Secondary Prevention Practices Among Adult Patients with Type 2 Diabetes Mellitus at Meru Level Five Hospital and Consolata Hospital Nkubu, Kenya

Abstract

Diabetes is chronic metabolic disorder characterized by states of hyperglycemia with disturbances of carbohydrates, fat and protein metabolism. Diabetes affects millions of people globally every day and the prevalence of the disease is on the rise due to unhealthy diet and lifestyle. The ailment is associated with significant disability, premature deaths, and enormous medical costs. The disorder usually results to chronic complications including cardiovascular diseases, diabetic nephropathy, diabetic neuropathy, foot ulcers and diabetic eye diseases that are all preventable through secondary preventive measures. Once an individual has been diagnosed with T2DM, secondary preventive approaches are essential in preventing the occurrence of chronic complications. However, lack of awareness of these measures has been cited as the common reasons for the development of complications. The study aimed to assess the practice and factors influencing secondary prevention among patients with Type 2 Diabetes Mellitus (T2DM) at Consolata Hospital Nkubu and Meru Level Five Hospital. A descriptive correlational study design was adopted to collect data from 357purposively sampled participants with T2DM using questionnaires and Focus Group Discussion Guide. Quantitative data was analyzed using SPSS version 25 at 95% confidence interval and a significance level p 0.05.Frequency tables, bar graphs and pie charts were used for descriptive statistics while Chi squares and logistic regression were used for inferential analysis. Most respondents attended Meru Teaching and Referral Hospital. Majority of the respondents were aged between 40- 60 years. Most respondents 31.6% had secondary level of education and majority 67% was employed. Concerning secondary prevention, majority did foot examination on every visit 70.6% and BP monitoring 69.5%while 56.5% did annual eye screening. Most respondents were married and did not engage in harmful social habits such as smoking and alcohol use. The following factors were significantly predicting practice of secondary preventive measures among diabetes patients at a p value ≤0.05; knowledge on complications for diabetes, distance to the facility, availability of drugs, good staff reception, receiving health education and counseling, good care-giver communication, availability of DM services, availability of supplies for screening DM complications, and client satisfaction all significantly influenced DM secondary prevention. Affordability of services, health insurance cover of the patients, monthly cost of DM management and traditional beliefs in managing DM all significantly influenced DM secondary prevention. The level of secondary prevention was poor which was influenced by a number of factors that needs be addressed to reduce the global burden posed by the disease.