Rate of glycaemic control and associated factors in patients with type 2 diabetes mellitus treated with insulin-based therapy at selected hospitals in Northwest Ethiopia: a multicentre cross-sectional study

Abstract

Objectives: This study was aimed to determine the level of glycaemic control and associated factors in patients with type 2 diabetes mellitus (T2DM) treated with insulin-based therapy.

Designs: Institutional-based multicentre cross-sectional study design was employed to conduct this study.

Settings: The diabetes follow-up clinics of selected hospitals in Northwest Ethiopia.

Participants: Adult patients with T2DM treated with insulin-based therapy at the selected hospitals who met the eligibility criteria were the study participants.

Main outcome measures: Good glycaemic control; when fasting blood glucose (FBG) level ranged from 70 to 130 mg/dL, and FBG <70 and >130 mg/dL was considered poor glycaemic control. A logistic regression model was used to identify determinants of poor glycaemic control. A p<0.05 at 95% CI was statistically significant.

Results: Of 403 study participants, 54.8% were males with a mean age of 55.03±10.8 years. Though patients with T2DM were treated with insulin-based therapy, most of the participants (72.5%) could not achieve the target FBG. The overall mean FBG was 177.1±54.3, and far from the target glucose level. Patients who could not practise self-monitoring of blood glucose were found more likely to have poor glycaemic control compared with those who practised self-monitoring (p<0.001). Whereas patients who had a normal body mass index (p=0.011) and who were treated with premixed insulin-based therapy (p=0.04) were found less likely to have poor glycaemic control compared with patients with obesity and who received NPH insulin based-regimens, respectively.

Conclusion: This study demonstrated that a significant proportion of the study samples could not achieve glycaemic targets and the average blood glucose was far higher than the recommended glycaemic target level. Insulin initiation and titration, considering the determinants of glycaemic control, could be recommended to achieve target glycaemic levels.

Keywords: Diabetes & endocrinology; General diabetes; General endocrinology.

Figure 1

Distributions of comorbidities and complications in patients with T2DM treated with insulin-based therapy attending hospitals of Northwest Ethiopian, 2021 (N=403). Others; bronchial asthma, diabetic ketoacidosis, malaria, skin disorders, anaemia, malnutrition. BP, blood pressure; T2DM, type 2 diabetes mellitus.

Figure 2

Rate of glycaemic control in patients with T2DM treated with insulin-based therapy (N=403). T2DM, type 2 diabetes mellitus.