Glycaemic control and its association with socio-demograpphic factors, sleep quality and comorbidities among adult patients with Type 2 diabetes mellitus attending outpatient clinics of A Tertiary Hospital Southwest Nigeria

Abstract

Background: Type 2 diabetes mellitus (T2DM) is globally a major non-communicable disease associated with chronic hyperglycaemia, complications, disability, and increasing healthcare costs. Evidence on glycaemic control among rural and mixed populations in Nigeria remains limited. The study determined the prevalence of good glycaemic control and its association with sociodemographic characteristics, sleep quality and comorbidities among patients with T2DM attending outpatient clinics of a tertiary hospital in rural southwest Nigeria.
Methods: A cross-sectional study was conducted across three outpatient clinics, over three months among 371 adult patients with T2DM. Data were obtained using interviewer-administered questionnaire and medical records, the Pittsburgh Sleep Quality Index, Morisky Medication Adherence Scale-8, and a modified Morisky dietary-adherence scale.  Respondents' BMI and glycated haemoglobin were measured. Chi-square and multivariable logistic-regression analyses were performed using 95% confidence intervals at a 5% significance level.
Results: The prevalence of good glycaemic control was 48.0%. Good glycaemic control was independently associated with age below 40 years (AOR = 3.134, 95% CI: 1.054–9.314, p = 0.040), high income (AOR = 2.114, 95% CI: 1.124–3.977, p = 0.020), good sleep quality (AOR = 3.370, 95% CI: 1.459–7.851, p < 0.001), absence of obesity (AOR = 2.492, 95% CI: 1.274–4.876, p = 0.008), absence of comorbidities (AOR = 2.766, 95% CI: 1.121– 4.365, p = 0.032), good medication adherence (AOR = 2.459, 95% CI: 1.236–4.315, p = 0.029), good dietary adherence (AOR = 3.277, 95% CI: 1.296–6.047, p = 0.041) and short duration of diabetes diagnosis (AOR = 3.819, 95% CI: 1.302– 9.164, p = 0.039)
Conclusion: Slightly more than half of participants had poor glycaemic control. Good glycaemic control was independently associated with younger age, higher income, good sleep quality, absence of obesity and comorbidities, medication and dietary adherence, and shorter duration of diabetes. Targeted diabetes management should promote sleep improvement, weight management, treatment adherence, and healthy dietary practices.