Worldwide, diabetes mellitus (DM) and cardiovascular diseases (CVDs) frequently co-occur among older adults. This study assessed diabetes self-management practices and identified key determinants of adherence among older Nigerians with comorbid CVDs attending geriatric outpatient clinics. A descriptive cross-sectional survey was conducted (August 2024–May 2025) across six tertiary hospitals, each representing a geopolitical zone in Nigeria. Multistage sampling was used to select hospitals, followed by convenience sampling of eligible adults aged ≥ 60 years with confirmed diagnoses of both DM and CVD ( n = 454). Data were collected using a culturally adapted, validated questionnaire (DMPAQ). Adherence was operationally defined as engagement in at least 75% of eight recommended diabetes self-management practices (i.e., participation in ≥ 6 of 8 practices), with each practice scored dichotomously (1 = performed as recommended; 0 = not performed as recommended). Analyses included descriptive statistics, chi-square tests, and odds ratios (ORs), with significance set at p ≤ 0.05. Using the predefined ≥ 75% adherence threshold (≥ 6 of 8 self-management practices), the proportion of participants classified as adherent was 42.7%. The previously reported value of 42.2% represents the mean percentage of recommended self-management practices performed across the study population, rather than the prevalence of adherence. Univariate logistic regression analysis identified tertiary education (OR = 3.19, 95% CI 2.18–4.68, p < 0.001), receipt of diabetes education (OR = 3.45, 95% CI 2.36–5.05, p < 0.001), diabetes medication status (OR = 3.09, 95% CI 2.11–4.52, p < 0.001), and diabetes management knowledge (OR = 0.25, 95% CI 0.17–0.36, p < 0.001) as significant predictors of adherence. Poor glycemic control was also significantly associated with lower odds of adherence (OR = 0.40, 95% CI 0.27–0.58, p < 0.001). Commonly reported barriers to effective diabetes management included difficulty managing coexisting diabetes and CVD (74.9%), poor access to healthcare services (71.8%), and high medication costs (68.3%). Adherence to diabetes self-management among older adults with CVD in Nigeria is suboptimal. When defined using a ≥ 75% composite threshold, fewer than half of participants met recommended self-management standards, while the mean adherence score (42.2%) further highlights overall suboptimal practice levels. Interventions that prioritize health literacy, glycemic control, and improved access to affordable medications and integrated chronic care are essential to improving outcomes in this high-risk population.
Ugwu et al. (Thu,) studied this question.
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