Date of Award

11-2023

Degree Type

Thesis

Degree Name

Master of Science in Advanced Practice Nurs​ing (MSc-APN)​

First Advisor

Prof. Wesley Too

Second Advisor

Dr. Diana Kassaman

Third Advisor

Prof. Eunice Ndirangu Mugo

Department

School of Nursing and Midwifery, East Africa

Abstract

Background: Diabetes Mellitus poses a significant global public health concern, marked by a surge in morbidity and mortality rates. Its incidence and prevalence have witnessed a consistent rise over recent decades, with a projected rise. Occurrence of complications is primarily attributed to Poor Glycemic Control, which is attributed diabetes related complications, among them retinopathy, atherosclerosis, renal complications, amputations, as well as life threatening conditions; Diabetes Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State(HHS).

Purpose: This study sought to identify the proportion as well as factors linked to poor glycemic control among Type 2 Diabetes Mellitus patients at Gatundu Level Five in Kiambu County, Kenya.

Methodology: Conducted between May and June 2022, this cross-sectional research adopted interviewer-administered semistructured questionnaires and file reviews for random blood sugar and HBA1C tests. Utilizing systematic sampling, 197 participants were selected, and SPSS V25 facilitated data analysis. Chi-square test and t-test were employed to identify factors associated with PGC, while logistic regression estimated the odds ratio (UOR). Ethical considerations were diligently observed.

Results: The study found that 2/3 of the participants (36%) exhibited poor glycemic control, (95% CI: 0.2950 to 0.4295), Mean random blood sugar was 10.8. Age of the participants was associated with poor glycemic control (p = 0.012), revealing a 3% decrease in the risk of PGC with each year increase in age (UOR = 0.972, 95% CI: 0.950, 0.994). Other risk factors included female gender, low income level, higher level of education, unemployment, and poor lifestyle practices; diet and exercises. Duration of disease (p = 0.007), and medication non adherence (p = 0.03), (p = 0.049) were also significantly linked to poor glycemic control. The study not only addresses the critical issue of poor glycemic control but also contributes to bridging existing knowledge gaps in identifying factors hindering euglycemia. The utilization of a semi-structured questionnaire in conjunction with comprehensive data analysis provides valuable insights into the factors influencing glycemic control.

Conclusion and Recommendations: Findings underscore the need for targeted interventions, particularly among the younger age group, and emphasize the importance of increasing awareness regarding factors influencing PGC, which also impact medication adherence

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Last Page

119

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