Influence of Duration of Diabetes, Presence of Comorbidities, and Medication Adherence Contributing to Poor Glycemic Control Among Clients at Kapkatet Sub-County Hospital, Kericho County Kenya

Abstract

Diabetes Mellitus (DM) remains a major public health concern, especially in low- and middle-income countries like Kenya, where poor glycemic control is highly prevalent. This study aimed to examine the influence of duration of diabetes, presence of comorbidities, and medication adherence on poor glycemic control among patients attending Kapkatet Sub-County Hospital. A hospital-based cross-sectional study was conducted among 300 adult patients diagnosed with diabetes mellitus. Data were collected through structured questionnaires and medical record reviews. Descriptive statistics were used to summarize demographic and clinical characteristics. Chi-square tests and logistic regression analysis were applied to assess associations between clinical factors and glycemic control. The study adhered to ethical guidelines including informed consent and confidentiality. Out of 250 respondents (response rate: 83.3%), 60% exhibited poor glycemic control (fasting blood glucose ≥ 7.2 mmol/L). Patients with a disease duration of over 10 years had a significantly higher likelihood of poor control (χ² = 27.12, p < 0.001). Comorbidities were present in 88 patients, with 62.5% of them exhibiting poor control, though the association was not statistically significant (p = 0.202). Patients on insulin therapy alone had the highest rate of poor control (94.1%), while those reporting difficulty accessing medications were significantly more likely to have poor control (χ² = 9.34, p = 0.002). Clinical factors particularly longer duration of diabetes and poor medication access are significantly associated with poor glycemic control. Though comorbidities were not statistically significant, their presence correlated with higher poor control rates. The findings call for targeted interventions, including structured follow-up for long-term patients, improved medication access, and strengthened patient education to enhance diabetes outcomes in rural health settings.