Factors Influencing Therapeutic Observance in Diabetic Subjects in the Province of Essaouira (Morocco): A Cross-Sectional Study.

Background: Therapeutic observance remains a major problem in managing diabetic subjects, just like in other pathologies treated by medication and lifestyle modification. This study aims to determine the rate of therapeutic observance among diabetic subjects in the province of Essaouira and to identify the factors that influence it. Methods: A cross-sectional questionnaire survey was conducted among 498 type 1 and 2 diabetic subjects, regularly being checked at different health centers in the province of Essaouira (Morocco). Results: Almost a quarter of the surveyed subjects (23.3%) had poor observance. The results of the binary logistic regression model show that, in order of importance, observance is associated with six factors: Availability and access to medical treatment (Odds Ratio OR: 3; 95% CI confidence interval [1.78-5.03]); the side effects related to the treatment (OR: 2.60; 95% CI [1.65-4.09]); the family support (OR: 1.58 ; 95% CI [0.95-2.61]); duration of diabetes (OR: 0.55 ; 95% CI [0.34-0.88]); the age (OR: 0.50 ; 95% CI [0.30-0.82]); awareness level about the disease (OR: 0.43 ; 95% CI [0.21-0.90]). Conclusion: The results of the present study have allowed us to identify several factors that can influence therapeutic observance, that prove necessary to be considered and acted upon.

Observance of hygiene and dietary rules and the associated factors among diabetic subjects in Essaouira Province, Morocco: a cross-sectional study.

Introduction: hygiene and dietary recommendations are a fundamental pillar of diabetes management. The objective of this study is to measure the rate of observance of hygiene and dietary rules and the factors associated with these among a group of Moroccan diabetic subjects. Methods: a cross-sectional questionnaire survey was conducted on 522 subjects with types 1 and 2 diabetes followed at different health centres in the province of Essaouira (Morocco). Results: non-observance of hygiene and dietary rules rate was assessed at 41,4%, (66.5% for diet, 32.4% for lifestyle and 30.8% for physical activity). Rural area (p<0.001), poor glycaemic control (p<0.001), ignorance of hygiene and dietary rules (p<0.001) and long duration of diabetes (p<0.01) are associated with non-observance of diet. Good family support (p<0.01) is associated with good observance of lifestyle recommendations, short duration of diabetes progression (p<0.01) is associated with good observance of physical activity recommendations. Conclusion: non-observance of hygiene and dietary rules is always a problem in the management of chronic diseases. Ignorance of hygiene and dietary measures, lassitude and difficulty in adapting to a new lifestyle are the main obstacles that diabetics must overcome in order to better manage their disease.