Factors impacting on diabetes knowledge, medication adherence and glycemic control among adult diabetics visiting a county teaching and referral hospital in Kenya: a cross-sectional study.

Introduction: optimal management of diabetes involves interplay between patients' understanding of their disease and medication adherence, which would eventually influence glycemic control. However, there is scant published literature on the interconnection of patient related factors that impact on optimal management of diabetes in resource-limited settings such as Kenya.

Methods: a hospital based cross-sectional survey involving 270 freely consenting adult diabetics investigated the interconnection between diabetes knowledge, medication adherence and glycemic control. Data on the patient´s knowledge and medication adherence was collected using validated tools whilst glycemic control was evaluated using the patients' glycated haemoglobin values. Data analysis was carried out using STATA version 13 statistical software, employing the chi square test for association and simple linear regression for prediction, with p ≤0.05 considered significant.

Results: participants´ level of knowledge on diabetes was significantly associated with the academic achievement (p=0.001), while their medication adherence was significantly associated with family support (p=0.001) and duration of disease since diagnosis (p=0.019). On linear regression, family support occasioned by the nature of participants' household setup, had a strong positive correlation [r=0.99 (CI 0.60-1.00)] with optimal glycemic control.

Conclusion: family support is an important determinant of medication adherence and optimal glycemic control among diabetic patients. Clinicians should team up with family members of diabetic patients for optimal glycemic control.