Effect of Lifestyle Modification and Medication Adherence on Glycaemic Control among Type-2 Diabetes Patients Attending Primary Care Setting in Northern Nigeria
- Mansur Abdullahi Maikano1; Grema Bukar A.2; Falaki Fatima Ahmad3 & Dan-inna Muhammad Zaharadeen1
- DOI: 10.5281/zenodo.23857606
- ISA Journal of Medical Sciences (ISAJMS)
Type 2 diabetes mellitus (T2DM) is a
chronic metabolic disorder characterized by insulin resistance and impaired
insulin secretion, leading to hyperglycaemia (elevated blood glucose levels).
It is linked to a high rate of disease burden, especially in underdeveloped
nations like Nigeria. It is assuming a pandemic proportion globally, with a
burden not only affecting the quality of life of individuals with the disease
but also adding financial burdens to their families and the nation’s economy.
Achieving good glycaemic control is the main aim of diabetes management. Yet,
it has been found that most diabetic patients’ glycaemic levels are poorly
controlled, largely due to a lack of commitment to lifestyle modification and
adherence to medications. This study determined the effect of lifestyle
modification and medication adherence on glycaemic control among type 2
diabetic patients among adult type 2 DM patients attending General Outpatient
Clinic at Usmanu Danfodiyo University Teaching Hospital Sokoto. This study was
a hospital-based cross-sectional study of 250 adults with type 2 DM Aged 18
years and above, selected using systematic random sampling over 12 weeks. The
respondents’ diabetes lifestyle, medication adherence and glycaemic control
were measured using the Simple Lifestyle Indicator Questionnaire (SLIQ),
Morisky Medication Adherence-8 (MMAS-8) and HbA1c index (glycated haemoglobin),
respectively. Data were analysed using the International Business Machine Corporation
Statistical Product and Service Solutions (IBM®SPSS statistics) version 26. A
p-value of < 0.05 at a 95% confidence interval was considered statistically
significant. There was a 100%
questionnaire response rate, and the mean age of the respondents was 54.4±
10.5, with a female majority (58%).. Among the study respondents, only (23.2%)
had good glycaemic control. Clinical attendance, family history of diabetes,
lifestyle modification and medication adherence were statistically significant
at bivariate analyses. Both medication adherence and regular clinical
attendance were statistically significant at the logistic regression level,
hence independent predictors of good glycaemic control. The respondents with
low medication adherence were 83% less likely to have good glycaemic control
than those with high medication adherence (AOR =0.17, CI=0.05-0.65).
Conversely, the respondents with medium medication adherence were 70% less
likely to have good glycaemic control than those with high medication adherence
(AOR= 0.30, CI = 0.15-0.59). The respondents who have unhealthy lifestyles were
46% less likely to have good glycaemic control than those with healthy
lifestyles (AOR=0.54, CI= 0.29-1.01), although it was not statistically
significant, P=0.52. The respondents with non-regular clinical attendance were
91% less likely to have good glycaemic control then those with regular clinical
attendance (AOR =0.09, CI=0.811-3.065), respondents with family history of
diabetes were 57% times more likely to have good glycaemic control then
respondents with no family history of diabetes (AOR =1.57, CI=0.011-0.645). The
findings indicate that influence of medication adherence and lifestyle
modification on glycaemic control cannot be over-emphasized. Hence, family
physicians and other health care providers should educate diabetes patients on
lifestyle modification and medication adherence benefits to achieve good glycaemic
control. This will ultimately improve the quality of life of type 2 diabetic
patients.
Keywords: Medication adherence, Lifestyle modification and Glycaemic control.
