Prevalence and Factors Associated with Type 2 Diabetes Self-Management Among Patients Attending Mbale Regional Referral Hospital: A Cross-Sectional Study in Eastern Uganda

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that requires sustained self-management to achieve optimal glycemic control and prevent long-term complications. Effective self-management involves adherence to medication, healthy diet, physical activity, blood glucose monitoring, and regular clinic attendance. However, evidence suggests that self-management practices remain suboptimal in many low- and middle-income countries, including Uganda, and data from regional referral hospitals are limited. This study aimed to determine the prevalence of self-management practices and identify factors associated with effective self-management among patients with T2DM receiving care at Mbale Regional Referral Hospital, Eastern Uganda. Methods: A hospital-based cross-sectional study was conducted between among 385 adults with T2DM attending the diabetes clinic. Participants were selected using systematic random sampling from the clinic registry. Data were collected using a structured interviewer-administered questionnaire, including the Diabetes Self-Management Questionnaire (DSMQ). DSMQ total scores were transformed to a 0–100 scale, with a cut-off of ≥70% defining good self-management. Descriptive statistics summarized participants’ characteristics, and bivariate and multivariable logistic regression analyses were performed using STATA version 17.0 to identify factors independently associated with good self-management. Results: Only 34.6% (133/385) of participants demonstrated good self-management. Factors independently associated with good self-management included higher education level (AOR = 2.4, 95% CI: 1.52–4.81, p=0.001), employment (AOR = 5.3, 95% CI: 3.53–9.18, p=0.02), higher monthly income (AOR = 3.2, 95% CI: 1.52–5.98, p=0.001), shorter diabetes duration (1–5 years vs >10 years; AOR = 2.7, 95% CI: 1.35–8.25, p=0.005), awareness of diabetes complications (AOR = 3.1, 95% CI: 1.70–5.76, p=0.041), and family support (AOR = 2.1, 95% CI: 1.60–7.74, p=0.006). General diabetes knowledge was not significantly associated with self-management. Conclusion: The prevalence of good self-management among T2DM patients at Mbale Regional Referral Hospital is low. Socio-economic factors, awareness of diabetes complications, shorter disease duration, and family support significantly influence self-management behaviors. Interventions targeting these factors are essential to improve diabetes outcomes in this setting.