Predictors of glycemic control, quality of life and diabetes self-management of patients with diabetes mellitus at a tertiary hospital in Ghana
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Background
The burden of diabetes mellitus (DM) in Sub-Saharan Africa is high and continues to increase. Effective DM management focuses on key goals such as glycemic control, prevention of acute and chronic complications and improvement of quality of life (QOL). This study therefore assessed predictors of glycemic control, QOL and diabetes self-management (DSM) of patients with DM in a tertiary hospital in Ghana.
Methods
We conducted a cross-sectional study involving face-to-face interviews of patients with DM attending clinic using structured questionnaires and validated study instruments as well as review of medical records. A multivariable logistics regression analysis was used to identify independent factors associated with good glycemic control, poor QOL and poor DSM practices.
Results
The study involved 360 patients with mean age of 62.5 ± 11.6 years and a female preponderance, 271 (75.3%). The mean HbA1c among study participants was 7.8 ± 2.7% of which 44.7% had HbA1C <7%. Patients on only oral DM medications (aOR 2.14; 95% CI 1.19-3.88, p=0.012) were more likely to have good glycemic control. Urban residence (aOR 0.24; 95% CI 0.06-0.87, p=0.030) and good DSM (aOR 0.05; 95% CI 0.02-0.13, p<0.001) were protective of having poor QOL however, recent hospitalization (within the past 3 months) (aOR 4.58; 95 % CI 1.58-13.26, p=0.005) had higher odds of poor quality of life. Patients who were divorced (aOR 6.79; 95% CI 1.20-40.42, p=0.030) had higher odds of poor DSM, while having attended the clinic for more than 3 years (aOR 0.32; 95% CI 0.12-0.81, p=0.016) was protective of poor DSM.
Conclusion
Good social support and sustained DSM interventions result in good DSM and ultimately improves quality of life of patients with DM.
