Date of Conferral

2022

Degree

Ph.D.

School

Public Health

Advisor

Namgyal Kyulo

Abstract

Diabetes mellitus (DM) is a significant public health concern globally and in Owerri, Nigeria. The deleterious effects of diabetes have been linked to poor glycemic control. According to the International Diabetes Federation, poor glycemic control is reflected in glycosylated hemoglobin (HbA1c) levels greater than 7.0%, which are associated with substantial morbidity and mortality. Studies have shown a dramatic rise in diabetic complications in Nigeria, particularly in Owerri. However, evidence is lacking on specific risk factors associated with poor glycemic control among DM patients in Owerri. With health insurance assuming a significant position in healthcare service delivery in Nigeria, addressing this gap is valuable. This was a cross-sectional study of predictors of glycemic control among 160 Type 2 diabetic patients attending the diabetes clinic at the Federal Medical Center, Owerri. The independent variables were health insurance (not insured, insured—private, and insured—public/National Health Insurance Scheme [NHIS]), education, body mass index, and blood pressure, while the dependent variable was glycemic control measured using HbA1c. Eco-social theory was the theoretical framework of this research. Bivariate and multiple logistic regression analyses showed that only health insurance (not insured and insured—public) was a predictor of glycemic control, with uninsured subjects at 32 times increased risk of poor glycemic control compared to insured—NHIS subjects. This finding has potential to promote positive social change through optimization of the NHIS in line with its enabling regulations and design of policies to explicitly cover diabetes preventive and control services in the scheme.

Download

Included in

Epidemiology Commons

Share

 
COinS