Enabling Factors of Glycemic Control Among Diabetic Clients Being Managed at Health Facilities in Nairobi County, Kenya

Abstract

Diabetes mellitus refers to a long-term disorder that occurs when pancreas is incapable of producing sufficient insulin and/or the body cells do not commendably utilize insulin. Globally, the prevalence of Diabetes Mellitus has been rising in the past two decades but at a faster rate in Low and Medium Income Countries. Diabetes being a complex endocrine disease is associated with other complications which are accountable for heavy burden to households in terms of treatment cost and decreased manpower. Self-care practices, sociodemographic characteristics and nutritional status have been shown to contribute greatly in the prognosis of diabetes. The broad objective of this study was to establish the enabling factors of poor glycemic control hence development of diabetic complications among clients in selected hospitals in Nairobi County. The study was conducted as hospital-based analytical retrospective cohort design. Kenyatta National Hospital, Mbagathi and Kayole II Hospitals were sampled to represent different levels of healthcare in the County. The study participants included 165 individuals more than 15 years of age who were attending outpatient diabetic clinics between the months of January and March 2021. The data were collected using semi-structured questionnaire uploaded in Online Toolbox Kit and extraction of data from the patient files. Analysis was done using SPSS and program R. The study showed that age (p=0.00), period after diagnosis with diabetes (p=0.00), area of residence (p=0.006), education level (0.00), education on modification of diet during management of diabetes (p=0.01), knowledge (p=0.03) and attitude (p=0.01) towards diabetes recommendations were significantly associated with poor glycemic control among diabetics. In conclusion, these factors were the enabling factors to development of diabetic complications. The study recommends that education on diet modification needs to be handled independently possibly on different sessions or days from the general diabetic education to allow better understanding by the clients.