INFLUENCE OF SOCIAL SUPPORT ON GLYCAEMIC CONTROL IN DIABETES MELLITUS PATIENTS ATTENDING THE OUTPATIENT CLINIC OF ECWA EVANGEL HOSPITAL , (NOW, BINGHAM UNIVERSITY TEACHING HOSPITAL), JOS.

Abstract

Objectives: The main objective of this study was to determine the influence of social support on
glycemic control in patients with diabetes mellitus (DM), attending the outpatient clinic of
Bingham University Teaching Hospital (BhUTH), Jos; with a view to making recommendations
to improve these support systems and thus promote adherence and ultimately, improve glycaemic
control. The research determined the level of glycaemic control, social support and adherence, as
well as factors affecting adherence in patients with DM. The study also determined the correlation
between social support and adherence, between adherence and glycaemic control and between
social support and glycaemic control in patients with DM.

Methods: This was a Hospital based Cross Sectional study. Patients who met the inclusion criteria
were selected using systematic random sampling technique. A physical examination was done to
determine their BP, weight, height, and peripheral neuropathy. Visual acuity and fundoscopy were
also done to check the state of their eyes. Questionnaires were then admistered to elicit their
sociodemographic characteristics, Social support and adherence. Urinalysis, glycosylated
haemoglobin and full blood count were carried out for these patients. The Data collected were
then analysed with SPSS-15.0 version.
Results: A total of 70 participants, made up of 29 males (41.4%) and 41 females (58.6%) were
studied. The mean age of the patients was 53,61years ±12.57 with literacy rate of 64.3%. 74.8%
of them were married and 58.6% of the patients were employed. However, 54.3% had a monthly
earning of Twenty thousand naira and below as a household income with only 10% having a
monthly household income of one hundred thousand naira and above.

The mean body mass index (BMI) was 27.33Kg/M2 and 55.7% of the participants were
overweight, while 18.6% were obese. Majority (62.9%) of the participants had disease duration of
0-5years and 41.4% had positive family history of DM.

Only 32.9 of the participants had good glycaemic control (HbA 1C of 7.0% or less). The
adherence to DM management in this study was set at 80% of adherence scores and only 35.7%
of the participants were adherent. Lack of finance (30.0%) was the commonest reason for poor or
non adherence. This was followed by lack of symptoms (23.33%), feeling of having been cured
(16.67%), side effects of drugs (13.33%), perceived drug inefficacy (10.0 %) and forgetfulness
(6.67%). Furthermore majority (67.2%) of the patients had social support score of 51% and above.
This study found functional and structural (practical or tangible) social support as the main forms
of social support received by the study participants.

There was a significant positive correlation between social support and adherence, between
adherence and glycaemic control and between social support and glycaemic control in patients
with DM. There was also a significant negative relationship between BMI and glycaemic control
and between disease duration and glycaemic control.

Conclusion: In spite of the limitations of the study, the results provide solid quantitative
evidence that social support has significant influence on glycaemic control in patients with DM. It
does not however prove a causal relationship nor does it try to show the link between the variables.
These are subjects for further studies.