FACTORS CONTRIBUTING TO POOR GLYCEMIC CONTROL IN DIABETIC PATIENTS UNDER FOLLOW- UP IN JIMMA SPECIALIZED HOSPITAL DIABETIC CLINIC.

Abstract

BACKGROUND: Diabetes mellitus is associated with chronic complications like neuropathy, nephropathy, retinopathy and cardiovascular diseases. Hyperglycemia is the most important risk factor for developing such diabetic complications. In this diabetic clinic poor glycemic control was reported prevalent and yet the contributing factors for the problem were not studied. Objective of the study: the aim of this study is to identify factors contributing to poor glycemic control in diabetic patients under follow-up.

MATERIALS AND METHODS: a retrospective cross sectional study was conducted among 217 diabetic patients who were under follow up at Jimma University specialized hospital Diabetic Clinic during September to March 2006. Cards of patients were selected by employing a systematic sampling technique using their card number. Data on demographic and clinical characteristics were abstracted from the cards. Data were cleaned, edited and entered in to a computer and analyzed using SPSS for windows version/1.0. Statistical tests for significance were done where deemed necessary at the level of significance of 0.05.

RESULTS: The mean age was 44 + 16.3 years with minimum and maximum ages 6 and 93 years, respectively. The mean Fasting blood sugar was 209mg/dl 81.7 with a minimum and maximum values being 75 and 565mg/dl, respectively. Seventy one percent were males, 38.2% had Type I, and 60.8% had Type II diabetes. There was a poor glycemic control in 99(45.6%) of the cases. Age, address and type of diagnosis showed a statistically significant association with poor gycemic control (P<0.05).

CONCLUSION: Age, distance from health care center and type of diabetes have significant association with the poor control of blood glucose level and hence are the two identified factors among perhaps several others which contribute to poor glycemic control in diabetic patients under follow-up.

RECOMMENDATIONS: Decentralization of diabetic health care service in rural village health centers is recommended as one measure to improve poor glycemic control and prevent or reduce the occurrence of diabetic complications and consequent mortality.