Determinants of diabetic related complications among type 2 diabetic patients visiting Mama Lucy Kibaki hospital

Abstract

Diabetes mellitus is a major public health concern globally. In Kenya, 2019 estimates by the WHO indicated a prevalence of 3.3%, equivalent to 1.5 million people. The prevalence is expected to increase by 4.5% by the year 2030 in the absence of effective preventive measures. Research done at KNH, indicated that hypertension was by far the most commonly diagnosed disease (63.3%), with eye (43.5%) and foot (41.1%) being the most common lengthy complications. This study sought to establish determinants of chronic complications of type 2 diabetes mellitus amongst patients visiting Mama Lucy Kibaki hospital in Nairobi, Kenya. The target population was diabetes patients at Mama Lucy Kibaki Referral Hospital in Nairobi, Kenya. Primary data was collected by the use of semi-structured questionnaire and an interview guides for both Focus group discussions and key informant interviews. Three focus group discussions were conducted and key informant interviews were done. All participants were provided their consent prior to their accepting to joining the study. This study was presented to Kenyatta National Hospital/University of Nairobi Ethical Research Committee for ethical approval. Chi-square test was used to explore associations between various variables. Correlation analysis was used to establish the association between continuous variables. FGD’s and Key informant interviews in form of notes were manually coded and analyzed based on themes (thematic analysis) which were developed from responses (scripts) in line with study objectives. Results showed that the proportion of type 2 diabetes mellitus complications among patients attending the hospital was estimated at 58.3 % (95% confidence interval, C.I., 52.3% - 64.2%). Three factors were significantly associated with complication status at 5% level of significance; age-group (P < 0.001), occupation (P < 0.001) and herbal medicine use (P < 0.001). Age above 70 years vs 18-35 years (prevalence ratio, PR, 1.72, CI 1.15-2.58), age 56-70 years vs 18-35 years (PR 1.59, CI 1.14-2.23), and herbal medicine use (PR 1.62, CI 1.36-1.94) were significantly associated with complication status. A majority of the respondents also noted that insulin therapy is critical in the regulation of blood sugar in the body. The study concludes that there was a higher proportion of patients who developed complications than those who had no complications with a majority of them developing hypertension, eye disease, kidney problems and nerve damage, respectively, as the most occurring type of complications. It is therefore recommended that the Ministry of Health to include herbal medicine practitioners in patient management programs to ensure their practices support rather than interfere with treatment.