Adherence to Diabetes Self-Management and the Associated Factors among Type 1 Diabetic Adolescents Attending Outpatient Diabetic Clinic at Public Hospitals in Addis Ababa, Ethiopia, 2021

Objectives: The purpose of this study was to determine the level of adherence to diabetes self-management and associated factors among type 1 diabetic adolescents attending outpatient diabetic clinics at Public Hospitals in Addis Ababa, Ethiopia. Methods An institutional-based cross-sectional study was carried out among 422 adolescents with type 1 diabetes attending outpatient diabetic clinics at four randomly selected public hospitals in Addis Ababa. The adolescents were interviewed using pretested questionnaires to give information on socio-demographic characteristics, medical factors, knowledge about type 1 diabetes, adherence to diabetes self-management, self-efficacy, and social support related to type 1 diabetes. A variable that has a P-value of <0.2 in bi-variable logistic regression analysis was subjected to multivariable logistic regression analysis to control the confounding factors. The level of significance was pronounced at P-value <0.05. Results In this study, a total of 414 diabetic adolescents were interviewed making a 98.1% response rate. About 218 participants (52.7%) had poor adherence to overall diabetes self-management. Self-efficacy (AOR=8.7, 95% CI:1.9-14.1, P=0.005), social support (AOR=4.6, 95%CI:1.5-13.5, P=0.006), age (AOR=0.2, 95%CI:0.1-0.4, P=0.001), good knowledge of the disease (AOR=9.046, 95%CI:3.83-13.5, P=0.000), moderate knowledge (AOR=6.763, 95%CI:2.18-12.921, P=0.001), and time since diagnosis of type 1 diabetes (AOR=0.1, 95%CI:0.02-0.2, P=0.005) were significantly associated with adherence to diabetes self-management. Conclusions and Recommendations: More than half of this population had poor adherence. The finding suggested that implementing a comprehensive guideline of adherence and expanding the recurrence of follow-up visits could be important for this population.