Patient related factors associated with glycaemic control in type II diabetic patients within the North Central Regional Health Authority, Trinidad

ABSTRACT

Background and Objectives: Preventative healthcare practices continues to be the basis for prevention of diabetes related complications. Established guidelines are likely to decrease the incidence of diabetes complications, however, patient related factors either perceived or real, prevent the utilization of medical services resulting in poorer health outcomes. The aim of this study was to identify the patient related factors leading to elevated HbA1c levels in type 2 diabetic patients at the health centres within the Northcentral Regional Health Authority, Trinidad and to determine the association between patient related factors and optimal glycaemic control as measured by HbA1c levels. Subjects and Methods: This was a cross-sectional study using convenience sampling of participants who were type II diabetics, over the age of 18 years, attending the chronic disease clinic for their usual appointment within selected health centres of the Northcentral Regional Health Authority during the period January 2018 to March 2018. After receiving ethical approvals and informed consent, a de novo, pretested self-administered and researcher-assisted survey was administered. Patients' barriers were determined by using the Independent Samples T test and Analysis of Variance in 2 groups of patients. Results: 254 subjects participated in this study with a response was 87.6% There were 7 patient related factors associated with glycaemic control identified based on the analysis of 200 patients with recorded HbA1c in this survey. The mean HbA1c was 8.360 with SD 2.062. Age (55-64years age group), use of insulin, emotional problems and anxiety were associated with higher mean HbA1c. Use of oral hypoglycaemic agents, personal responsibility for diabetes care and being retired were also associated with lower mean HbA1c. Conclusion: This study identified several patient related predictors of glycaemic control based on the mean HbA1c in the public health system in parts of North and Central Trinidad. Implementation of relevant interventional programs are needed to remove these factors and improve patient outcomes.