Assessment of Antidiabetic Medicines Use and Glycemic Control Among Type 2 Diabetes Mellitus Patients at Lacor Hospital, Uganda

Abstract

Background: Diabetes mellitus (DM) is one of the non-communicable diseases (NCDs) that is on the rise and causes serious health problems. Appropriately chosen antidiabetic drug therapy controls the associated complications of DM. Insufficient knowledge on the use antidiabetic drug therapy among other factors causes a decrease in drug efficacy and thus poor glycemic control. Measuring glycated hemoglobin (HbA1c) levels has been known to be a good indicator of the extent of glycemic control in such patients. Objectives: The purpose of this study was to assess the patients’ knowledge on the use of antidiabetic medicines and its impact on glycemic control using HbA1c measurement among type 2 DM patients at Lacor hospital in Uganda. Method: A simple random sample of 126 type 2 DM patients were recruited at the diabetes clinic at Lacor hospital in Gulu, Uganda. The study was a cross-sectional descriptive study, carried between April and June 2017 and data was collected from patients who consented. The participants were interviewed using a structured questionnaire to evaluate knowledge on the use of antidiabetic medicines and a blood sample was drawn to measure the HbA1c level as a measure of glycemic control. Five healthcare providers sampled from the outpatient department were interviewed using a second structured questionnaire to determine the level of Lacor preparedness in the provision of diabetic education to the DM patients. Descriptive statistics have been used to summarize data. The data has been tabulated and presented graphically. Univariate and bivariate statistical analysis has further been carried on obtained data. Results: Overall, 72.3% (n=64) of study targeted patients had good knowledge on antidiabetic medicine use (mean average 59.8%). The level of education was strongly significant a predictor of adequate knowledge on use of diabetic medicines (AOR =4.501, 95% CI; 1.94, 7.06, P = 0.001). However, high knowledge score on DM management was negatively associated with poor glycemic control (COR= 0.793, (95% CI; 0.64, 0.98). Generally, good glycemic control was reported in 48.4 % of participants. Female had 3 fold (AOR=0.373, 95% CI; 0.16, 0.93, p= 0.031) lower odds of having poor glycemic control. In addition, taking diclofenac tablets in combination with antidiabetic medicines (COR= 7.241, 95% CI; 0.86, 60.7) and identification of drug by color (AOR=5.043, 95% CI; 2.16, 10.80, P= 0.000) were positively associated with poor

glycemic control. Other factors found to affect glycemic control in the study population were adherence to regular exercise, reduction consumption of fatty meals, and self-monitoring of blood glucose which related to good glycemic control. Conclusion and recommendation: Majority of type 2 diabetic patients had poor glycemic control. Patients with high level of education had adequate knowledge on the use of antidiabetic medicines. Strategies to improve on quality of education on diabetic management and promoting self-care activity could promote good glycemic control.