Glycemic Control Among People Living with Diabetes and Human Immunodeficiency Virus in Ethiopia: Leveraging Clinical Care for the Looming  Co-Epidemics

Tsegaye Melaku,1 Legese Chelkeba,1 Zeleke Mekonnen,2 Kabaye Kumela1 1Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia; 2School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Tsegaye Mela...

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Autores principales: Melaku T, Chelkeba L, Mekonnen Z, Kumela K
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Publicado: Dove Medical Press 2020
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spelling oai:doaj.org-article:5b622eea95ad41bcb9c3bea3fee5a63b2021-12-02T11:12:54ZGlycemic Control Among People Living with Diabetes and Human Immunodeficiency Virus in Ethiopia: Leveraging Clinical Care for the Looming  Co-Epidemics1178-7007https://doaj.org/article/5b622eea95ad41bcb9c3bea3fee5a63b2020-11-01T00:00:00Zhttps://www.dovepress.com/glycemic-control-among-people-living-with-diabetes-and-human-immunodef-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Tsegaye Melaku,1 Legese Chelkeba,1 Zeleke Mekonnen,2 Kabaye Kumela1 1Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia; 2School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Tsegaye MelakuJimma University, Jimma, EthiopiaTel +251 913765609Email tsegayemlk@yahoo.comBackground: Antiretroviral therapy has decreased human immunodeficiency virus related mortality. However, the incidence of diabetes mellitus is increasing among people living with human immunodeficiency virus and adds complexity to the standards of care.Objective: The study was aimed to determine the glycemic control and delivery of clinical care among people living with diabetes and human immunodeficincy virus in Ethiopia.Methods: A comparative prospective cohort study was conducted among patients living with diabetes at follow-up clinics of Jimma Medical Center in two study arms. The first arm was people living with diabetes and human immunodeficiency virus. The second arm was human immunodeficiency virus negative patients living with diabetes. The expanded English version of the summary of diabetes self-care activities scale was used to measure self-care behaviors. In order to identify the predictors of glycemic control, multivariable Cox regression analysis was used. Statistical significance at p-value ≤ 0.05 was considered.Results: A total of 297 eligible participants were followed for one year, with a mean age of 44.35± 12.55 years. Males accounted for 55.9%. After one year of follow-up, 61.9% of diabetes people living with human immunodeficiency virus, and 49% of human immunodeficiency virus-negative patients with diabetes poorly met blood glucose target (p=0.037). Female gender [AHR: 2.72; 95% CI (1.21– 5.72)], age > 31 years [AHR: 2.48; 95% CI (1.34– 11.01)], increased waist circumference [AHR: 3.64; 95% CI (2.57– 16.12)], overweight [AHR: 3.63; 95% CI (1.65– 22.42)], chronic disease comorbidity [AHR: 2.02; 95% CI (1.44– 2.84)], human immunodeficiency virus infection [AHR: 3.47; 95% CI (2.03– 23.75)], living longer with diabetes (> 5 years) [AHR: 3.67; 95% CI (3.26– 4.14)] showed a higher risk of blood sugar control failure and were independent predictors of uncontrolled glycemia. Tuberculosis infection increased the risk of uncontrolled blood sugar among people living with diabetes and human immunodeficency virus[AHR:3.82;95% CI(2.86-5.84].Conclusion: Significant gaps were observed in achieving the recommended glycemic target and involvement of patients on self-care care behavior in the study area. The co-occurrence of tuberculosis, human immunodeficiency virus, and diabetes is triple trouble needing special attention in their management. It is high time to leverage the clinical care of the looming co-epidemics through chronic comprehensive care clinic.Keywords: human immunodeficiency virus, glycemic control, treatment outcome, self-care behaviorMelaku TChelkeba LMekonnen ZKumela KDove Medical Pressarticlehuman immune deficiency virusglycemic controltreatment outcomeself-care behaviorSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 13, Pp 4379-4399 (2020)
institution DOAJ
collection DOAJ
language EN
topic human immune deficiency virus
glycemic control
treatment outcome
self-care behavior
Specialties of internal medicine
RC581-951
spellingShingle human immune deficiency virus
glycemic control
treatment outcome
self-care behavior
Specialties of internal medicine
RC581-951
Melaku T
Chelkeba L
Mekonnen Z
Kumela K
