Factors that affect Glycaemic Control among Type 2 Diabetes Mellitus Patients in Kwahu South District Eastern Region, Ghana

Abstract

Diabetes mellitus (DM) has become one of the most common chronic diseases globally, and it has assumed an epidemic status in the past few decades especially in low and middle income countries. The most frequent form is Type 2 diabetes which represents more than 85% of cases; other forms are Type 1 (10%) and Gestational diabetes (5%). Type 2 diabetes is a progressive disease associated with an increased risk of developing several complications which include; cardiovascular diseases, diabetic retinopathy and nephropathy. These complications are directly and strongly related to hyperglycaemia. Aggressive treatment to control hyperglycaemia is much more effective in reducing the number of complications than standard treatment. The study aims to determine the proportion of poor glycaemic control and identify the factors affecting the glycaemic control of type 2 DM. The glycated haemoglobin (HbA1c) of 382 type 2 diabetes mellitus patients attending diabetic clinic at Atibie Government Hospital were determined. Simple random sampling was applied to select 100 patients who had HbA1c > 6.5% as cases, and 100 with HbA1c < 6.5% as controls. Using a multivariate logistic regression model, factors that are associated with poor glycaemic control were determined. Majority had well controlled glycaemic status (64%). The commonest comorbidity was hypertension (60.5%). Patients with no family support are six times more likely to have poor glycaemic control as compare to those with family support (OR 6.40, 95% CI 1.70, 23.9 0, p= 006). Income level less than Gh₵ 250, and High Density Lipoprotein were strongly associated with poor glycaemic control (OR 0.063, 95% CI 0.008, 0.505 p=0.009, OR 0.31, 95% CI 0.17, 0.56, p<0.001) respectively. Prevalence of poor glycaemic control was 36%. Low income level and HDLP were significant risk factor for poor glycaemic control. We recommended that HbA1c assay equipment and reagents should be provided for all district hospitals, regular lipid profile should be carried out at regular short intervals. Diabetic patients with low financial status should be assisted.