Treatment Pattern and Factors Associated with Blood Pressure and Fasting Plasma Glucose Control among Patients with Type 2 Diabetes Mellitus in Police Referral Hospital in Ethiopia

Abstract

BACKGROUND: The prevalence of T2DM in Ethiopia is on the rise according to certain studies. Appropriate management approaches are required to achieve desired goals of therapy in the clinical setup. This study was conducted to assess the treatment pattern and the factors associated with BP and FPG control among patients with T2DM in Federal Police Referral Hospital.METHOD: An institution based cross sectional study was conducted from 15th October 2016 to 15th January 2017. A Systematic random sampling technique was employed in selecting the study participants. Data was collected using semi-structured interview and visiting medication records. SPSS version 20 was used for data analysis.RESULTS: Out of a total of 414 participants who fulfilled the inclusion criteria, 361 were successfully interviewed and considered for further analysis. Target BP level was achieved in 206(57.1%) of the patients, whereas the proportion of hypertensive diabetics who attained the recommended BP target was 19.4% (n=40). Of the 361 participants who were checked about their current FPG level, only 142(39.3%) were found to be <130mg/dl. However, 87(24.1%) participants were found to control both BP and FPG levels. Gender, military status, comorbidity, type oftherapy and dietary adherence showed a statistically significant association with outcome variables.CONCLUSION: The proportion of participants with T2DM who achieved target BP, FPG or both was suboptimal. A comprehensiveapproach that involves targeted education on self-management strategies, individualized treatment plans, and continuous evaluation of treatment outcomes should be practiced.KEYWORDS: Blood pressure, Cross sectional study, Ethiopia, Fasting plasma glucose control, type 2 diabetes mellitus

Development of a Complex Intervention for Effective Management of Type 2 Diabetes in a Developing Country

“…Evidence from the interviews and focus groups we have undertaken, previous findings [ 11 , 12 , 13 , 60 ], feedback from the co-design workshops, and the context of the hospital enabled identification of the health problem. We identified that improving the effectiveness of type 2 diabetes management for patients with type 2 diabetes was the specific problem existing at the diabetes centre of TASH.…”

“…Ineffective management of type 2 diabetes has been associated with poor clinical outcomes, which include disease progression, and increased health services utilisation, such as repeated hospitalisations and high all-cause mortality [ 5 , 6 , 7 ]. In Sub-Saharan Africa (SSA) [ 8 , 9 , 10 ] including Ethiopia [ 11 , 12 , 13 ], there exists a high rate of diabetes-related morbidity and mortality, high cost of diabetes care, and poor quality of life for patients with type 2 diabetes. Excessive levels of diabetes-related problems and high cost of type 2 diabetes care in SSA are attributed to widespread lack of treatment success, stemming from inadequate organisational involvement and delivery of care [ 8 , 9 , 14 ].…”

Prevalence and Factors Associated with Type 2 Diabetes Control in Sub-Saharan Africa: A Systematic Review and Meta-analysis

“…Four studies found that the presence of comorbidities was associated with poor glycaemic control [53,75,77,87]. The presence of hypertension lead to poor glycaemic control in one study [16].…”

“…Eight studies assessed the relationship between the female gender and glycaemic control [18,29,34,51,61,64,65,73], two studies found that the female gender was associated signi cantly with poor glycaemic control [18,34] versus one study that linked it to good glycaemic control [29]. Male gender in respect of glycaemic control was assessed by eleven studies [27,31,39,44,58,66,75,77,83,85,87], two studies associated it with good glycaemic control [58,75], while two studies linked it to poor glycaemic control [27,87]. Fifteen studies assessed the relationship between educational level and glycaemic control, in one study, primary, secondary, or tertiary education levels were associated with good glycaemic control [29].…”

“…Regular attendance at scheduled appointments has been associated with good glycaemic control in two studies [49,85]. Good medication adherence has been associated with good glycaemic control in two studies [40,77] while two other studies showed no association [75,78]. Low medication adherence had a signi cant association with poor glycaemic control in three studies [33,48,86].…”