Association of comorbid and metabolic factors with optimal control of type 2 diabetes mellitus

Abstract

Background:Type 2 diabetes mellitus (T2DM) is a poorly controlled epidemic worldwide that demands active research into mitigation of the factors that are associated with poor control.Aims:The study was to determine the factors associated with suboptimal glycemic control.Materials and Methods:Electronic medical records of 263 adult patients with T2DM in our suburban internal medicine office were reviewed. Patients were divided into two groups: Group 1 [optimal diabetes control with glycosylated hemoglobin (HbA1c) of 7% or less] and Group 2 (suboptimal diabetes control with HbA1c greater than 7%). The influence of factors such as age, gender, race, social history, comorbid conditions, gestational diabetes, family history of diabetes, diabetes management, statin use, aspirin use, angiotensin convertase enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) use, body mass index (BMI), blood pressures, lipid profile, and urine microalbumin level were analyzed in the two groups.Results:In the suboptimal diabetes control group (N = 119), the majority (86.6%) of the patients were 41-80 years old. Factors associated with the suboptimal control were male gender [odds ratio (OR) 2.6, 95% confidence interval (CI), 1.579-4.321], Asian ethnicity (OR 1.4, 95% CI, 0.683-3.008), history of peripheral arterial disease (PAD; OR 3.9, 95% CI, 1.017-14.543), history of congestive heart failure (CHF; OR 3.9, 95% CI, 1.017-14.543), elevated triglycerides (OR 1.004, 95% CI, 1.000-1.007), and elevated urine microalbumin level of 30 mg/24 h or above (OR 4.5, 95% CI, 2.446-8.380). Patients with suboptimal diabetes control had a 3.8 times greater odds (95% CI, 1.493-6.885) of receiving the insulin and oral hypoglycemic agent together.Conclusions:In adult patients with T2DM, male gender, Asian ethnicity, CHF, PAD, management with insulin along with oral hypoglycemic agents, hypertriglyceridemia, and microalbuminuria were associated with suboptimal control.

Correlation of serum lipid profile and glycemic control parameters in patients with type 2 diabetes mellitus

“…However, Roy et al in their study showed that the patients older than 40 years had poorer glycemic control, compared to older patients (16). Possible reasons for poor glycemic control of younger adult patients may be the fact that they are less motivated to manage their diabetic condition, as they may be busy with their job, and have less time to comply with a healthy lifestyle, medication, and clinic visits (17).…”

Factors that Correlate with Poor Glycemic Control in Type 2 Diabetes Mellitus Patients with Complications

“…A total of 657 patients were included in this study; the majority of the patients had poor glycemic control (78.2%), males were predominant in this study, and a significantly higher risk of poor glycemic control was associated with females ( p < 0.001). Roy et al [ 31 ] showed escribed sub-optimal control in males.…”

Factors in Gestational Diabetes Mellitus Predicting the Needs for Insulin Therapy

“…First, it has been reported that GDM mothers were more likely to be overweight/obese and of Asian ethnicity [ 8 ]. Second, in a recent study trying to determine the factors that were associated with suboptimal glucose control in type II diabetes, Asian ethnicity was found to be one of the contributing factors [ 9 ]. Third, in terms of GDM, it was also found that the prevalence of GDM was also the highest in Asian ethnicity, and although it was very difficult to compare the proportion of GDM patients that need insulin therapy across from different regions, limited data did support that there were great variations among different ethnicities; for example, women with GDM from southeast Asia had the lowest prevalence of insulin therapy (37.2%), while Anglo-Europeans has the highest (56.7%) [ 10 , 11 ].…”