Association between glycemic control and diabetes self-management practices among older Nigerian adults with type 2 diabetes: a cross-sectional study

Abstract

This hospital-based, cross-sectional study examined the association between glycemic control and diabetes self-management behaviors among older adults with type 2 diabetes mellitus (T2DM) in Nigeria. Data were collected between August 2024 and September 2025 across 12 tertiary hospitals from Nigeria’s six geopolitical zones. A two-stage sampling technique was used, selecting hospitals based on their expertise in diabetes care and recruiting 762 participants aged ≥60 years (mean age = 70.75). Ethical approval was obtained, and informed consent was provided by all participants. The Glycemic Control and Diabetes Self-Management Questionnaire (GCDSMQ) was employed to assess sociodemographic characteristics, clinical data, and self-management behaviors. Descriptive and bivariate analyses, including chi-square tests and multivariable logistic regression, were conducted to identify factors associated with glycemic control. Results indicated that 37.1% of participants achieved normal glycemic control. Key self-management behaviors, such as regular blood glucose monitoring, adherence to medication, and physical activity, were significantly associated with improved glycemic control. Female gender and employment status were also significant predictors of better glycemic control, while other factors like age, marital status, and diabetes duration did not show significant associations. The study highlights the importance of self-management behaviors and socioeconomic factors in achieving optimal glycemic control among older Nigerian adults with T2DM. Interventions targeting these factors could improve diabetes care in this population.