Factors Associated with Glycemic Control Among People Living with Type 2 Diabetes in Douala, Cameroon

Abstract

Background: Effective self-care management is crucial for improving glycemic control in Type 2 Diabetes Mellitus. This study explores self-care management practices and associated factors of glycemic control among type 2 diabetes patients at Laquintinie Hospital and Presbyterian Health Complex Bepanda in Douala, Cameroon. Methodology: A cross-sectional survey was conducted using a mixed-method approach, with a systematic random sample of 230 participants. Quantitative data were collected via revised Summary of Diabetes Self-Care Activities questionnaire, and qualitative data through focus group discussions. Glycemic control was assessed using HbA1c levels. Descriptive statistics summarized data on characteristics of participants, social support and self-care practices. Associations between characteristics of participants, social support and self-care practices with glycemic control were examined using inferential analysis; chi-square, Wilcoxon rank-sum tests and logistic regression. Qualitative data were analyzed thematically. Results: Statistically significant association was found between dietary self-care and glycemic control (AOR = 2.07, 95% CI: 1.08–4.03, p = 0.030). Foot care was statistically significantly with glycemic control (AOR = 1.97, 95% CI: 1.02–3.88, p = 0.046). Financial support emerged as a statistically significant predictor (AOR = 0.43, 95% CI: 0.20–0.85, p = 0.020). Qualitative data reinforced these findings by highlighting financial constraints, high food and supply costs and high cost of monitoring supplies. Conclusion and Recommendations: Poor dietary practices, inadequate foot care, and lack of financial support were statistically significantly with poor glycemic control among individuals with type 2 diabetes. No significant associations were found for physical activity, glucose monitoring, overall self-care, or smoking. Medication adherence was poor across all participants. These findings underscore the need for strategies aimed at enhancing dietary self-care, foot care practices and financial support through the provision of affordable, culturally appropriate nutritional guidance, structured diabetic foot care education, and subsidization of diabetes supplies.