Level of Glycemic Control and Barriers of Good Compliance among Diabetic Patients in Al-Madina, Kingdom of Saudi Arabia

Abstract

Background: Diabetes mellitus (DM) is an important health problem which necessitates long term follow up and control. Aim: This study is designed to determine the level of glycemic control among diabetic patients in Al-Madina and to explore which type of DM shows better glycemic control. In addition, we aim to define barriers of good compliance in diabetic patients who have a HbA1c test of 7% or more. Subjects and Methods: A cross sectional analytic study was conducted and included diabetic patients participated in the campaign (Your Health is Your Life II) held in Al-Madina. Data collected by administering a questionnaire and measuring glycosylated hemoglobin (HbA1c), blood pressure, weight and height for all participants. Results: Among 164 participants, only 24.4% achieved the recommended goal of HbA1c level (<7%). Higher percentage of achieving this goal is observed among type 2 diabetics (26.2%) than type 1(10.5%). Higher educational level, being on diet prescribed by a physician or a dietitian, duration of DM less than 5 years and visits of diabetic clinic within the past 3 months were associated with better HbA1c level while age above 50 and treatment with both (insulin+pills) or insulin alone were associated with lower level of control. Forgetfulness was the barrier in more than the half of patients with HbA1c of 7% or more while fear of insulin injection is the only factor which showed statistically significant difference between males and females. Conclusion: High percentage of patients did not attain the recommended target of HbA1c level which is nearly comparable to results reported from many countries. This may indicate the presence of a gap between recommendations of the international guidelines and the actual practices. Regular clinic visits and higher educational level of the patients may contribute to better glycemic control.