Lifestyle and Socioeconomic Determinants of Glycemic Control among Patients with Type 2 Diabetes in Borama, Somaliland: A Cross-Sectional Analysis

Objective This study aimed to identify the lifestyle and socioeconomic determinants of glycemic control among patients with Type 2 Diabetes Mellitus (T2DM) in Borama, Somaliland, and a region with limited data on non-communicable diseases. Methods A hospital-based, cross-sectional study was conducted from March 2023 to September 2023 at Borama Regional Hospital, involving 152 adult T2DM patients selected via systematic random sampling. Data on sociodemographics, lifestyle factors (physical activity, dietary habits, tobacco use), and glycemic control (HbA1c dichotomized as ≤7.0% for good control and >7.0% for poor control) were collected using structured questionnaires and medical record reviews. Multivariate binary logistic regression was performed to identify independent predictors of poor glycemic control. Results The prevalence of poor glycemic control was high, affecting 63.8% of participants. Multivariate analysis revealed that poor physical activity (Adjusted Odds Ratio [AOR] = 3.85, 95% CI: 1.62–9.14, p = 0.002), unhealthy dietary habits (AOR = 4.51, 95% CI: 1.89–10.78, p < 0.001), unemployment or casual employment status (AOR = 2.98, 95% CI: 1.25–7.11, p = 0.014) and lower educational attainment (χ 2 = 6.45, p = 0.011) were independent predictors of poor glycemic control. Gender, and age were not significant independent predictors in the adjusted model. Conclusion A substantial proportion of T2DM patients in Borama experience poor glycemic control, strongly influenced by modifiable lifestyle factors and socioeconomic status. Interventions targeting improved physical activity, healthier dietary practices, and socioeconomic support for unemployed individuals are crucial for enhancing diabetes management outcomes in this setting and aligning with global health targets like Sustainable Development Goal 3 (SDG 3).