Organisational and individual characteristics associated with glycaemic control among patients with type 2 diabetes: cross-sectional study in China

Abstract

ObjectiveThere is a high prevalence of poor glycaemic control among patients with type 2 diabetes (T2DM) in China. This study aimed to explore both organisational and individual characteristics associated with glycaemic control among patients with T2DM.DesignCross-sectional survey.SettingShandong Province, China.ParticipantsThe participants were 2166 patients with T2DM and 337 healthcare providers from 36 urban communities and 36 rural villages in Shandong Province.Primary and secondary outcome measuresMultistage stratified sampling procedures were used to measure demand-side individual demographic, clinical and self-management characteristics, and supply-side organisational characteristics, and the status of glycaemic control. Multilevel logistic regression analysis was performed to assess key determinants of glycaemic control.ResultsOnly 42.8% of the patients with T2DM achieved good glycaemic control. Age, income, hypertension and self-efficacy were significantly positive predictors of optimal glycaemic control, while duration of diabetes, antidiabetic drugs and monitoring of blood glucose were significantly negative predictors of that. Private VCs (OR=0.48, 95% CI 0.29 to 0.82, p<0.01) and lack of healthcare providers (OR=0.69, 95% CI 0.53 to 0.89, p<0.01; OR=0.71, 95% CI 0.52 to 0.98, p<0.05) were significantly negative predictors of optimal glycaemic control, while diabetes knowledge level of healthcare providers (OR=1.36, 95% CI 1.02 to 1.83, p<0.05; OR=1.45, 95% CI 1.00 to 2.10, p<0.05) and kinds of antidiabetic drugs (OR=1.37, 95% CI 0.97 to 1.93, p<0.1; OR=1.46, 95% CI 1.07 to 2.00, p<0.05) were significantly positive predictors of that.ConclusionsGlycaemic control was suboptimal among patients with T2DM in China. The determinants of failing to achieve good glycaemic control included both organisational and individual characteristics. Potential interventions that target patients, providers and the healthcare organisations should be taken to improve the glycaemic control and health outcome among patients with T2DM.

Prevalence, awareness and control of type 2 diabetes mellitus and risk factors in Chinese elderly population

“…The data were checked carefully by professionals to verify accuracy and completeness [ 20 ]. Awareness was defined as the proportion of individuals who reported a history of physician-diagnosed diabetes [ 15 ]. Control was defined as the proportion of patients with diabetes with FPG < 7.0 mmol/L, which indicated that self-reported history of diagnosed diabetes patients with FPG < 7.0 mmol/L at this physical examination were considered to have glucose control.…”

“…Poor diabetes control rates impose a significant financial burden on individuals, families, healthcare systems, and countries. A study suggested that approximately $110 billion (12% of total health expenditure) was spent on the treatment and management of patients with diabetes in China in 2015 [ 15 ]. Thus, it is imperative to identify factors that affect blood glucose control to prevent and delay diabetes.…”

Association of CYP19A1 and CYP1A2 genetic polymorphisms with type 2 diabetes mellitus risk in the Chinese Han population

“…T2DM is a complicated and multi-factorial disease, and is a serious threat to global public health. It was reported that in China there are over 100 million patients with diabetes and the prevalence rate is still on the rise [22]. Therefore, this population-based case-control study was set up, and firstly demonstrated the effects of CYP19A1 and CYP1A2 gene polymorphisms on the T2DM susceptibility.…”

“…Previous studies also demonstrated that the enzyme activity of CYP1A2 and the speed of caffeine metabolism are increased in the T2DM group because of a higher caffeine intake [21]. The gene expression of CYP1A2 was also found to decrease in mice fed a high-fat diet [22]. In all above mentioned studies, researches have examined the functional activity of CYP1A2 in T2DM, but none of them focused on the genetic association.…”

Association between Dietary Inflammatory Index and Type 2 diabetes mellitus in Xinjiang Uyghur autonomous region, China

“…Current projections estimate that between 2017 and 2045 the number of people suffering from diabetes will increase more than 50%, with the vast majority diagnosed with T2DM (Cho et al, 2018). In 2017, the prevalence of diabetes in China was 11.2% (Wang et al, 2020).…”