Management Of Type 2 Diabetes Mellitus By Diabetic Clients In Nyandarua County, Kenya

ABSTRACT

Type 2 diabetes mellitus (T2DM), is the most common form of diabetes, characterized by disorders of insulin resistance, insulin secretion, obesity, lipid abnormalities, hypertension, and cardiovascular diseases. Physical inactivity and the adoption of sedentary lifestyle often accompanying the transition to modern diet are key factors leading to this condition. The marked increase of Type 2 Diabetes Mellitus (T2DM) necessitates active development and implementation of efficient prevention programs as the condition is a major public health concern in the world. The main objective of the study was to determine management of T2DM by diabetic clients in North Kinangop Catholic hospital and Engineer sub-County hospital in Nyandarua South sub-County, Kenya. A cross-sectional facility based study was carried out in the two facilities. The study population comprised T2DM clients, residents of the sub-County aged 18 years and above who consented to participate in the study. Data collection was by use of researcher administered questionnaire. The data was entered, coded and cleaned in the Microsoft excel software, and then transferred into SPSS Version 20.0 (SPSS Inc, USA) for analysis. Descriptive statistics were computed to generate frequencies, mean and median. Relationship between levels of knowledge on the recommended management interventions, socio-demographic factors and management practices were examined using chi-square and bivariate analyses. Majority of the clients were females (59.5%). Majority of participants (83.3%) had never been screened for DM except at the point of diagnosis during which screening was initiated by health care providers. Participants delayed enrolling into DM management program because most of them (64.4%) did not know about it while 2.2% had to consult their families. A small proportion of the participants (28%) had good knowledge on T2DM management interventions. Practices applied by the clients in self-managing T2DM included diet, exercise, taking diabetic medications and monthly weight monitoring. Socio-demographic and economic characteristics that were found to be significantly associated with clients’ management of T2DM were college/university education level (n=294, df-3, χ2 -4.433, P- 0.035) and income level of Kshs 5,001-10,000 per month (n=294, df-3, χ2-5.999, P-0.006). Conclusions made from the study are that there is low level of knowledge on T2DM management interventions, practices for management of T2DM that participants applied included balanced diabetic diet, exercise, drug therapy and weight monitoring though fairly undertaken. Level of education and income significantly influenced clients’ management of T2DM. The study recommends creation of awareness on T2DM management in Nyandarua County so as to improve clients’ knowledge of management interventions for T2DM, health education on T2DM management practices to empower clients to effectively manage the condition. The national and Nyandarua County government’s Department of Health to subsidize diabetic services so as to improve clients’ affordability and utilization.