Patient-Related Determinants of Glycaemic Control in People with Type 2 Diabetes in the Gulf Cooperation Council Countries: A Systematic Review

Abstract

The aim of this systematic review is to assess patient-related factors affecting glycaemic control among people with type 2 diabetes in the Arabian Gulf Council countries. MEDLINE, Embase, PsycINFO, CINAHL, and Cochrane CENTRAL databases were searched from their date of inception to May 2016. Two researchers independently identified eligible studies and assessed the risk of bias. A total of 13 studies met the inclusion criteria. One study was population based, six recruited participants from multiple centres, and the remaining were single centred. The majority of the studies were of low to moderate quality. Factors associated with poor glycaemic control include longer duration of diabetes, low level of education, poor compliance to diet and medication, poor attitude towards the disease, poor self-management behaviour, anxiety, depression, renal impairment, hypertension, and dyslipidaemia. Healthcare providers should be aware of these factors and provide appropriate education and care especially for those who have poor glycaemic control. Innovative educational programs should be implemented in the healthcare systems to improve patient compliance and practices. A variation in the results of the included studies was observed, and some potentially important risk factors such as dietary habits, physical activity, family support, and cognitive function were not adequately addressed. Further research is needed in this area.

Glycaemic control for people with type 2 diabetes in Saudi Arabia – an urgent need for a review of management plan

“…Our findings support the previous study that showed an association between inadequate glycaemic control and low income as well as low adherence to medications [ 18 , 52 , 62 ]. Low income decreases the likelihood of adherence to lifestyle modifications and treatment regimen [ 62 ], and low adherence to management plan is a known risk factors for poor glycaemic control [ 18 , 52 ].…”

“…Similar to studies conducted in the Arabian Gulf [ 49 , 50 ] and other countries [ 18 , 51 ] we found that younger age groups (≤60 years) were at higher risk of inadequate glycaemic control. Younger people are more likely to be affected by the change in lifestyle and less likely to be adherent to a management plan because of active occupational and social life [ 52 ]. Old people, in contrast, are less likely to be affected by the change in lifestyle and more likely to adhere to a management plan because they might be more concerned about their health, especially when they start to have comorbidities and complications [ 49 ].…”

Effects of FamilyDoctor Concept and Doctor-Patient Interaction Satisfaction on Glycaemic Control among Type 2 Diabetes Mellitus Patients in the Northeast Region of Peninsular Malaysia

“…There were several known significant factors associated with glycaemic control, as repetitively described in other studies. The factors include age, sex, race, duration of diabetes, educational level and employment status [12][13][14][15]28]. In this study, factors including age, sex, race and duration of diabetes were found significantly associated with glycaemic control, thus were controlled in the analysis.…”

“…A study by Nduati et al found that female diabetic patients had three times higher odds for poor glycaemic control as compared to male diabetic patients [15]. Meanwhile, the duration of diabetes affects the function of β cells of the pancreas and the likelihood to comply with diabetic management [28].…”

A statistical model to identify determinants of glycemic control in patients with type 2 diabetes with different pharmacotherapeutic profiles

“…In some cases, after a patient's clinical and nonclinical characteristics are analyzed, glycemic control may be considered to be acceptable even with a glycated hemoglobin (HbA1c) value above that generally recommended [10]. To achieve successful glycemic control, it is important to be aware of the related determinants [11].…”