratio (OR) = 0.96, 95% confidence interval (CI): 0.933–0.988), high medication adherence (OR: 2.757, 95% CI: 1.308–4.693), and better health literacy (OR= 2.124, 95% CI: 1.917–4.921). Duration of diabetes mellitus (DM > 7 years) was inversely related to good glycemic control (OR = 2.255, 95% CI: 1.189–4.276). Conclusion: Our study showed that glycemic control was suboptimal, and factors associated with that were: older age, high medication adherence, and better health literacy. Knowledge of these factors could be an entry toward helping patients and targeting interventions to improve glycemic control and prevent diabetes-related complications.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Takeshi Horii ◽  
Makiko Iwasawa ◽  
Yusuke Kabeya ◽  
Koichiro Atuda

Abstract Polypharmacy (PP) occurs in patients with type 2 diabetes (T2DM) owing to multimorbidity. We evaluated concomitant PP and medication adherence in T2DM 3 years after initiation of administration of a hypoglycaemic agent using a nationwide claim-based database in Japan. Factors associated with medication PP and imperfect adherence were identified using multivariable logistic regression. PP was defined as using ≥6 medications. Patients with proportion of days covered (PDC) of <80% were defined as having poor medication adherence. A total of 884 patients were analysed. Multivariate analysis revealed that age, total number of consultations and body mass index (BMI) are factors that influence PP. Factors associated with PDC < 80% were 2–3, 4–5 and ≥ 6 medications compared with 1 medication, male sex, <17 consultations and age 50–59 and ≥ 60 years compared with <40 years. In conclusion, older age, high total number of consultations and BMI ≥ 25 kg/m2 are risk factors for PP. PP influenced good medication adherence at the end of the observation period.


2021 ◽  
Author(s):  
Azeez Oyemomi Ibrahim ◽  
Tosin Anthony Agbesanwa ◽  
Segun Mathew Agboola ◽  
Olabode Muftau Shabi ◽  
Adewumi Oluwaserimi Ajetunmobi ◽  
...  

Abstract Background: : Despite the high burden of Asymptomatic Malaria and Type 2 diabetes mellitus in sub-Saharan African, limited data exist regarding their co-occurrence and its associated clinical impacts of asymptomatic malaria parasitaemia on Type 2 diabetes mellitus in rural setting. The purpose of this study is to determine the prevalence of glycemic control and asymptomatic malaria parasitaemia; and to investigate the influence of socio-demographic characteristics and asymptomatic malaria parasitaemia on glycemic control among patients with Type 2 diabetes mellitus.Methods: Hospital-based cross-sectional study was conducted on 150 T2DM patients at Federal Teaching Hospital, Ido-Ekiti, SouthWestern Nigeria, between April and September 2019. Systematic random sampling technique was adopted to recruit the respondents. Socio-demographic data were obtained using a semi- structured interviewer administered questionnaire and clinical files. Venous blood samples were collected and processed for glycosylated haemoglobin sugar estimation and malaria parasite detection by microscopy. Data were analyzed using SPSS version 20.0. Multivariate logistic regression analysis was used to identify the influence of asymptomatic malaria parasitaemia and the socio-demographic profile on glycemic control.Results: The mean age, mean glycemic control and mean parasite density of the respondents were 64.8±11.1 years, 6.9±2.1% and 1123.4±433.8 respectively. The prevalence of poor glycemic control and asymptomatic malaria parasitaemia were 30.0% and 14.0% respectively. Old age, female gender, lack of formal education and asymptomatic malaria parasitaemia were associated with poor glycemic control.Conclusion: The study revealed that Type 2 diabetes mellitus patients in Ido-Ekiti, Nigeria, harbor asymptomatic malaria parasitaemia and that Asymptomatic malaria parasitaemia, old age, female gender and illiteracy were negative predictors of glycemic control. Therefore, type 2 diabetes mellitus patient with poor glycemic control should be screened for asymptomatic malaria parasitaemia. Also, respondents with these identified predictors should be targeted with focus care and qualitative health education to improve their glycemic control level.


2019 ◽  
Vol 15 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Salam Alqudah ◽  
Anan S. Jarab ◽  
Eman A. Alefishat ◽  
Fadia Mayyas ◽  
Maher Khdour ◽  
...  

Background: The limited implementation of clinical pharmacy service programs and the lack of studies identifying barriers to achieve blood glucose control have all attributed to the increased proportion of type 2 diabetes patients who have poor glycemic control in Jordan. Objective: To explore factors associated with higher HbA1c in patients with type 2 diabetes in Jordan. Methods: Variables including socio-demographics, disease and treatment factors were collected from171 patients with type2 diabetes at an outpatient diabetes clinic in Amman. Validated questionnaires were used to assess medication adherence, self-care activities, diabetes knowledge and healthrelated quality of life in addition to data collected from medical records. After the single-predictor analysis, stepwise linear regression was performed to develop a model with variables that best predicted hemoglobin A1c. Results: Medication adherence was inversely associated with HbA1c values (β = -0.275; t = 2.666; P < 0.01), indicating better glycemic control. Receiving insulin therapy was also associated with less HbA1c values and better glycemic control (β = - 0.184; t = 2.080; P < 0.05). Patients who had one or more comorbid conditions (β = 0.215; t = 2.264; P < 0.05) and those with longer diabetes duration (β = 0.092; t = 1.339; P < 0.05) were found to have significantly higher HbA1c values. Conclusion: Emphasizing medication adherence, particularly for patients with longer duration of diabetes and those with multiple comorbid diseases should be strongly considered in future diabetes management programs implemented to improve glycemic control in patients with type 2 diabetes.


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