Empirical Study of Factors Associated with Diabetes Mellitus Control Among Patients in Tertiary Hospitals in Enugu State

Glycaemic control among people with type 2 diabetes in Nigerian tertiary hospitals is suboptimal, reflecting the intersection of medication adherence challenges, healthcare system factors, and lifestyle determinants that require empirical characterisation for programme improvement. This study empirically examined factors associated with glycaemic control among patients with type 2 diabetes in tertiary hospitals in Enugu State, South East Nigeria. A cross-sectional analytical study was conducted at two tertiary hospitals (University of Nigeria Teaching Hospital and ESUT Teaching Hospital) enrolling 320 adult patients with confirmed type 2 diabetes who had been on treatment for at least six months. HbA1c level was the primary outcome (good control defined as HbA1c below 7.0 percent). A structured questionnaire assessed medication adherence (MMAS-8), dietary behaviour, physical activity, self-monitoring of blood glucose, knowledge of diabetes management, and healthcare system utilisation. Multivariable logistic regression was applied. Results showed that only 38.4 percent of patients achieved the HbA1c target. Significant predictors of poor control included medication non-adherence (OR 4.2; p < 0.001), absence of blood glucose self-monitoring (OR 3.1; p < 0.001), poor dietary compliance (OR 2.8; p < 0.001), and physical inactivity (OR 2.1; p < 0.01). Healthcare system factors including appointment non-compliance (OR 2.6; p < 0.001) and drug stockouts (OR 2.3; p < 0.01) also significantly predicted poor control. The study recommends structured diabetes self-management education, affordable SMBG device access, and consistent drug supply as integrated strategies for improving glycaemic control. Keywords: diabetes mellitus, glycaemic control, HbA1c, Enugu State, South East Nigeria