Diabetes Mellitus in Kirehe District Hospital: Assessment of determinants of good clinical outcomes. Findings from the Electronic Medical Record data for Non Communicable Diseases recorded since 2010-2015.

Abstract

Aims: Nowadays, diabetes mellitus is continuing to be an increasing international health burden. But, there was made international settings and guidelines to combat this epidemic crisis. This thesis attempts to assess the factors associated with good outcomes of diabetes program provided by KIREHE district hospital to stabilize the level of glycemia of patients and delay diabetes complications. Methods: Data were cross-sectionaly collected from routine Electronic Medical Records of patients treated for diabetes from January 2010 to December 2015 at KIREHE Hospital. Two hundred and one diabetic patients were enrolled into the study. Socio-demographic and clinical characteristics were collected from the records. Descriptive statistics on baseline demographic and clinical characteristics were performed. Bivariate analysis was conducted to identify variables that were statistically significant and were subsequently considered into the multivariate analysis. Finally, logistic multivariate analysis was used to assess the relationship of independent variables of interest and program outcome defined as Hba1c level. Good diabetic outcome was defined as having Hba1c value ≤ 7 and bad outcome was Hba1c >7. Results: The descriptive analysis revealed that among 201 sampled patients, 70.2% had Hba1c>7 at the date of enroll into the program. It was further indicated that more than 65% aged above 45 years and 18% used alcohol. The bivariate analysis revealed that BMI, age, number of visit and treatment status are statistically associated with the clinical and programmatic outcome whereas the reduced model of binary logistic regression revealed that only having a BMI ranged between 18.5 and 25(OR: 2.357), being on either oral therapy or insulin therapy (OR: 1.972 and 1.231 respectively) and regularly visits to DM professionals (OR: 3.239) contributes to better outcome of diabetes management. Conclusions: Our findings indicate that diabetes can be effectively managed with reasonable outcomes by strengthening the education of patients as well as regularly treatment of patients. We also found relatively high risk of early developing complications among adult patients.