Socio-Demographic Environmental and Clinical Factors Influencing Diabetes Mellitus Control in Community Pharmacies of Lahore Pakistan

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Abstract
Background: Diabetes Mellitus (DM) represents a significant public health challenge in Pakistan, with a high prevalence exacerbated by various socio-demographic, clinical, and environmental factors. Community pharmacies offer an accessible setting for managing chronic diseases, yet the combined influence of these factors on diabetes control within Pakistani community settings remains underexplored. Objective: This study aimed to assess the impact of socio-demographic, environmental, and clinical factors on diabetes control among patients attending community pharmacies in Lahore, Pakistan. Methods: A cross-sectional study was conducted involving 321 patients with type 2 diabetes recruited from community pharmacies across three regions of Lahore. A structured questionnaire, developed based on international guidelines, was used to collect data on socio-demographic characteristics, clinical history, lifestyle behaviors, and environmental factors. Diabetes control was categorized as controlled, partially controlled, or uncontrolled. Data were analyzed using descriptive statistics, chi-square tests, and multiple logistic regression in SPSS version 26.0. Results: Key socio-demographic predictors of better diabetes control included higher education levels (AOR=1.317-2.338, p≤0.006), rural residence (AOR=0.857, p=0.001), and non-obese status (AOR=1.057, p=0.006). Significant clinical and lifestyle predictors were treatment adherence (AOR=1.287, p< 0.001), regular physical activity (AOR=1.387, p< 0.001), healthy dietary patterns (AOR=1.317, p< 0.001), and longer duration of diabetes (>5 years, AOR=1.277, p=0.008). Conversely, a family history of diabetes (AOR=1.967, p< 0.001) and the presence of comorbidities were associated with poorer control. Smoking status was also influential, with ex-smokers demonstrating better control than current smokers. Conclusion: Diabetes control is multifactorial, strongly influenced by education, residence, obesity, lifestyle behaviors, and treatment adherence. Interventions targeting modifiable risk factors through patient education, lifestyle counseling, and personalized care are essential to improve diabetes outcomes in community settings. These findings underscore the critical role of community pharmacists in providing holistic diabetes management.

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