Glycemic control self-management barriers and associated factors among older Nigerians with type 2 diabetes mellitus
TL;DR
Poor glycemic control was common among older adults with T2DM recruited from selected communities across Nigeria’s six geopolitical zones and several sociodemographic characteristics were associated with glycemic control in crude bivariate analyses, although these associations should not be interpreted as independent or causal relationships.
Abstract
Type 2 Diabetes Mellitus (T2DM) disproportionately affects older adults in low- and middle-income countries, including Nigeria. This study examined sociodemographic and clinical characteristics, diabetes practices, barriers, and factors associated with glycemic control among older Nigerians with T2DM. A community-based cross-sectional study was conducted among 896 older adults (≥ 60 years; mean age: 71.1) with confirmed T2DM, recruited through multistage sampling from 30 selected communities across Nigeria’s six geopolitical zones. The selected communities comprised 15 urban and 15 rural communities. Diabetes-management practices were assessed using the Type 2 Diabetes Mellitus Assessment Questionnaire (T2DMAQ), while glycemic control was determined from recent fasting blood glucose (FBG) and/or glycated haemoglobin (HbA1c) records. Descriptive statistics, Pearson’s chi-square tests, and crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Statistical significance was set at p < 0.05. Participants were predominantly female (65.6%) and aged > 70 years (62.9%). Poor glycemic control was observed in 68.4%, while 88.6% reported diabetes-related complications. Adherence to diabetic-specific diets (29.9%) and regular physical activity (43.1%) was low. Major barriers included lack of welfare support (88.7%), transportation (84.3%), and treatment and medication expenses/costs (83.0%). Glycemic control was significantly associated with age, education, employment, income, residence, and T2DM history (all p < 0.001). Higher odds of poor glycemic control were observed among participants aged > 70 years (OR = 1.91, 95% CI 1.43–2.54, p < 0.001), and urban residents (OR = 2.24, 95% CI 1.69–2.99, p < 0.001). Poor glycemic control was common among older adults with T2DM recruited from selected communities across Nigeria’s six geopolitical zones. Several sociodemographic characteristics were associated with glycemic control in crude bivariate analyses, although these associations should not be interpreted as independent or causal relationships. The findings highlight the need for further research examining the social, economic, and healthcare-contextual factors relevant to diabetes management among older Nigerians.