Uncontrolled Glycemic Level and its Associated Factors among Adult Diabetes Mellitus Patients Who Visited Diabetic Clinic of Tibebe Ghion Specialized Hospital, Bahir Dar, Northwest Ethiopia

Abstract

<title>Abstract</title> <bold>Background: </bold>Despite the advancement of glycemic management in diabetes, achieving target glycemic control in clinical practice is very challenging. As a result, identifying the factors that influence glycemic control is crucial to improve the quality of people living with diabetes. <bold>Objective: </bold>To assess the uncontrolled glycemic level and its associated factors among adult Diabetes mellitus patients on follow up at the Diabetic clinic of Tibebe Ghion Specialized Hospital, 2023. <bold>Methods: </bold>An institution based cross sectional study was conducted among 229 adult diabetes mellitus patients at Tibebe Ghion Specialized Hospital from November 2023 to January 2024. The samples were selected using systematic random sampling technique. Pretested, structured, and interviewer-administered questionnaires were used to collect sociodemographic, diabetes self-care and diseases related factors parameters. HbA1c was used to assess glycemic control. Data were entered using Epidata Manager version 4.6 and analyzed using SPSS version 27. Multivariable logistic regression analysis was used to identify determinants of glycemic control, considering with a p-value of &lt;0.05 as statically significant, with a 95% confidence interval. <bold>Results:</bold> The mean HbA1c of the participant in the past 3 months were 8.0% [SD ± 1.8547%] and 158(69.0%) participants were having poor and or inadequate HbA1c (HbA1c ≥ 7.0). Not having access to self-monitoring blood glucose (SMBG) tools (AOR=5.48 ,95%CI 2.21-13.57), polypharmacy (AOR = 3.68, 95%CI 1.17-11.59), minimal physical activity (AOR = 3.52, 95%CI 1.17-10.53), physical inactivity (AOR = 6.55, 95%CI 2.20-19.42), poor medication adherence (AOR = 8.05, 95%CI 2.53-25.56) and body mass index (BMI) ≥ 25.0kg/m2 (AOR = 4.37, 95%CI 1.39-13.73) were factors associated with inadequate and poor glycemic control. <bold>Conclusions:</bold>This study revealed that seven out of 10 participants had inadequate and or poor glycemic control levels. Poor glycemic control practice was associated with not having access to SMBG tools, taking poly-pharmacy, sedentary life style, poor medication adherence and BMI ≥ 25.0kg/m2. Effective and tailored interventions are needed to mitigate exposure to these risk factors to improve glycemic control and reduce uncontrolled diabetes related complications.