The Management of Type 2 Diabetes Mellitus: Compliance, Barriers and Effect on Glycaemic Control of Adult Outpatients in Sunyani Municipality, Brong Ahafo Region - Ghana
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Date
NOVEMBER 2017
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Abstract
Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by persistent high levels of blood glucose with serious micro- and macro-vascular complications. Effective management of T2DM including lifestyle changes can minimize the levels of diabetes related diseases and deaths. A person affected by T2DM should learn to accept the new lifestyle modifications because poor glycaemic control puts type 2 diabetics at higher risks of developing life threatening complications. This makes adherence to management therapies paramount in achieving good glycaemic control. The study aimed to assess compliance, barriers to diabetes self-care management practices and effect on glycaemic levels of adult type 2 diabetes outpatients receiving care at four selected hospitals in Sunyani, Ghana. A cross - sectional study design was used and 300 known type 2 diabetics aged 30 years and above attending diabetes clinic in four selected health facilities in Sunyani were recruited using simple random sampling technique. Structured questionnaires comprising both open and close ended questions were used to collect demographic data and data on compliance and barriers. Fasting blood glucose levels were measured with a glucose metre. The study results revealed that 11.7%, 24.3% and 20.7% of the study participants had fasting blood glucose levels ranging between 4.0 - 6.0mmol/L, 6.1 - 7.9mmol/L and 8.0 - 9.9mmol/L respectively while the majority (43.3%) of the participants had fasting blood glucose levels of 10mmo/L or above. Greater proportions (78%) of the participants have had diabetes self-care management education with only 22% reporting no education. The study showed self-reported compliance of 79%, 18.3% and 6% for medication, diet and exercise respectively. Factors such as forgetfulness, financial constraints, bitterness of drugs, pains from injections; restrictive diets, small portion sizes and lack of support; fatigue, pains in limbs and laziness were identified to be barriers to medication, diet and exercise regimen adherence respectively. Although compliance to
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medication was found to be higher than diet and physical activity recommendations, there were no significant associations between medication (p = 0.789), dietary regimen (p = 0.341), physical activity (p = 0.547) and fasting blood glucose levels.
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A thesis submitted to the Department of Biochemistry and Biotechnology
in partial fulfilment of the requirements for the award of Master of Philosophy Degree in Human Nutrition and Dietetics