Strategies for the prevention of type 2 diabetes mellitus among adults in Bale Zone, South East Ethiopia

Abstract

The purpose of this study was to develop strategies to prevent type 2 diabetes mellitus (T2DM) among adults in the Bale Zone, south-east Ethiopia. The study was organised into three phases. Phase I involved a population-based quantitative descriptive cross-sectional design to determine the prevalence of T2DM, analyse its risk factors, and describe adults' knowledge and perceptions towards T2DM risky behaviours and their prevention among adults in the Bale Zone administrative towns. It involved 557 adults aged 18 and above. The data was collected using a structured questionnaire for the interview, physical measurements, and fasting blood glucose testing. Phase II focused on an unmatched case-control study to identify determinants of T2DM and involved 182 T2DM patients and 362 control adults without diabetes from selected hospitals in the Bale Zone using a structured questionnaire, physical measurements, mental stress, and food insecurity. The data were processed using the statistical package for social sciences (SPSS) version 25 and STATA software version 14 for both phases 1 and 2 of the study. The validity and reliability of the data were ensured. The rigour of the data in phases 1 and 2 of the study was ensured through validity and reliability. Simple descriptive statistics and multivariate logistic regression were used to analyse the data. The study was conducted with consideration for ethical principles of research such as beneficence, justice, informed consent, respect for individuals, privacy and confidentiality, and scientific integrity. In phase III, based on the findings of the two phases of the study, an extensive literature review, and expert opinions, the researcher developed strategies for the prevention of T2DM in adults. In Phase I, the prevalence of T2DM was found to be 6.7%, with only 8.2% aware of their status. Factors such as not eating fruit, eating animal fat, not engaging in vigourous-intensity physical activity related to work, having a higher BMI, and having high blood pressure (hypertension) have all been significantly associated with T2DM. In terms of knowledge about T2DM risky behaviours and prevention, 42.6% of respondents had a "low" level, 38.3% had a "medium" level, and 19.1% had a "high" level. The majority of respondents demonstrated high perceptions of susceptibility, severity, and the benefits of applying preventative activity to T2DM. In phase II, the determinants of T2DM were age over 50 years, male sex, primary and secondary education, medium wealth index ,ever smoking, current alcohol use, food insecurity, and mental stress. The prevalence of T2DM in the study area was higher than the national prevalence in Ethiopia and has become a significant public health problem, yet there are limited efforts or activities to prevent it. The developed strategies from this research, if implemented, will help reduce the burden of T2DM among adults in Ethiopia.