Poor glycemic control and associated factors in diabetic people attending a reference outpatient clinic in Mato Grosso, Brazil

Abstract

Objective. To identify the proportion of poor of glycemic control and associated factors among people with type 2 diabetes attending a regional reference outpatient clinic in Mato Grosso (Brazil).
 Methods. This is a cross-sectional quantitative study based on data from medical records of 338 people with type 2 diabetes who attend a state reference outpatient clinic in Mato Grosso (Brazil). Information on glycemic control, sociodemographic factors, lifestyle and clinical conditions was collected.
 Results. The prevalence of elevated glycated hemoglobin was 47.34%. In the Poisson multiple regression model analysis with robust variance, poor glycemic control was significantly associated (p<0.05) with the following factors: insulin use (Prevalence Ratio -PR = 2.03), fasting glucose ≤70 and ≥100 mg/dL (PR = 2.0), postprandial glucose ≥180 mg/dL (PR = 1.76), no physical activity (PR = 1.62), the interaction between age group ≤59 years and the time of disease diagnosis >10 years (PR = 1.58), and presence of arterial hypertension (PR = 0.79).
 Conclusion. Most users of the reference outpatient clinic with type 2 diabetes had poor glycemic control associated with risk factors that alter glycated hemoglobin and negatively affect the achievement of established glycemic levels.

Glycemic Control for Type 2 Diabetes Mellitus Patients: A Systematic Review

“…This systematic review included 12 articles that met the eligible criteria (Table 1) [16][17][18][19][20][21][22][23][24][25][26][27]. The included articles were published either in 2021 [16][17][18][19][20][21][22] or in 2020 [23][24][25][26][27]. No articles were published in 2022.…”

“…There were 10 cross-sectional studies [16,[18][19][20][21][22][23][24][25]27], whereas the remaining two studies were either retrospective observational [17] or retrospective [26]. Among the cross-sectional studies, there were seven studies that reported a cross-sectional design only [18][19][20][22][23]25,27], whereas the remaining three studies reported that the studies were prospective cross-sectional [16], descriptive-analytical cross-sectional [21], and descriptive cross-sectional [24]. The overall prevalence of poor glycemic control was 45.2%…”

“…The risk of poor GC was increased two-fold among patients on oral anti-diabetic drugs + insulin compared to oral anti-diabetic drug alone, and patients who didn't understand the instructions of pharmacists as well as patients who had poor practice. The included 12 articles were from nine different countries: two studies from Ethiopia [16,22], two studies from Saudi Arabia [18,26], one study from Iraq [17], two studies from Indonesia [19,25], one study from Brazil [20], one study from Burkina Faso [21], one study from Morocco [23], one study from Eretria [24], and one study from Egypt [27]. There were five studies reported from Arabian countries [17][18]23,[26][27].…”

“…Glycemic control was determined majorly based on HbA1C as reported in 10 studies [17][18][19][20][21][23][24][25][26][27], whereas only two studies considered glycemic control based on fasting blood glucose (FBG) [16,22]. Two studies considered poor glycemic control at HbA1C ˃7% [19,21], whereas one study considered poor glycemic control at HbA1C=7% [26], and others considered it at HbA1C≥7% [17][18]20,[23][24][25]27]. Regarding the level of FBG, one study considered good glycemic control with FBG at 70-130 mg/dL and poor glycemic control with FBG of less than 70 and more than 130 mg/dL [16].…”

“…The American Diabetic Association (ADA) reports glycosylated hemoglobin (HbA1c) as the best tool for measuring glycemic control to prevent complications and reduce its cost for management [29]. In our analysis, we found that a large majority (n=10) of studies used HbA1c as an assessment for glycemic control [17][18][19][20][21][23][24][25][26][27], whereas only two studies determined glycemic control based on fasting blood glucose [16,22]. However, the 10 studies that used HbA1c for the determination of glycemic control used different cutoffs; two studies considered poor glycemic control at HbA1c more than 7% [19,21], whereas seven studies considered it poor at HbA1c≥7% [17][18]20,[23][24][25]27] and one study considered it poor at HbA1c=7% [26].…”