Glycemic Control Among People Living with Diabetes and Human Immunodeficiency Virus in Ethiopia: Leveraging Clinical Care for the Looming  Co-Epidemics
description Tsegaye Melaku,1 Legese Chelkeba,1 Zeleke Mekonnen,2 Kabaye Kumela1 1Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia; 2School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Tsegaye MelakuJimma University, Jimma, EthiopiaTel +251 913765609Email tsegayemlk@yahoo.comBackground: Antiretroviral therapy has decreased human immunodeficiency virus related mortality. However, the incidence of diabetes mellitus is increasing among people living with human immunodeficiency virus and adds complexity to the standards of care.Objective: The study was aimed to determine the glycemic control and delivery of clinical care among people living with diabetes and human immunodeficincy virus in Ethiopia.Methods: A comparative prospective cohort study was conducted among patients living with diabetes at follow-up clinics of Jimma Medical Center in two study arms. The first arm was people living with diabetes and human immunodeficiency virus. The second arm was human immunodeficiency virus negative patients living with diabetes. The expanded English version of the summary of diabetes self-care activities scale was used to measure self-care behaviors. In order to identify the predictors of glycemic control, multivariable Cox regression analysis was used. Statistical significance at p-value ≤ 0.05 was considered.Results: A total of 297 eligible participants were followed for one year, with a mean age of 44.35± 12.55 years. Males accounted for 55.9%. After one year of follow-up, 61.9% of diabetes people living with human immunodeficiency virus, and 49% of human immunodeficiency virus-negative patients with diabetes poorly met blood glucose target (p=0.037). Female gender [AHR: 2.72; 95% CI (1.21– 5.72)], age > 31 years [AHR: 2.48; 95% CI (1.34– 11.01)], increased waist circumference [AHR: 3.64; 95% CI (2.57– 16.12)], overweight [AHR: 3.63; 95% CI (1.65– 22.42)], chronic disease comorbidity [AHR: 2.02; 95% CI (1.44– 2.84)], human immunodeficiency virus infection [AHR: 3.47; 95% CI (2.03– 23.75)], living longer with diabetes (> 5 years) [AHR: 3.67; 95% CI (3.26– 4.14)] showed a higher risk of blood sugar control failure and were independent predictors of uncontrolled glycemia. Tuberculosis infection increased the risk of uncontrolled blood sugar among people living with diabetes and human immunodeficency virus[AHR:3.82;95% CI(2.86-5.84].Conclusion: Significant gaps were observed in achieving the recommended glycemic target and involvement of patients on self-care care behavior in the study area. The co-occurrence of tuberculosis, human immunodeficiency virus, and diabetes is triple trouble needing special attention in their management. It is high time to leverage the clinical care of the looming co-epidemics through chronic comprehensive care clinic.Keywords: human immunodeficiency virus, glycemic control, treatment outcome, self-care behavior
format article
author Melaku T
Chelkeba L
Mekonnen Z
Kumela K
author_facet Melaku T
Chelkeba L
Mekonnen Z
Kumela K
author_sort Melaku T
title Glycemic Control Among People Living with Diabetes and Human Immunodeficiency Virus in Ethiopia: Leveraging Clinical Care for the Looming  Co-Epidemics
title_short Glycemic Control Among People Living with Diabetes and Human Immunodeficiency Virus in Ethiopia: Leveraging Clinical Care for the Looming  Co-Epidemics
title_full Glycemic Control Among People Living with Diabetes and Human Immunodeficiency Virus in Ethiopia: Leveraging Clinical Care for the Looming  Co-Epidemics
title_fullStr Glycemic Control Among People Living with Diabetes and Human Immunodeficiency Virus in Ethiopia: Leveraging Clinical Care for the Looming  Co-Epidemics
title_full_unstemmed Glycemic Control Among People Living with Diabetes and Human Immunodeficiency Virus in Ethiopia: Leveraging Clinical Care for the Looming  Co-Epidemics
title_sort glycemic control among people living with diabetes and human immunodeficiency virus in ethiopia: leveraging clinical care for the looming  co-epidemics
publisher Dove Medical Press
publishDate 2020
url https://doaj.org/article/5b622eea95ad41bcb9c3bea3fee5a63b
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AT mekonnenz glycemiccontrolamongpeoplelivingwithdiabetesandhumanimmunodeficiencyvirusinethiopialeveragingclinicalcarefortheloomingnbspcoepidemics
AT kumelak glycemiccontrolamongpeoplelivingwithdiabetesandhumanimmunodeficiencyvirusinethiopialeveragingclinicalcarefortheloomingnbspcoepidemics
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