Quality of Glycemic Control Among Diabetic Women of Reproductive Age at Kenyatta National Hospital in 2019, a Cross-sectional Study

Abstract

Background. Diabetes mellitus (DM), is a non-communicable progressive disorder characterized by hyperglycemia due to insulin deficiency or insulin resistance or both. It has emerged as a major national and global health problem. Women of reproductive age (between 15 years – 49 years) are at an increased risk of diabetes especially during pregnancy. About 60 million women of reproductive age have DM worldwide and about 14% of all pregnant women develop gestational diabetes mellitus. These women require special attention owing to their vulnerability to long term micro-vascular and macro-vascular as well as pregnancy-specific complications. The glycemic control status of diabetic patients affects their management and there is evidence that lowering blood glucose as close to normal range as possible is a primary strategy for delaying or slowing these complications. The quality of glycemic control among diabetic women of reproductive age in Kenya has not been studied. This study provides some background into management of diabetic women of reproductive age (DWRA) as well as guiding subsequent research Broad objective. To determine the quality of glycemic control and characteristics of diabetic women of reproductive age (DWRA) at Kenyatta National Hospital. Methodology Study Design A cross-sectional study to determine the quality of glycemic control among the diabetic women of reproductive age. Hemoglobin A1c (HbA1c) testing done and patients subsequently interviewed using a standardized structured questionnaire. Study site. Diabetic clinic at Kenyatta National Hospital xii Data Management and Analysis Data cleaned,entered and analyzed by use of SPSS version 24. Continuous data analyzed by use of means and standard deviation. Categorical data analyzed and displayed by use of frequencies and proportions. Results A total of 176 diabetic women of reproductive age were enrolled into the study. The mean age was 36.5 years. The mean HbA1C was 8.2%. 102 patients (58%) had poor glycemic control i.e. HbA1c more than 7% while 74 patients (42%) had good glycemic control. Majority of the patients (46.6%) were on insulin monotherapy, followed by 27% on oral hypoglycemic agents (OHA). Patients aged 35 years and above were two and a half times as likely to have poor glycemic control compared to younger patients. Patients who don’t test blood sugar are 80% less likely to have good glycemic control. Conclusion. There is high prevalence of poor glycemic control among diabetic women of reproductive age at KNH at 58%. Older patients above 35 years of age are 2.5 times as likely to have poor glycemic control compared to younger patients. Patients who don’t test their blood sugars are 80% less likely to have good glycemic control.