Self-care behaviors and glycemic control in Nigerian patients with type 2 diabetes: a pilot cross-sectional study

Self-care behaviors are essential for managing type 2 diabetes mellitus (T2DM), even among patients receiving specialized clinical care. However, limited evidence exists on how these behaviors affect glycemic outcomes in Nigerian patients already engaged with endocrinology services. This study assessed self-care practices and their association with glycemic control among T2DM patients attending two specialized clinics in Gusau, Nigeria.

A cross-sectional study was conducted among 262 adult T2DM patients from two endocrinology clinics in Gusau, Nigeria. Participants were recruited using a convenience sampling approach during routine clinic visits. Each completed questionnaires on demographics, the Summary of Diabetes Self-Care Activities (SDSCA), and the Morisky Medication Adherence Scale (MMAS-4). Fasting blood glucose levels were used to assess glycemic control. Logistic regression analyzed the association between self-care behaviors and glycemic outcomes; linear regression identified influencing factors.

Among 262 participants, 45.8% had uncontrolled fasting blood glucose (≥ 7 mmol/L). Higher overall self-care scores were significantly associated with better glycemic control (OR 0.83; 95% CI 0.78-0.88; P < 0.001). Dietary adherence (OR 0.72; 95% CI 0.61-0.85), physical activity (OR 0.74; 95% CI 0.65-0.84), and blood glucose monitoring (OR 0.22; 95% CI 0.09-0.54) were significantly associated with improved glycemic outcomes. Foot care (OR 0.98; P = 0.797) and medication adherence (OR 3.21; P = 0.095) showed no significant association. Males, older adults (≥ 60 years), and Yoruba/Igbo participants had lower dietary scores, while exercise scores were higher among males, singles, and Igbo patients. Longer diabetes duration (≥ 20 years) was linked to better medication adherence and exercise.

Self-care behaviors were significantly associated with glycemic control among T2DM patients attending two specialized endocrinology clinics in Gusau, Nigeria. Interventions tailored to demographic and cultural contexts are essential to strengthen adherence in key areas such as diet, physical activity, and glucose monitoring. These findings underscore the importance of supporting self-management, even in patients with established access to clinical care.