Predictors of glycemic control, quality of life and diabetes self-management of patients with diabetes mellitus at a tertiary hospital in Ghana

Abstract

Background: The burden of diabetes mellitus (DM) in Sub-Saharan Africa is high and continues to increase. Effective DM management focuses on key goals such as glycemic control, prevention of acute and chronic complications and improvement of quality of life (QOL). This study therefore assessed predictors of glycemic control, QOL and diabetes self-management (DSM) of patients with DM in a tertiary hospital in Ghana. Methods: We conducted a cross-sectional study involving face-to-face interviews of patients with DM attending clinic using structured questionnaires and validated study instruments as well as review of medical records. A multivariable logistics regression analysis was used to identify independent factors associated with good glycemic control, poor QOL and poor DSM practices. Results: The study involved 360 patients with mean age of 62.5 ± 11.6 years and a female preponderance, 271 (75.3%). The mean HbA1c among study participants was 7.8 ± 2.7% of which 44.7% had HbA1C <7%. Patients on only oral DM medications (aOR 2.14; 95% CI 1.19-3.88, p=0.012) were more likely to have good glycemic control. Urban residence (aOR 0.24; 95% CI 0.06-0.87, p=0.030) and good DSM (aOR 0.05; 95% CI 0.02-0.13, p<0.001) were protective of having poor QOL however, recent hospitalization (within the past 3 months) (aOR 4.58; 95 % CI 1.58-13.26, p=0.005) had higher odds of poor quality of life. Patients who were divorced (aOR 6.79; 95% CI 1.20-40.42, p=0.030) had higher odds of poor DSM, while having attended the clinic for more than 3 years (aOR 0.32; 95% CI 0.12-0.81, p=0.016) was protective of poor DSM. Conclusion: Good social support and sustained DSM interventions result in good DSM and ultimately improves quality of life of patients with DM.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The author(s) received no specific funding for this work.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Not Applicable

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was obtained from Komfo Anokye Teaching Hospital’s Institutional Review Board with ethical approval number of KATH IRB/AP/111/23. Written informed consent was obtained from all participants.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

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Data Availability

All relevant data are within the manuscript and its Supporting Information files.

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