Exploring the facilitators and barriers to effective diabetes self-management among type 2 diabetic patients at a teaching hospital in Ghana

Background: Type 2 diabetes mellitus (T2DM) requires persistent self-care to prevent complications; however, good self-care is often blocked by structural and socio-economic conditions. In Sub-Saharan Africa, diabetes prevalence is growing alongside lingering health system and economic challenges. This study explored the support system and hindrances to controlling diabetes and consequently examined how socioeconomic factors influenced adults with T2DM at Sunyani Teaching Hospital in Ghana. Methods: A cross-sectional study was carried out on 320 adults receiving care at a tertiary hospital with the diagnosis of T2DM. The data collection was conducted using a structured questionnaire that comprised the perceived facilitators and barriers to the self-management rating scale on a 5-point Likert scale. An index for facilitators and barriers was then computed. Multiple linear regressions with socio-economic determinants such as educational attainment, income and insurance coverage as study variables were conducted on self-care assessment scores while controlling for demographic variables. Results: The composite facilitator score was modest (mean = 2.82/5), while the composite barrier score indicated moderate constraints (mean = 3.16/5). Transportation difficulty and affordability of medications and monitoring supplies were the most strongly perceived barriers. Education (B = 0.334, p < 0.001), income (B = 0.332, p < 0.001), and insurance status (B = 0.388, p < 0.001) were significant positive predictors of facilitator scores. Conversely, education (B = −0.367, p < 0.001), income (B = −0.336, p < 0.001), and insurance status (B = −0.373, p < 0.001) were significant negative predictors of barrier scores. Age, sex, marital status, and diabetes duration were not independently associated with self-management scores. Conclusions: Socioeconomic conditions significantly influence diabetes self-management among patients at Sunyani Teaching Hospital. Factors such as formal education, income, and insurance coverage significantly determine both enabling and constraining characteristics, while demographic characteristics per se do not appear to predict self-management capacity. Therefore, helping to build structured self-management interventions and improving protection mechanisms with financial resources, as well as resolving transportation and cost, would be crucial to enhancing diabetes outcomes in resource-limited settings.