Abstract:
Introduction: Good quality care in Type 2 diabetes mellitus (T2DM), whose
prevalence is approximately 10% in Kenya, may prevent or delay diabetes
complications. This study determined blood glycemic targets, defined by
HbA1c levels (>6.5% [53 mmol/mol]) and associated factors among patients
receiving diabetes management at Kenyatta National Hospital in Kenya. Me
thods: In this cross-sectional study conducted between May to September
2017, we obtained blood samples from 381 consenting T2DM patients at
tending KNH. The study collected data using a detailed questionnaire while
taking glycemic measurements. Factors associated with poor glycemic control
(HbA1c levels >6.5%) were determined using Ordinal logistic regression mod
eling, STATA software version 13. Results: 103 (27.1%) T2DM patients with
poor glycemic control were identified. In multivariate analysis, independent
risk factors associated with poor glycemic control and their 95% confidence
intervals included: concurrent hypertension (aOR 1.6, [1.1, 2.4]), receiving ≥3
oral anti-diabetes medication (aOR 2.4, [1.3, 4.6]) and good adherence to
medication based on self-reporting (aOR 6.2, [1.9, 41.3). Independent protec
tive factors included self-monitoring of blood glucose levels (aOR 0.35, [0.2,
0.4]), patients aged 51 to 60 years (aOR 0.5, [0.3, 0.9]), weight between 50 and
70 kgs (aOR 0.5, [0.3, 0.9]) and receiving 1 to 2 diabetes medication (aOR 0.4,
[0.3, 0.7]). Conclusion: Significantly high proportion of T2DM patients re
ceiving treatment at KNH had poor glycemic control. Addressing comorbidi
ties and promoting good glycemic control among long-standing T2DM pa
tients receiving ≥3 oral anti-diabetes medication is key to delaying or pre
venting chronic diabetes complications. Self-monitoring of blood glucose le
vels needs to be encouraged as suggested by its protective effect. While dif
DOI: 10.4236/jdm.2021.111002 Feb. 9, 2021
10
Journal of Diabetes Mellitus
M. C. Muringo et al.
ferences in risk between diverse weights and ages need further studies, inno
vative ways of authenticating self-reports, e.g., triangulation, are required to
ensure credibility. This work supports the Government of Kenya’s Vision 2030
in creating a healthy and productive population contributing to the country’s
economic growth.
