Objective:

To investigate the relationship between glycemic control and factors such as diabetes-related distress, self-care practices, financial strain, and cost-related non-adherence among patients with type 2 diabetes mellitus (T2DM) in Nigeria, highlighting the significance of these factors in the context of Nigeria's diabetes burden.

Key Findings:

• Mean HbA1c was 7.04%, with 43% of respondents having HbA1c ≥7%.
• 32% of participants experienced diabetes-related distress, 56% had poor self-management, 54% reported financial toxicity, and 48.3% practiced cost-related non-adherence.
• Poor self-management and diabetes-related distress were significantly associated with poor glycemic control (p < 0.05).
• Financial toxicity and cost-related non-adherence were not significantly associated with glycemic control (p > 0.05).
• Younger age, use of multiple antidiabetic medications, insulin use, and lack of access to an endocrinologist were significant covariates of poor glycemic control.

Interpretation:

The study highlights that poor self-management and diabetes-related distress are critical factors influencing glycemic control among T2DM patients in Nigeria, while financial factors did not show a significant association, suggesting a need for targeted healthcare interventions.

Limitations:

• The study was limited to three secondary-level hospitals, which may not represent the broader population, potentially affecting the generalizability of the findings.
• The reliance on self-reported measures may introduce bias, impacting the accuracy of the data collected.

Conclusion:

Approximately half of the participants had poor glycemic control, indicating the need for diabetes education focused on behavioral modification and psychological support, alongside improved access to endocrinologists, while also recognizing the importance of addressing financial factors.