Diabetes Knowledge, Self-Care Behaviors Adherence and Glycemic Control among Adult Patients With Type 2 Diabetes Mellitus in Jimma University Specialized Hospital, South West Ethiopia

Abstract

Background: The main target in diabetic care is to improve the patient quality of life and maintain optimal metabolic control with minimal complications. This can be achieved by making the patient adherence to self care behaviors and its medication by educating the patients about the importance of to self care management and medication adherence. Objective: This study assessed diabetes related knowledge, self-care behaviors adherence and glycemic control among adult Patients with type 2 diabetes mellitus Methods: A facility based cross-sectional study was conducted among type 2 diabetic patients attending diabetes clinic in Jimma University Specialized Hospital from February 14 – April 9, 2014. Data were collected with a semi structured questionnaire using Morisky 8-Item medication adherence, Expanded Version of the Summary of Diabetes Self-Care Activities and Diabetes Knowledge Test.The data were analyzed using Statistical Package for Social Science version 20.0 and descriptive statistics, Bivariate and stepwise multivariate analysis were performed to examine the outcomes and their factors among study participants. Results: Among 309 respondents, arround one fourth of the patient had low medication adherence, 137(44.3%) had poor knowledge on diabetes and 157(50.8%) had poor self care adherence. Majority of patients 219(70.9%) had poor blood glycemic control (mean FBS > 130mg/dl). Illitrate [AOR=3.46, 95%CI (1.01-11.91), P= 0.049], employed [AOR=2.47, 95%CI (1.13-5.39), P= 0.023], combination of insulin and oral medication [AOR=4.59, 95%CI (1.05- 20.14), P= 0.043] and poor medication adherenc [AOR=5.08 95%CI (2.02-12.79), P= 0.001] were independent predictors of poor glycemic control. Absence of family history of the disease [AOR=2.004, 95%CI (1.06-3.81), p=0.034], patients who can read & write [AOR=7.300, 95%CI (1.55-32.43), p=0.009], 5-10 years on treatment [AOR=2.017, 95%CI (1.11-3.67), p=0.022], and age group of 42-50 years [AOR=2.005, 95%CI (0.99-4.03), p=0.049] were the predictors of poor self care behaviors adherence. Conclusion: Nearly half of patients have poor adherence to overall self care behaviors. Majority of patients have poor knowledge about diabetes. Nearly one fourth of patients have low medication adherence and poor glycemic control. Patients with low level of education, with occupation of farmer and employed, on insulin & pills combination, and lower adherence to their medication were likely to have poor glycemic control. Diabetic patients who have no family history of diabetes, lower level of education, long duration on treatment, and patients on the age group of 42-50 years are independent predictors for overall poor self care behavior adherence. Therefore, need to develop strategies in order to improve diabetic knowledge, adherence and quality of diabetic care for better clinical outcome.