Abstract:
With the prevalence of diabetes escalating globally, diabetes prevalence in Kenya is
estimated to be 4.56% with an approximate 12% and 2.7% in both urban and rural
settings respectively. Many patients are still reffered to national referral hospitals and
even outside country for specialized end organs damage care due to poor glycemic
controls. The study determined factors associated with glycemic control, among T2DM
patients attending Mathari National Teaching and Referral Hospital diabetes clinic
Nairobi, Kenya. A descriptive cross sectional study design was applied and a systematic
random sampling technique to recruit 149 study subjects. Scientific and Ethical approval
was sought from KNH/UON- ERC before data collection. Quantitative data was
collected using a structured questionnaire and a guide was used for qualitative data (one
key informant interviews and two focus group discussions). Blood samples were drawn
to determine HbA1c, lipid profile, blood sugar and urine for microalbumin Creatinine
Ratio levels. Data was analyzed using Statistical Package for Social Scientists version 20
(SPSS). Descriptive analysis was used to summarise the data and associations between
variables were tested using Chi Square statistics. Differences between parameters
estimates were deemed statistically significant at p < 0.05. Qualitative data was analyzed
thematically after translation and transcription. The mean age of the study participants
was 54.9 (SD ± 10.14) and a total of 122 (81.9%) out of 149 T2DM patients had poor
glycemic control with a mean HbA1c of 9.1%. Over three quarter 135 (90.6%) had
uncontrolled FBS, 37.6% with elevated T-Chol, 60.4% having dyslipedemia and 35.4%
having moderate to severely increased UACR. Gender (OR = 3.029, 95% CI: 1.287 –
7.129, p = 0.010), FBS (OR = 8.14, 95% CI; 2.541 - 26.0810, p = 0.001) and using
drugs for other co-morbidities OR = 2.519, 95% CI; 1.009 - 6.288, p = 0.035) were
significantly associated with glycemic control. This study revealed a high burden of poor
glycemic control among T2DM patients attending Mathari Teaching and Referral
Hospital and thus emphasis on improving awareness and management through
structured diabetes education programs to fill the practice gap in glycemic control.
Keeping tight control of FBS and routine screening for co-morbidities like hypertension,
kidney disorders and dyslipidemia to prevent premature development of complications.
