Abstract:
Diabetes mellitus is a major public health concern globally. In Kenya, 2019 estimates by
the WHO indicated a prevalence of 3.3%, equivalent to 1.5 million people. The
prevalence is expected to increase by 4.5% by the year 2030 in the absence of effective
preventive measures. Research done at KNH, indicated that hypertension was by far the
most commonly diagnosed disease (63.3%), with eye (43.5%) and foot (41.1%) being
the most common lengthy complications. This study sought to establish determinants of
chronic complications of type 2 diabetes mellitus amongst patients visiting Mama Lucy
Kibaki hospital in Nairobi, Kenya. The target population was diabetes patients at Mama
Lucy Kibaki Referral Hospital in Nairobi, Kenya. Primary data was collected by the use
of semi-structured questionnaire and an interview guides for both Focus group
discussions and key informant interviews. Three focus group discussions were
conducted and key informant interviews were done. All participants were provided their
consent prior to their accepting to joining the study. This study was presented to
Kenyatta National Hospital/University of Nairobi Ethical Research Committee for
ethical approval. Chi-square test was used to explore associations between various
variables. Correlation analysis was used to establish the association between continuous
variables. FGD’s and Key informant interviews in form of notes were manually coded
and analyzed based on themes (thematic analysis) which were developed from responses
(scripts) in line with study objectives. Results showed that the proportion of type 2
diabetes mellitus complications among patients attending the hospital was estimated at
58.3 % (95% confidence interval, C.I., 52.3% - 64.2%). Three factors were significantly
associated with complication status at 5% level of significance; age-group (P < 0.001),
occupation (P < 0.001) and herbal medicine use (P < 0.001). Age above 70 years vs 18-
35 years (prevalence ratio, PR, 1.72, CI 1.15-2.58), age 56-70 years vs 18-35 years (PR
1.59, CI 1.14-2.23), and herbal medicine use (PR 1.62, CI 1.36-1.94) were significantly
associated with complication status. A majority of the respondents also noted that insulin
therapy is critical in the regulation of blood sugar in the body. The study concludes that
there was a higher proportion of patients who developed complications than those who
had no complications with a majority of them developing hypertension, eye disease,
kidney problems and nerve damage, respectively, as the most occurring type of
complications. It is therefore recommended that the Ministry of Health to include herbal
medicine practitioners in patient management programs to ensure their practices support
rather than interfere with treatment.