Barriers to Diabetes Self-Management and Family Support Among Older Adults in Resource-Limited Settings in Nigeria

TL;DR

This study explores diabetes management challenges and family support among older adults in rural Nigeria, highlighting barriers like lack of insurance and medication access.

Contribution

The study identifies key predictors of diabetes self-management in resource-limited settings and emphasizes the need for targeted interventions in rural communities.

Findings

89% of participants lacked health insurance, and 74.5% of rural participants did not take Metformin.

Only 21% received dietary guidance, and 34% engaged in regular physical activity.

Health insurance status, medication adherence, and healthcare follow-up were significantly associated with diabetes management.

Abstract

Diabetes is a growing public health concern among older adults, particularly in resource-limited settings where access to healthcare is constrained. This study examined diabetes self-management and family support among older adults in Adamawa State, Nigeria, using a cross-sectional, descriptive design with 810 participants across five local government areas. Data were collected through validated surveys and collected using the Kobo Toolbox. Results indicated that older adults face significant barriers to diabetes management, including lack of health insurance (89%), high out-of-pocket expenses, and limited access to medication, with 74.5% of rural participants not taking Metformin. Dietary and lifestyle interventions remain insufficient, as only 21% of participants reported receiving guidance on low-fat diets, and 34% engaged in regular physical activity. Correlation analyses revealed significant associations between diabetes management and factors such as health insurance status (p < .001), adherence to prescribed medication (p < .001), and healthcare follow-up (p < .001). Regression analysis identified local government area, diabetes diagnosis duration, and healthcare access as key predictors of diabetes self-management (R² = 0.221, p < .001). The findings underscore the need for targeted interventions to improve diabetes care among older adults, particularly in rural communities. Strengthening healthcare access, financial support mechanisms, and culturally tailored education programs could enhance self-management and reduce diabetes-related complications in this vulnerable population.