Healthcare seeking behaviors and control of clinical parameters among people with diabetes and hypertension comorbidity in Chirirbandar, Dinajpur, Bangladesh: a cross-sectional study

Abstract

Introduction: The global burden of non-communicable diseases (NCDs), including diabetes and hypertension comorbidities, disproportionately affects low and middle-income countries (LMICs). This study investigates healthcare seeking behaviors and the control of clinical parameters among adults living with diabetes and hypertension comorbidity in Chirirbandar, Dinajpur, Bangladesh. Method: A cross-sectional study was conducted from November 20 to December 10, 2024, targeting adults aged 18 and above with diagnosed diabetes and hypertension co-morbidity. Data were collected from 387 participants using semi-structured questionnaires and clinical measurements, following the national and World Health Organization guidelines. Descriptive and multivariable logistic regression were performed to report prevalence and identify associated factors. Findings: The majority of the study participants were female. Approximately 60% of participants exhibited uncontrolled diabetes, while 89% showed uncontrolled hypertension. Healthcare seeking behaviors revealed a reliance on private dispensaries and rural practitioners, with limited adherence to recommended follow-ups and medication. Older age and retired individuals were associated with better blood sugar control. Behavioral risk factors, including sedentary behavior, and high BMI, were associated with poor hypertension control. Surprisingly, physical inactivity was associated with better hypertension control and increased fruits and vegetables intake correlated with worse diabetes control, warranting further investigation. Conclusion: The findings highlight significant gaps in the management of diabetes and hypertension comorbidity in rural Bangladesh. Strengthening healthcare infrastructure, promoting self-care practices, and targeted public health interventions are critical for improving blood pressure and blood sugar control among people with hypertension and diabetes co-morbidity.