Barriers to effective control of type 2 diabetes in outpatient clinics in Mosul: A case control study

Abstract

Background: Diabetes disease is a heterogeneous disorder with distinct genetic, etiological, immunological, and pathophysiological mechanisms that result in glucose intolerance and hyperglycemia.  Barriers to effective diabetes controls are extending and interrelating with one another. Determining these hurdles is critical in enabling patients to improve their diabetes control and long-term problems. Aim: To assess barriers to effective control of type-2 diabetes in outpatient clinics in Mosul city. Patient and method: a case-control study, was done on 200 diabetic patients, 100 with uncontrolled diabetes ad 100 with controlled, who were attending Al-Wafa center for diabetes and endocrinology, and 4 other health centers in Mosul for the period between the 1^st of February till the 31^st of July 2019.  Barriers include communication barriers, personal, self-management, and care barriers. Oral and written consent was taken from each participant.  Data was filled by the investigator through direct interviews with the patient or relative. Results: study showed that  frequency of all barriers domains was high in patients having uncontrolled diabetes and the difference was statistically significant (OR=6.93, 95% CI= 3.50-13.68, p-value=0.0001) in communication barriers and (OR=3.46, 95% CI= 1.94-6.17, p-value=0.0001) in personal barriers (OR=1.84, 95% CI= 1.05-3.23, p=0.033), (OR=1.94, 95% CI= 1.10- 3.43, p=0.022) in self-management barriers and care barriers, respectively. Conclusion: frequency of all domains was higher in patients having uncontrolled diabetes and the highest impact on the control of diabetes mellitus type 2 from the communication barriers.