BARRIERS TO EFFECTIVE INSULIN THERAPY IN ADULT PATIENTS WITH POORLY CONTROLLED TYPE 1 DIABETES MELLITUS: A STUDY AT ASELLA REFERRAL AND TEACHING HOSPITAL, ARSI UNIVERSITY, ETHIOPIA (2025).

Abstract

Abstract Background: Poor glycemic control remains a major challenge in the management of diabetes mellitus and is associated with increased morbidity and mortality. This study aimed to assess the barriers to effective insulin therapy in adult patients with poorly controlled type 1 diabetes mellitus attending Asella Referral and Teaching Hospital, Ethiopia. Objective: To assess the barriers that hinder effective insulin therapy in adult patients with poorly controlled T1DM attending the diabetic follow-up clinic at Asella Referral and Teaching Hospital, Asella, Ethiopia in 2025. Methodology: A cross-sectional study was conducted among 273 type 1 adult diabetes patients on follow-up at ARTH. Data was collected by kobotool box and was entered using and analyzed by SPSS version 27. Descriptive statistics was carried out, and categorical variables were reported as frequencies and percentages whereas; median and interquartile range (IQR) was used for continuous variables. Binary logistic regression analysis was applied to identify barriers associated with poor glycemic control in adult patients with type 1 DM. P value < 0.25 in the bivariate logistic regression was fitted into the multivariable logistic regression analysis. The level of significance was declared at a p-value of <0.05. Results: Out of 273 type 1 diabetes patients included in the study, 157 (57.5%) had poor glycemic control.The factors associated with poor glycemic control were depression (AOR = 2.92; 95% CI: 1.39–5.95.15; p = 0.004), lower monthly income (AOR=1.54;95% CI[1.30-2.96];p=0.049),basal-only insulin regimens (AOR = 2.045;95%,CI :1.055-3.964; p = 0.034), and good adherence (AOR = 0.39; 95% CI: [0.16–0.97]; p=0.04). Conclusion:The occurrence of poor glycemic control is high among adult patients with diabetes who visit ARTH.The results emphasize the view that ideal glycemic control must be an integrated methodology that covers mental health, socioeconomic issues, and compliance with therapy, in addition to clinical management Key words: Type 1 diabetes mellitus, Glycemic control, ARTH, Ethiopia